We carried out a review of the data available to us about Udal Garth on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Udal Garth, you can give feedback on this service.
Udal Garth is a residential care home providing personal care to up to 8 people. The service provides support to people with learning disabilities and/or autistic people. At the time of our inspection there were 8 people using the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support:
People made choices and took part in meaningful activities which were part of their planned care and support.
People who experienced periods of distress had plans in place which helped ensure staff understood how to support them safely.
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People’s care and support was provided in a safe, clean, well equipped, well-furnished and well-maintained environment which met their sensory and physical needs.
Staff worked in partnership with external organisations so people could access the health and social care they needed.
People were supported with their medicines in a way that was safe and met their preferences.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care:
Staff actively promoted equality and diversity when supporting people. They understood each person’s unique needs and preferences and tailored the support they provided around these. People enjoyed undertaking activities and interests they were interested in. They were given the opportunity by staff to actively engage in and try new activities.
People were protected from abuse and poor care. The service had enough appropriately skilled staff to meet their needs and keep them safe.
Risk assessments were in place relating to people’s health and care needs. Where appropriate, positive risk taking was encouraged and enabled. Staff supported changes that individuals might want to make and assessed risks continuously.
Right Culture:
People received good quality care, support and treatment from trained staff and specialists who were able to meet their needs and wishes. Staff knew and understood people well and were responsive to immediate requests for support as well as longer-term goals. People appeared comfortable and confident in the service and with the staff who supported them.
The registered manager was keen to enable people to live a meaningful life every day. This ethos was reflected in the staff team. Staff placed people’s wishes, needs and rights at the heart of the service.
People and those important to them, including advocates, were actively involved in planning their care.
The registered manager and staff regularly checked and evaluated all aspects of the service. This helped identify any areas for improvement.
The registered manager was supported by senior managers to maintain the quality of the service.
For more details, please see the full report which is on the CQC website at
Rating at last inspection The last rating for this service was good (published 16 May 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
Social stories had been created for some people who did not initially want the COVID-19 vaccination.
There was a clear system on entering the service, for staff, visitors and professionals to record COVID-19 test results, wash their hands and put on PPE, (personal protective equipment, such as masks and gloves).
Staff told us the team had offered each other emotional support through the pandemic and become closer as a result.
The registered manager had competed a mental health first aid course so they could better support people or staff whose mental health was affected by the pandemic.
Udal Garth accommodates up to eight people with learning disabilities and/or autism in one adapted building. The care service reflected the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
People were safe living at Udal Garth. They were supported by staff who received the right training to meet their needs, who had been recruited safely and who understood how to protect them from abuse. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were empowered to make choices about their lives including how they spent their days. Staff understood people’s communication methods and ensured people’s wishes were listened to and acted upon. Staff sought consent before providing care and ensured people’s privacy and dignity were respected. People chose what they ate and drank and were supported to maintain a healthy diet.
People were supported by staff who treated them with affection and compassion. People’s records detailed how they wanted to be supported, what their aims for the future were and how staff could help reduce any risks to them. People were supported to remain healthy and saw healthcare professionals when they needed or wanted to; they also received their medicines as prescribed.
People lived in a service that was well led. The registered manager and staff ensured they were up to date with best practice and used this knowledge, along with quality monitoring activities, to improve the service. Staff told us they felt supported and listened to and their wellbeing was considered. The provider also monitored the quality of the service and checked action was being taken where gaps had been identified
Udal Garth provides care and accommodation for up to eight people who have a learning disability and associated conditions such as autism. At the time of the inspection eight people were living at the service. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.
Udal Garth is part of The Priory group, an organisation providing services to elderly people as well as people with a learning disability. The service is a modern property located in Torpoint. The premises were well maintained, pleasant and roomy. People had large bedrooms which had been decorated and furnished in line with their personal preferences. All the bedrooms were en-suite. There were plenty of shared areas where people could spend time together or alone as they chose. This included three activity huts in the gardens which were used for cooking, arts and crafts and relaxing.
The atmosphere at Udal Garth was relaxed and calm. Interactions between staff and people were friendly and supportive. Staff were aware of how people liked to be supported and what was important to and for people. One person chose to spend much of their time in their room. Staff described to us how they worked to protect them from the risk of becoming socially isolated.
