Combe House

Safeguarding processes and systems were in place to protect people from the risk or abuse and neglect. Staff were aware of their responsibility to safeguard people and how to raise concerns. Risk assessments detailed individual risks known to people and how staff should support people to mitigate these. We observed staff following the risk assessments during our site visits. There were sufficient numbers of suitably trained and experienced staff to meet people’s needs. People received their commissioned one to one hours to support them engage in activities that were important to them and staff were engaged with them throughout this. There was a consistent staffing team who knew people and their needs well, with minimal use of agency workers.

People’s needs were assessed at regular intervals to ensure their changing needs were met. The service encouraged people, their relatives and advocates to be part of this process. People’s mental capacity to make decisions had been appropriately assessed and restrictions put in place to keep people safe when absolutely necessary. In these situations, the least restrictive option had been used to ensure people still had maximum choice and freedom.

People were supported to be as independent as possible, and encouraged to make choices for themselves around the care they received. This maximised their freedom to make choices about their lives.

People received person centred care and were treated as individuals. People were encouraged and supported to take part in outings and activities that were meaningful to them. Staff supported people to ensure they were free from barriers that could be caused by discrimination and inequality. The registered manager had ensured communication needs had been accounted for by producing documents in easy read and pictorial formats for people. They had also ensured there was a culture of people and their relatives being able to raise concerns in confidence they would be resolved. Any learning points from these were raised with staff during staff meetings and individual supervision meetings. Where possible, people’s relatives and representatives had been involved in documenting people’s end of life care wishes.

The ethos and values of the registered manager and staff members ensured the culture in the service was one of inclusivity, positivity, and equality. Feedback from relatives and staff was that the service had improved since the arrival of the Registered Manager. Staff had clear understanding of their roles and responsibilities, and felt confident in being able to speak up and raise concerns if needed. There were effective governance systems and processes in place to drive improvement within the service. Staff worked in partnership with external stakeholders to achieve good outcomes for people, including the community mental health team and GPs.