Cathedral View

Systems were in place to ensure accidents and incidents were reported, recorded, investigated and any areas of learning or improvement were identified and shared with staff. Outcomes were monitored and staff confirmed they were able to discuss all accidents and incidents to learn and improve future practice.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions they had choice, control and freedom over their lives. The provider had systems to record DoLS applications and associated conditions. Staff and leaders told people about their rights around consent and respected these when delivering person-centred care and treatment.

Where people lacked capacity to make specific decisions, staff followed the principles of the Mental Capacity Act 2005 (MCA). This ensured that care was delivered lawfully and in line with people’s wishes. Staff had received training on consent and mental capacity so they could apply this knowledge in practice.

Safeguarding concerns were promptly and appropriately shared with relevant agencies. Staff received role-specific safeguarding training and were equipped to identify individuals at risk. They understood the systems, processes and procedures in place to protect people from abuse and felt confident raising any concerns.

Fire safety equipment was within the required testing dates, and relevant test certificates were available and displayed. Safety checks were carried out regularly and any remedial action required reported and acted on to ensure the environment was kept safe.

Recruitment checks had been completed for all newly appointed staff prior to commencing in their roles. Staff had completed mandatory and role-specific training. However, a review of the training records identified that some training and competencies had lapsed or was approaching its renewal date. The registered manager acknowledged and acted on this information promptly.

People were supported by enough staff who had the skills and knowledge to support them safely. People were on the whole supported by a consistent staff team who knew people well and could respond effectively to any changes in need. Staff were clear about the actions they would take if they found people unwell. They communicated well with people and their relatives to promote positive outcomes and refer people to health and social care services as needed.

Medicines were administered safely and monthly medicines audits were completed to ensure medicines were administered and managed safely in line with people’s prescriptions and the provider’s policies. Policies and procedures were in place to guide staff in the safe administration of medicines.

Care plans included person-centred information about people’s nutrition and hydration needs, allergies and intolerances, including details of any enhanced monitoring, risks or related health conditions. Peoples care and support was provided in line with their care plan. Risk assessments were personalised and detailed, including the actions needed to mitigate risks. Staff demonstrated they knew people well. Staff could identify triggers which may produce an emotional or behavioural response from people.

People’s needs were reviewed before they stayed at the service so staff could identify any changes in these and adapt the support provided accordingly when people came to stay. This meant care plans remained accurate and reflective of people’s current needs. This included a review of their needs, preferences and aspirations which ensured staff fully understood people’s individual support requirements.

Staff and leaders worked effectively with individuals and professionals to provide safe and responsive care, supported by positive external feedback.

Staff treated people with kindness, empathy and compassion and respected their privacy and dignity.

People, relatives and carers’ were given the opportunity to feedback, share ideas and raise complaints. People, relatives and carer’s felt listened to.

Leaders demonstrated they were actively involved in the day-to-day operation of the service and demonstrated a strong commitment to providing person-centred care that met people's individual needs and preferences.

Management supported a no blame culture, learning from incidents and using the opportunities to try new ways of working. Management was responsive to our feedback during the assessment.

Staff spoke positively about management, describing them as visible and well respected.

There was a positive speak up culture within service, staff confirmed this.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed autistic people and people with a learning disability respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

Staff told us they felt supported in their role.One staff member told us, “Very well managed and organised. Always provided with information. On call manager available for support and a quick response” and another staff member told us, “Yes, we can raise and discuss in meetings and one to one and we are listened to and our ideas are taken onboard. This is the best service and best team I have worked in.”