Caradon

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People received safe care and support from staff who understood their needs and followed healthcare guidance from professionals. Staff knew how to safely support people around their individual risks and how to protect people from abuse and neglect. Staff supported people to safely take risks which enabled them to have a greater level of independence. Staff received appropriate training and were recruited safely. The provider ensured there were enough well-trained staff to provide individualised support to people in a timely and safe way. A serious incident had been recorded and staff and people using the service were adequately supported and lessons learnt. Incident management and communication were effective which meant staff felt involved and knowledgeable about what was going on. People had been assessed and supported to move in, for some this was a gradual process for others not so much depending on their circumstances.The manager recorded safeguarding concerns and reported them as appropriate to CQC and the local authority and would assist in the investigation when asked to. We did not identify any safeguarding concerns as part of this inspection. There was information around the service advising people how to raise concerns.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Risk assessments were in place for activities and kept under review. People were supported to access appropriate services to ensure their health needs were met. Staff meetings and daily handovers were used to feedback information and risks were escalated. Key worker meetings helped ensure adequate oversight of peoples needs and risks and incidents were recorded and discussed. People's support plans were dynamic and updated in line with learning. Families were involved as the service sought to know more about the people supported.

There was a clear leadership structure and learning from events and incidents. The manager was open and transparent. There was an action plan in place and the home had been working with the quality assurance officer to make improvements as required. A serious incident had been recorded and staff and people using the service were adequately supported and lessons learnt. The manager was open and transparent in his dealing with us, and the service was subject to external audits. Staff told us their induction and training helped them deliver the care and support people needed.

Incident management and communication were effective which meant staff felt involved and knowledgeable about what was going on. There were clear lines of responsibility and accountability, and good recording of peoples needs. The service had a robust electronic system of recording and transmitting incidents and issues.

We observed people who appeared settled in their own home and with the staff supporting them. The house was suitably laid out and was modern and comfortable. Staff said they had identified some teething problems and had to adapt peoples care and support as they went. One person's room had been adapted with assistive technology to assist in seizure management.

Staff said they had identified some teething problems and had to adapt peoples care and support as they went. Staff told us parents had been very much involved and they had collated as much information as they could. The manager told us that they were still getting to know the people, and engaged with the relevant health professionals to ensure better outcomes for people.

The provider had successfully managed the transition of six people with complex needs into Caradon, and they were all thriving. One healthcare professional we spoke to, told us that "I worked with the staff to transition a young gentleman from his family home into Caradon. I found the team to be very responsive, well organised and communicated well between myself, the day service he attended and with his family to co-ordinate a smooth transition".

Assessment processes and care plans were robust, and people’s days were planned out. There was an overview of people’s health and when they had health appointments and when they were due.

People were safeguarded as far as reasonably possible because they were supported by staff who had been safely recruited and trained to identify and act on any signs of abuse or neglect. People had support from outside professionals and families who could act in their best interest if required. Staff were trained to deescalate situations should they arise, and the environment lent itself to people’s needs.

Staff we spoke to confirmed they understood what was meant by safeguarding and confirmed they had received a robust induction and training in this area. Both said they would escalate concerns as appropriate and felt the management team were responsive to concerns and very approachable. Staff said that they would report any incident of concern and also completed incidents records, body maps, and were able to give clear examples. The manager recorded safeguarding concerns and reported them as appropriate to CQC and the local authority and would assist in the investigation when asked to.

We did not identify any safeguarding concerns as part of this inspection. There was information around the service advising people how to raise concerns.

Safeguarding concerns were reported as appropriate, and this was logged. Staff confirmed that they completed incident forms, body maps and incidents where appropriate were safeguarded and handed over.

Risk assessments were completed as appropriate, Staff supported people to ensure risks were managed such as supporting them in the kitchen and with personal care. People had the support they needed and staff supervision across the day and evening. Sensor alarms were in place for those with epilepsy.

Staff told us they received training in positive behaviour support and were mindful of people’s negative behaviours and how to keep them and others safe. Staff were aware of risks associated with peoples care and support. Staff told us clearly about the fire safety procedures. Staff said they had regular drills and people responded appropriately. When we arrived, we were asked to sign in and advised there was no planned fire drill.

During our visit we did not observe any obvious risks. Everything was well laid out with no clutter. Fire doors were in place and closed and key fobs were used to ensure doors that needed to be locked were such as the laundry room. Food was stored at appropriate temperatures, stored correctly, and labelled when opened.

The was a health and safety poster telling staff who to refer to. Team leaders carried out health and safety duties and were the designated fire officer. Staff received health and safety training and we saw clear health and safety audits. The inspector advised staff that shower temperature should be taken and not to rely on thermostatically controlled valves which were not always fail safe. On our second visit, we saw evidence that this advice had been acted upon and staff were recording daily.

