Archived: Talbot Street

Updated 26 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by an inspector.

Service and service type

Talbot Street is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be available at the service to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

During the inspection we spoke with the registered manager and two support workers. As this was an inspection to check whether the service had sustained its good rating, we looked at a smaller number of records than usually. This included two people's care files, medicine administration processes, and other records relevant to the quality monitoring of the service.

We observed interactions between people and staff. We undertook general observations of the home over the course of the inspection, including the general environment, décor and furnishings and bedrooms of the people who lived at Talbot Street.

After the inspection

We spoke with two social care professionals who knew the service.

Updated 26 October 2019

About the service

Talbot Street is a residential care home. This service supports people with autism; The service is registered to care for three people; there were three people living at the service at the time of the inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

We saw many examples where staff had supported people to become more independent, make choices and increase their physical and emotional wellbeing. With staff support and by increasing their understanding, personalised daily routines were established, reflecting people's preferences and healthy eating was promoted.

People’s experience of using this service and what we found

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Talbot Street is located in an area that enabled people using the service to participate in their own local community. People were active each day to local places of interest and shops and enjoyed activities at a day service. Social activities also took place at home, with regular trips to local restaurants and pubs.

The service was highly effective at promoting people's independence. People had made significant achievements. This included personal care and daily activities such as laundry, cleaning their home, shopping, preparing snacks and drinks.

Staff had developed effective communication with people. This meant that they were able to make their own decisions about their support; staff ensured they were supported to make choices on a day to day basis. Pictures depicting activities, places, people and meals were used, together with picture boards to demonstrate people’s activity plans.

Risks that people faced had been assessed and those identified were safely managed. Medicines were managed safely. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm.

People were encouraged and supported to eat and drink well. People were given a choice of suitable meals and snacks. Staff supported people to make meals of their choice throughout the week. People were supported to access healthcare when needed.

People were offered choice and control and where able consented to their care and support. Staff supported people to be as independent as possible with activities of daily living, such as personal care, shopping, cooking and laundry.

Staffing levels were appropriately managed, and people received care from consistent, regular staff. Enough staff were employed each day to meet people's needs, keep them safe and give them the opportunity to take part in their chosen activity.

Staff received a range of training appropriate to their role and people's needs, and were supported by the registered manager through regular supervision.

Effective systems were in place to check the quality and safety of the service. The environment was clean and safe and in a good state of repair and decoration.

The leadership of the service promoted a positive culture that was person-centred and inclusive. The registered manager and the staff team showed a desire to improve on the service provided and in turn the quality of life experiences for the people at Talbot Street.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 9/05/2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.