Forge House Services Limited

Forge House Services Limited is a detached 2 storey building in the market town of Cullompton. The home provides level access to the garden, lounge and dining room, with people's bedrooms on the ground and first floor.

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.

Significant improvements had been made since the last inspection. People were enabled to be involved in decision making as they were able, regarding their food choices. People were no longer subjected to restrictive practices regarding a healthy diet for all. Improvements had been made around people's mealtime experiences which were personalised to each person.

People had their own bedrooms and had access to shared facilities including a garden. People were protected from the risks associated with the spread of infection and were supported to take their medicines safely.

Improvements had been made to the environment with people involved in the decision making. Environmental risks we identified at the last inspection had been addressed and risks associated with fire evacuation had improved.

People were enabled to access specialist health and social care support where appropriate.

Risk assessments had been completed in a person-centred way for all identified risks to people.

People's care and support plans had been rewritten and were more personalised and gave staff clearer guidance to support people safely. Care plans and risk assessments were regularly reviewed and involved relatives and advocates as appropriate. Improvements were needed to ensure care records displayed people's names, the date they were written and who had written them.

The registered manager had a system to review and investigate accidents from re-occurring. This included looking for trends and identifying any learning to reduce the risk of an incident happening again.

Right Care: Improvements had been made since our last inspection. The registered manager had reported safeguarding concerns appropriately to CQC, and/or the local safeguarding authorities. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people's needs and keep them safe.

A lot of work had been undertaken to improve people's care and support plans to reflect people's individual needs and aspirations. People had care and support plans that were personalised, holistic and reflected their needs and aspirations. Relatives confirmed they were included in decision making about their relative's care.

Staff knew people's needs and were kind and caring. They supported people in a more person-centred way and promoted their dignity, privacy and human rights.

People were supported to eat and drink enough to maintain a balanced diet. Staff involved people in choosing their food and plan their meals. People were observed enjoying the food at the home.

Staff supported people to maintain their health and worked jointly with healthcare professionals to improve outcomes for people.

People were still able to participate in group activities if they chose but were also encouraged to pursue their own individual interests and spending time in their local community.

Right Culture: Improvements had been made to ensure staff placed people's wishes, needs and rights at the heart of everything they did. Improved information in care records and planning involving people about their preferences enabled staff to have a more consistent approach to support people.

As part of the local authority, Provider Quality Support Process (PQSP). The registered manager had regular input from health and social care professionals. They were responsive to feedback from all areas as they wanted to improve the service.

The registered manager was working with staff to ensure any risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

People received support from staff who knew them well. Staff told us the culture of the service had improved since our last inspection. One staff member said, "Things are much better, everyone is getting more choice and more independence."

The registered manager and management team took a genuine interest in what people, staff and other

professionals had to say. The management team worked directly with people and led by example.

Routines within the home were more personalised to individual people. The registered manager was aware of CQC's framework in relation to inspecting services for people with autism and learning disabilities and was working with staff to ensure support for people followed these principles.

The registered manager and staff team had worked with people to enable them and those important to them to work with staff to develop the service. Relatives and staff confirmed they would be able to raise concerns to enable improvements to be made to the service. Relatives were asked by the provider about their opinions of the service.

Staff were recruited safely and there were enough staff on duty to meet people's needs. People were protected from abuse and poor care. The provider supported staff with training and supervision and appraisals were scheduled. Staff had completed appropriate training to support and understand people's individual needs and provide enabling support to people. The registered manager had scheduled learning disability and autism training for April 2023. People at the service lived with learning disability and autism and this training would assist staff to have a better understanding and be able to support people safely.

The provider had more robust systems in place to monitor the quality of the service to people. There were improved audits being undertaken and actions taken when things went wrong. These actions were added to the provider's service improvement plan as required.