Cavendish

Updated 8 July 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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

The service had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The first day of our inspection was unannounced. The second inspection date was announced to enable us to return to the service at a time when people were available and happy to speak with us.

What we did before inspection

We reviewed all information we held about the service. This included information received from our partner agencies and looking at the statutory notifications that had been submitted. Notifications are changes, events and incidents that the service must inform us about.

We sought feedback from Healthwatch, commissioners and two health professionals with regular involvement with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually 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

We communicated with five people who used the service and spoke with five relatives about their experience of the care provided. Where people were unable to talk with us, we used different ways of communicating to understand their experience of the service. This included using Makaton and pictures and spending time engaging with their activities to enable meaningful observations of their body language and engagement with staff. One person chose to write about the activities they took part in and why they were important to them.

We spoke with seven members of staff including the registered manager.

We reviewed a range of records. This included four people’s care records and three medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also read.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 8 July 2022

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

About the service

Cavendish is a care home for up to six people living with learning disabilities and/or autism. The service was fully occupied at the time of our inspection.

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

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.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: People lived in a homely environment and their quality of life had improved since being supported by Cavendish. Relatives described how people were “Living their best lives” and continuously encouraged to learn new skills and do things that were meaningful and excited them.

There were always enough staff on duty. Staffing levels were set with funding authorities according to people’s needs. Staff worked flexibly to enable people to follow their interests and hobbies. Recruitment processes involved people and ensured that they were always supported by suitable staff.

People experienced choice and control over their lives and staff encouraged them to achieve their own levels of maximum independence. People’s diverse communication methods were understood, and staff were proactive in the way they actively involved people in all decisions about their support.

People were proactively supported to maintain good health and experienced improved health outcomes as a result. The team had excellent working relationships with other professionals to ensure that people received the very best holistic care.

Right care: People were placed at the very heart of the service and were supported by a team of committed, kind and caring staff. Person-centred care was automatic, and staff were passionate about supporting people in a way that not only met their needs but also enabled them to lead happy, confident and fulfilling lives. Staff supported people with skill and expertise to ensure they could enjoy maximum freedom whilst remaining safe. People’s privacy and dignity were upheld as a matter of routine.

Staff had an excellent understanding about how to safeguard people. There were robust systems in place to manage allegations of abuse and staff were confident about their responsibilities in keeping people safe from harm. Risks to the health, safety and well-being of people were addressed in a personalised and enabling way that promoted their independence.

Right culture: The atmosphere in the service was relaxed and friendly with lots of fun and laughter being shared. Positive relationships between people and staff had been developed that were based on trust and respect. Managers had created a culture where diversity was celebrated and equality the norm. People were respected as partners in their own care and empowered to lead happy and independent lives that were free from unnecessary restrictions. People and relatives were confident to raise concerns or suggest changes for the service as well as to the way they received support.

Staff enjoyed working at the service and were trained and supported to be the best that they could be. The registered manager was an excellent role model and there were sound systems in place to develop staff and promote reflective practice. Staff were proud to work at Cavendish and this in turn led to the delivery of high-quality support.

Quality assurance processes were robust and action plans to improve the service were prioritised and completed quickly. Learning was shared from within and outside the organisation and community contacts were well established.

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 the service under the previous provider was good (published 6 December 2016. The provider changed in May 2019 and the service has not been inspected to provide a rating under the new provider.

Why we inspected

This was a planned inspection to provide a rating for the service following its re-registration.

We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.

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.