One person was happy to show us their room and it was spacious and personalised. Another found the transition of moving into Caradon difficult and had damaged their room. Staff had ensured their safety and were looking to create a safe space with reinforced walls which were spongy so reduced the risk of injury on impact. There were seizure monitors in place for people with epilepsy, and the staffing levels were in line with people's assessment.

The manager was supported by administrators and maintenance and were able to provide evidence that the home, the equipment, and furniture was all subject to regular checks to ensure its safety. We noted that the television was encased to prevent injury in case. Thermostatically controlled valves had been fitted and there were safe processes should an emergency occur.

The home was clean and in a good state of repair. Staffing levels were appropriate and not intrusive. People had both privacy and support. There is a large, secure and well maintained garden, and we saw people being supported to take part in gardening and taking care of chickens in an enclosure

Servicing records were viewed included fire safety, legionnaires, water safety, environmental health reports, asbestos, and these were in order, where remedial actions were identified these were addressed. Staff had received the right training to meet people's needs. The home had input from the organisation's Compliance Manager and property management director, meaning issues were quickly escalated and resolved.

People had agreed hours of support and there were enough staff at all times to meet people’s individual needs. People were supported by male and female staff and their preferences were taken into consideration. A staff photo board helped people see who would be supporting them. Most staff worked long days which gave more flexibility around activities and trips out. Following a safeguarding incident, a person's staffing had been amended to all male staff, and this, together with input from other health professionals, had led to a significant turn around for the person, meaning they could continue to live at Caradon.

Staff told us they were on a two-week rotating rota so knew hat shifts they were working. Staff also said the manager was understanding on their needs and built in some flexibility to help staff work more effectively. They said the shift pattern worked well and they were well supported. The manager said recruitment had been gradual and they had enough staff to cover shifts, agency staff were kept to a minimum and if absolutely necessary they would stick to the same agency. Some staff from the bank or agency went on to be permanent members of staff. Staff Well-being was seen to be a priority for the Management team, and the home had a well being wall for staff with lots of information and activities the staff did as a team. The manager and deputy had administrative support and their hours were not on the rota which freed up their time to provide effective support to staff.

Our observations were there was a diverse group of staff who all brought something different to the role. Staff worked well as a team and the service was well organised around the needs and interests of people using the service. Staff were keen to speak to us and were proud of their job, and the support they were able to offer people.

Assessments determined people’s level of need and rotas were designed to show who was working and allocations were completed in advance to support day services and activities. The Provider had used the health and care visa scheme to recruit some staff from overseas. Staff told us that they had been supported to settle within their local community, which has meant they could focus on supporting people effectively. The home embraced the cultural diversity within the staff team.

People looked smart and wore clothes of their choice. The home was clean, organised and well decorated. I person's bedroom we looked at was personalised and they were supported by staff to keep their home clean.

Staff told us they were all responsible for cleaning within the service and some was completed at night, and some was allocated to the member of staff not assigned to a specific person during the day. Staff confirmed they had completed infection control training.

The service was clean throughout with no obvious signs of wear and tear. The kitchen was well organised, and food was stored correctly in the fridge and labelled. Colour coding was used to distinguish between different chopping boards. There were no odours or clutter.

People were encouraged and supported to wash their hands before meal preparation. We observed staff wearing the correct PPE prior to meal preparation. The service had received 5 stars from the Food Standards Agency.

People were not able to tell us about their experiences around medicines but all, but one person had regular medicines. Staff told us everyone took their medicines as prescribed, and this was kept under regular review. People were supported by staff who knew them well and medicines practices observed were person centred. Medicines were kept safely in people’s rooms and administered at appropriate times in line with people’s routines.

Team leaders were trained to administer medicines and staff confirmed there was a medicine trained member of staff on each shift including night staff as people might require occasional medicines such as pain relief. The team leader stated staff all complete medicines training but staff administering medicines complete training and have an assessment of their competencies. Staff training to administer medicines were in place and staff signed of as competent before they were permitted to administer medicines. Due to large numbers of staff, it was agreed only senior staff should administer medicines to reduce risks of errors, but staff told us they were trained and able to use an epi pen when required for one person with severe allergies.

Medicine records were stored electronically and recorded on administration. Staff confirmed there were no regular prescribe as needed medicines (PRN) and no issues around refusal. We asked about medicines specific for people with a learning disability or autism. The manager shared with us the success story where anti-psychotic medication had been introduced to a person, this had been gradually reviewed and reduced to a minimal dose, and there was visible transformation in the person's quality of life. Medicines had already been administered when we arrived with the exception of one person, so we observed them receiving their medicines, medicines were secure, and the member of staff introduced us to the person and asked their permission for us to observe. Medicines were administered, observed as swallowed before signing and staff asked for consent before administering. Medicine protocols were in place. We also asked about nonverbal pain protocols for people. These were in place.