People were able to access the local community and amenities easily as the town centre was within walking distance. People took part in a range of activities including using a local gym, taking part in music sessions and playing pool. Session plans were developed to guide staff on how to support people well when undertaking specific activities. These included information on how to help ensure people did not become anxious or distressed. Relatives told us their family members had full and active lives.
Recruitment practices helped ensure staff working in the home were fit and appropriate to work in the care sector. New staff were required to undertake a thorough induction when they started their employment. This included familiarisation with the service, training and shadowing more experienced staff members. Staff had received training in how to recognise and report abuse, and all were confident any concerns would be taken seriously by the registered manager.
There were sufficient numbers of suitably qualified staff to support people according to their assessed needs. Half of the staff team had been employed at the service for over two years and understood people’s needs well. Staff told us they communicated well as a team and were well supported by a robust system of supervision, appraisal and staff meetings. All the relatives we spoke with were complimentary about the staff team describing them as; “amazing” and “lovely.”
The registered manager had a good understanding of the Mental Capacity Act and the correct procedures had been followed when people had been assessed as lacking capacity to make decisions. Staff supported people to make day to day decisions such as what to wear, when to go to bed and what to eat.
People were supported to visit external healthcare professionals when necessary. People’s health was monitored appropriately and regular health checks and medicine reviews took place.
Staff demonstrated a shared approach to supporting people which valued small successes. They were committed to encouraging people to widen their horizons and were not discouraged when planned activities or routines did not go well.
There were effective quality assurance systems in place to monitor the standards of the care provided. People’s opinions were sought out and recorded to help ensure they were taken into account when planning care.
We met with all the people who lived at Udal Garth, spoke with five members of staff including the registered manager and reviewed comments received from a recent relative's questionnaire.
We found the care and support of people living at Udal Garth was effectively co-ordinated and where necessary other professionals input was being considered and actively arranged. We saw people participating in activities and they appeared relaxed and content.
The staff we met told us, "It's lovely here." Staff spoke positively about the new change in management, they told us they felt more involved and were keen to improve the service. Staff said they felt supported, listened to and involved. We were told, "...it's amazing now, more enjoyable to work here." People told us they had more confidence now, that it was, "more open and free."
Staff had good induction programmes, programmes of essential training and specialist training such as managing epilepsy to ensure they had the skills they needed to care for people.
The registered manager had started to develop good systems for monitoring the quality of the service being provided and had high ambitions for ensuring clinical excellence.
At the time of our visit there were 8 people living in the home. We were able to meet all of the people using the service, however, due to their complex care needs and limited verbal communication it was difficult for people to tell us what they thought of the service and the care they received.
We used a number of different methods to gather information about people's views and experiences of the service.
We spent time observing people and the support being provided by staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experiences of people who could not talk to us. We saw some examples of staff interacting positively with people they were supporting. However, we also observed a number of occasions when staff did not interact with people and did not respond when people using the service were trying to communicate with staff or others around them. We spoke to the Registered Manager about our observations following our visit.
We examined the care files belonging to three people who lived in the home. We were also able to meet these people and observe them within the home and while they were being supported by staff.
We spent time talking to staff who were on duty as well as the deputy manager who was in charge of the home on the day of our visit.
Following the visit we spoke to two relatives and two professionals who had been involved in supporting people who had used the service.
Relatives we spoke to said that the staff were 'kind and caring' and were helpful when organising and supporting visits home to family.
We did note that a relative raised concerns about the high turnover of staff and the detrimental affects this may have on people who require a staff team who know them well and understand their needs. The relative we spoke to said that they were happy to raise their specific concerns with the manager and hoped that these would be listened to and addressed.
The manager informed us that there were changes being made to the management and running of the service. We were told that the service was in a period of transition and policies and procedures were being updated to reflect these changes. Staff and relatives we spoke to said that they were being kept well informed of the changes and that they trusted that the management would take into consideration the impact any changes may have on people currently using the service.
We saw some examples of people being involved in their care and making decisions about daily living, such as what they wanted to eat. We did raise concerns about locks on people's bathroom doors and the communal kitchen and that without formal processes being followed these restrictions may not respect and maintain people's rights, choices and independence.
We found that people engage in a range of activities inside and outside the home, and are supported to maintain contact with family and friends. Some of the staff we spoke to said that they felt some people may be restricted in the opportunities available to them due to the needs of others within the service. This issue was raised with the manager following the inspection.
The staff we spoke to were able to tell us about the different types of abuse and what they needed to do to keep people safe.