Caradon

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.

People had received a range of assessments and support around their needs. For example, one person was taken weekly to the speech therapist. We were assured staff understood people well and were able to communicate effectively. Need to know information was readily available in people’s folder in the kitchen but this should be in their bedrooms to protect their confidentiality. We observed staff communicating well with each other and working as a team. We asked for assurances around monitoring of health and bowels and were assured systems were in place and people were supported. Good oversight of peoples needs meant any changes could be identified and responded to. People at the service were subject to deprivation of liberty safeguards (DOLs) and these had all been applied for, three had so far been granted. Mental capacity assessments were in place for decisions and showed what had been assessed, who was involved and what the outcome was. These were dynamic documents which were kept under review.

Through observation we noted people were treated well and people were able to express their individuality and staff respected their choices. We observed people being included in every activity, and staff equally engaged to make it a more enjoyable experience. A family member we spoke to told us that the staff and management at Caradon had "managed his transition with care and dignity, and I could no think of a more perfect home for him". Staff accepted that people sometimes demonstrated behaviours that challenge, but staff wanted to learn from this and find out how they could support people better. People dressed individually and staff were able to anticipate their needs and ensure these were met appropriately. Support was designed around each individual and staff said people could influence who worked with them. The service had an electronic care planning system and people’s needs were clearly documented and reviewed in line with peoples needs and risks.

Appropriate staffing enabled people to be supported in the way they wanted to be supported. People had only recently moved into the service, and some had found this transition easier than others, social activities were being introduced based on people’s preferences and from feedback from parents. There had been a serious safeguarding incident and we were able to see that the provider had proactively worked with other external agencies to ensure lessons were learnt. Staff were given confidence and knowledge to support people effectively, and people were kept safe. During our site visit on 15 May 2024, completed a Short Observational Framework for Inspection (SOFI), and saw people smiling and interacting well with staff in a relaxed environment and joining in activities within the home. One person was identified as using sign language, but a staff member told us they had not had specific training sign language training. Staff did appear to know people well and were observed laughing with people. The service had clear and accessible information around the service which could be used to help people know what was happening across the day such as picture cards and now and next boards.

People were observed being supported by staff in an environment which was appropriate to their needs and that were least restrictive. Key fobs enabled people to keep their possessions secured and accessible to them when required. The manager and deputy were experienced in their field and showed a genuine interest and compassion for people and staff they were supporting. A staff member told us how wellbeing of staff was important to ensure that the managers got the best out of staff and supported them to bring their best selves to work. Staff spoken with told us that they were well trained, supported and able to raise concerns with the confidence that these would be acted upon. We found that the manager and deputy engaged with the quality monitoring officer from the Local authority, and other external professionals, to ensure better outcomes for the people at Caradon. Through a reflective document titled Opportunities for Learning, the management team analysed incidents to prevent re occurrence. The manager and deputy were receptive of our feedback, and demonstrated immediate will to act on them.