222 Bills Lane

Updated 25 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 13 December 2018 and was unannounced.

The inspection team consisted of one Inspector Manager.

Prior to the inspection visit we reviewed information that we held about the service such as statutory notifications. These are events that happen in the service that the provider is legally required to tell us about. We also considered the last inspection report and contacted Health Watch. This is an independent Organisation who champion for people who use health and social care services. They did not have any information to share with us.

During the inspection, we spoke with both of the people who used the service for their views about the service they received. We spoke with the registered manager, the deputy manager and a support worker. We spoke with a person’s relative by telephone.

We looked at the care records of both people who used the service, the management of medicines, as well as a range of records relating to the running of the service. This included meeting minutes, audits and checks and the management of health and safety risks.

Updated 25 December 2018

This inspection took place on 13 December 2018 and was unannounced.

222 Bills Lane 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 accommodates a maximum of four people who have learning disabilities. At the time of the inspection two people were using the service.

At our last inspection in February 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The care service has been developed and designed in line with 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.

A registered manager was 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 and associated Regulations about how the service is run.

People continued to receive a safe service where they were protected from avoidable harm, discrimination and abuse. Risks associated with people’s health care needs had been assessed and planned for. These were monitored for any changes. Risks associated with the living environment had mostly been assessed. People did not have any undue restrictions placed upon them. There were sufficient staff to meet people’s needs in a flexible way and safe staff recruitment procedures were in place. People received their prescribed medicines safely and these were managed in line with best practice guidance. Accidents and incidents were analysed for lessons learnt and these were shared with the staff team to reduce further reoccurrence.

People continued to receive an effective service. Staff received the training and support they required including specialist training to meet people’s individual needs. People were supported with their nutritional needs and healthy diets were promoted. Staff worked well with external health and social care professionals, people were supported to access health services when required. 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. The principles of the Mental Capacity Act (MCA) were followed.

People continued to receive care from staff who were kind, compassionate and treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported and their families. They understood people’s needs, preferences, and what was important to them. Staff knew how to comfort people when they were anxious and made sure emotional support was provided. People’s independence was promoted and people were supported to achieve their goals.

People continued to receive a responsive service. People’s needs were assessed and planned for with the full involvement of the person and professionals involved in their care. Care plans were user friendly and up to date. People had opportunities to lead their lives in the ways they chose, pursue their interests and maintain relationships with those important to them. There was a complaint procedure and action was taken to learn and improve where this was possible. End of life care was provided in a sensitive and person-centred way.

People continued to receive a service that was well-led. The monitoring of service provision was effective and there was an open, transparent and person-centred culture with good leadership. People, external stakeholders and staff were asked to share their feedback about the service and action was taken in response.

Further information is in the detailed findings below