Our House

About the service

Our House is a residential care home providing accommodation and personal care to five people with learning disabilities at the time of the inspection. The service can support up to 5 people.

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

Right Support:

People were not always supported to have maximum choice and control of their lives and staff were not always supporting people in the least restrictive way possible. The service could not always demonstrate they were acting in people's best interests.

People were not always protected from the risk of harm as staff did not always receive appropriate training to support people in safe, consistent and effective ways.

Right Care:

People were supported by staff who knew them well and who had been safely recruited. People had access to a range of professionals to support them with their needs. However, the care planning was not always up-to-date and reporting requirements were not always being followed.

Right Culture:

The staff was trying to develop an open and empowering culture. People and their relatives knew how to make a complaint and felt confident they would be listened to. However, we found more work was needed to ensure the service was operating in accordance with the regulations and best practice guidance.

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 2 March 2020).

At our last inspection we recommended the provider took steps to support staff in providing their duties more effectively. At this inspection we found the provider had made some improvements, but further improvements were needed.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted in part due to concerns received about safeguarding processes. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements.

We found that safeguarding reporting and recording processes were not always being followed. The support provided was not always following best practice guidance. Monitoring and auditing systems were in place but were not always sufficient.

You can see what action we have asked the provider to take at the end of this full report.

The provider has taken some effective action to mitigate the risks, but further improvement is required.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Please see the safe, effective, caring, responsive and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Our House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the consistent provision of person-centred care, adequate staffing, and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Since the last inspection we recognised that the provider had failed to send statutory notifications to CQC. This was a breach of regulation. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Our House is a small residential care home providing personal and nursing care to five people with learning disabilities aged 18 to 65. At the time of the inspection four people were using the service.

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.

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

There were enough staff to meet people's needs. The staff were checked to ensure that they were safe and had had appropriate knowledge and experience to provide care that people needed. However, the staff were not supported by management through supervision and one-to-one meeting. Improvements were needed in this area. We made a recommendation in this area.

The manager drew lessons from incidents, accidents, complaints and audits to make further improvements to the service. Systems were in place for relatives to give feedback about the service.

People had risk assessments which identified possible risks to them and provided guidance for staff on how to manage the risks. Staff knew what safeguarding meant to record and report any incidents of abuse. Health and safety systems were in place to ensure that the facilities and premises were safe. Infection control systems were in place to ensure the risk of cross infections was managed. Medicines were administered by staff and the manager continued to train and assess their competency to ensure they systems were effective.

People's needs were assessed before they started using the service. This ensured that people were admitted only if the service was suitable to their needs. Care plans were person-centred, which meant that they reflected people’s needs, interests, preferences, choices and how they wanted staff to support them. People were supported to have maximum choice and control in their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People and relatives told us staff ensured people's privacy and treated them with respect and dignity. Staff knew how to communicate with people using different means of communication. This ensured people's needs were identified and responded to effectively.

Staff supported people to have meals of their choice. Staff also understood and met people's needs in terms equality and diversity.

People had access to healthcare. People also enjoyed activities and kept in touch with friends and relatives.

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

Rating at last inspection

At the last inspection the service was rated Good (report published on 6 September 2017).

Why we inspected:

This was a planned inspection based on the registration date of the service. You can see what action we have asked the provider to take at the end of this full report.

Follow up:

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on 10 August 2017 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Our House on our website at www.cqc.org.uk.

Our House provides accommodation and support with personal care for five people with a learning disability. At the time of the inspection there were five people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are “registered persons”. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our focused inspection on 10 August 2017, we found that the provider had followed their plan which they had told us would be completed by 9 August 2017 and legal requirements had been met.

During this inspection we found the provider had made improvements. We found the registered manager liaised with the GP and had improved the management, administration and auditing of all medicines. The registered manager had also sent notifications and essential information to the local authorities and CQC as required. The registered manager, who was not present at the last inspection, was back at work and we noted that the service was well managed. The registered manager was supported by two senior care workers and an assistant director of operations, who regularly came to the service to undertake auditing of various aspects of the service.

Our House provides accommodation and support with personal care for five people with a learning disability. At the time of the inspection there were five people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are “registered persons”. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People lived in spacious, clean and tidy premises. Staff understood their responsibilities to identify and report incidence of abuse. There were enough staff available to provide care and support people needed. People were confident that staff reviewed and followed their risk assessments in order to manage potential risks to their health and safety.

Staff recruitment processes were robust to ensure that new staff had been properly checked to ensure they were fit to work with people who used the service. Staff also had opportunities to develop their skills through the support, supervision and training they received at the service.

People were encouraged and supported to make their own decisions about their food, care and activities. Staff had received training on Mental Capacity Act 2005 and Deprivation of Liberty Safeguards for them. We found that the management of ‘medicines when required’ were not always effective. We made a recommendation about this and asked the provider how they intended to make improvement.

The care provided at the service was good. Staff were friendly, kind and caring. All people at the service looked clean and happy. Records showed people had regular medical checks. They also had a variety of activities within the service and in the community.

Although there were good systems and practices such as surveys and meetings to obtain people, relatives and staff views about the quality of care provided at the service, the management was not always effective.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.

We found that people were treated with respect and their health needs were met. A healthcare professional told us 'the staff are excellent. They pick things up and contact the GP when needed. They don't force anything on people but work in partnership with them.' A relative said 'they are absolutely on the ball and are very quick at noticing if someone is not well.' There were systems in place to ensure that people received their prescribed medication safely and appropriately.

People were given meals that they liked and that met their nutritional and health needs. A relative told us 'she enjoys her food and eats well. They are always asked what they want and their individual choices are catered for as far as possible." Another said 'they make sure she gets the nourishment she needs.'

People were protected from the risks of unsafe or inappropriate care because accurate and appropriate records were maintained.