Building Care Services Around the Needs of Clients Leads to Outstanding Rating by CQC

Tigh Sogan care home in Croydon has been rated Outstanding overall by the Care Quality Commission following an inspection in February 2018.

The service provides accommodation and care to people with Learning Disabilities.

They were particularly commended for their approach to managing and reducing challenging behaviour.  Each person was supported to create a ‘personal folder’ where they recorded things which they liked and things they did not like, which could be triggers to challenging behaviour. Staff received regular training, approved by the British Institute of Learning Disabilities, in positive behaviour support. Staff said the training was excellent and that the provider gave on-going support in helping people stay safe. Residents said they felt safe and relatives were in agreement. Staff discussed safeguarding at each team meeting.

The relative of one resident, who had a poor quality of life in their previous placement and refused to engage with people or in any meaningful activities, said: “Our son has got his life back and this has changed our lives too. They’ve done wonders for him here. The progress he has made and the support is outstanding. It’s so person-centred. There are group activities but there are always staff available if he wants to do something else.”

The provider recently began a programme at a local hospice to train staff in understanding how to provide high-quality care to people at the end of their lives. As part of the programme people are supported to consider how they would like to receive care at the end of their lives through involvement with their families.

Key Findings

• The provider had excellent systems in place to support people in relation to behaviours which challenged the service. Assessing needs and implementing consistent ways of working tailored to each person. 
• Staff received training in relation to positive behaviour support and understood people’s needs well.
• Care plans were carefully designed so people's emotional needs, individual preferences and interests were well catered for.  Each person was supported to live a meaningful life despite difficulties they experienced in their day to day lives and previous difficulties in engaging in activities. 
• People had individualised activity programmes in place which met their particular interests and needs very well.  Staff supported people to increase choice and control in their lives through their excellent understanding of people's needs and preferences. 
• People were at reduced risk of social isolation as the provider actively encouraged socialising and building relationships. 
• Systems were in place to reduce the risk of abuse. 
• Staff were well supported with induction, training, supervision and annual appraisal to help them understand their role and responsibilities. 
• The provider identified, assessed and managed risks relating to people’s care as well as to the premises. 
• There were sufficient numbers of staff deployed to support people with each person receiving individual support throughout the day. 
• People received coordinated care when moving between services such as hospital admissions and when newly admitted to the care home. People were supported in relation to their day to day health and to access healthcare services they required. 
• Staff understood people’s communication needs well and adapted their communication for the different individuals. People were encouraged to develop their independent living skills. 
• The registered manager created a positive, encouraging environment for people, staff and relatives who visited the service and had a good understanding of their role and responsibilities. Leadership was visible and capable at all levels and staff also understood their role well. 
• The provider had good governance systems in place to audit and improve the service with frequent checks of the service in line with CQC standards.