Archived: The Risings

Updated 3 March 2020

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.

Inspection team

This inspection was carried out by one inspector.

Service and service type

The Risings 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 that 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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. including the previous inspection reports and notifications received by the CQC. A notification is information about important events which the service is required to tell us about by law. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection-

People who lived at The Risings had communication difficulties due to their learning disability and associated conditions, such as autism. We spoke with two people who used the service. Verbal communication for some people was very limited and they were not able to understand and provide information and feedback about their care and experiences at the service. We therefore spent time with people as they went about their daily routines and observed the care and support being provided.

We spoke with one relative about their experience of the care provided. We spoke with six members of staff including the registered manager, deputy manager and care workers.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at six 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 reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training records and staff rotas. We spoke with one professional who regularly visited the service

Updated 3 March 2020

About the service

The Risings is a five-bedroom detached house on the outskirts of Exeter. The service provides accommodation and support for up to five younger adults with a range of complex learning and behavioural difficulties. At the time of the inspection there were five people living there.

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

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 applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were very relaxed and interacted confidently with staff. Those who were able told us staff were kind and they felt safe. This was confirmed by relatives we spoke to.

People were supported to engage in a wide range of activities both within the home and the local community, which maximised their quality of life.

Staff promoted people’s privacy and dignity, enabling them to make choices and have as much control and independence as possible. Staff ensured people were supported with their communication, which meant they had a voice.

An open, transparent and positive culture helped people and staff feel valued and supported. There was a comprehensive quality assurance programme. Clear processes were in place to ensure effective monitoring and accountability.

We observed people were supported by sufficient numbers of suitably trained and competent staff.

There had been a lot of changes in the staff team, however this was now stabilising as recruitment and retention were improving.

Staff were recruited safely, and safeguarding processes were in place to help protect people from abuse. Risks associated with people's care had been assessed and guidance was in place for staff to follow. Care plans were detailed, person centred and reviewed regularly with people and their relatives where appropriate. The format had been revised, and they were now more person centred and easier to read. There were systems in place to ensure information about any changes in people’s needs was shared promptly across the staff team.

People received their medicines safely, and in the way prescribed for them. The provider had good systems to manage safeguarding concerns, accidents, infection control and environmental safety.

Staff worked effectively with external health and social care professionals to meet people’s healthcare and nutritional needs.

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 12 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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

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.