Archived: One One Eight

One One Eight is a care home which provides therapeutic support for up to six younger adults who have a mental health condition. It is a service for those people with enduring mental health needs who wish to work towards recovery in a supported environment. At the time of the inspection, six people were using the service.

People’s experience of using this service and what we found

There was a strong, visible person-centred culture at the service. Without exception, people and family members spoke very positively about the caring nature of staff. One person told us they felt “privileged” to live at the home. Staff were extremely caring and empathetic in their approach to people. Respecting equality and diversity was embedded in the service. All decision-making centred around people. Staff were exceptional at supporting people to express their views so they got the care and support they needed. Staff excelled at supporting people to maintain and increase their independence.

The service was exceptionally person-centred and responsive to people’s individual needs. Staff developed extremely positive relationships with people to ensure their needs were met. People were regularly engaged in person-centred activities and to access the wider local community. Healthcare professionals spoke very positively about the creativity of staff. Staff had taken innovative steps to meet people’s information and communication needs. The person-centred approach and regular, daily engagement with people meant any concerns or issues were immediately identified and resolved before becoming a formal complaint.

The provider and management team were highly motivated and passionate about making sure people received person-centred and high-quality care. Staff felt the leadership of the service was exceptional. There was a strong emphasis on continuous improvement. The provider and management team had carried out extensive research into best practice. There were consistently high levels of constructive engagement with people, family members and staff. The service had forged and maintained excellent links with health and social care professionals and other local organisations. The provider had robust governance processes in place to ensure they were able to monitor and assess the quality of their service.

The service worked with people so they could take ownership of their medicines in preparation for a move into independent living. This included discussions about a reduction in the use of anti-psychotic medicines and safe ways to achieve this. Appropriate safeguarding procedures were in place and staff had been trained in how to protect people from abuse. Risks were well documented and managed. The provider carried out appropriate security and identification checks when they employed new staff.

People and family members spoke positively about the staff. Regular assessments and reviews took place to ensure people’s needs were being met. People were supported with their healthcare needs and had access to healthcare professionals when required. People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 22 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

One One Eight is a care home which provides therapeutic support for up to six younger adults who have a mental health condition. It is a service for those people with enduring mental health needs who wish to work towards recovery in a supported environment. The goal of the service is to provide people with the tools they need to move on to a more independent living arrangement where possible. The service is a town house situated within walking distance of York city centre. The house is over three floors with bedrooms on each floor. There are good transport links and amenities close by.

There was a registered manager employed at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There was a clear management structure at the service. There was a senior management team who held weekly management meetings which were informed by reports sent to the management team.

Feedback from everyone we spoke with was extremely positive about all aspects of the service.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice

People had access to health and social care professionals whose feedback showed that they had confidence in the service.

There were sufficient staff to meet people’s needs and they been recruited safely. Staff numbers were varied according to the support people required. Staff were trained in subjects considered mandatory by the service as well as additional areas which were specific to people who used the service. Staff had been supported through regular supervision.

The provider had done all they could to safeguard people through staff training, having policies and procedures in place to guide staff and having clear guidance and support for staff.

Risks to people’s health had been identified and plans were put in place, agreed by each person, to manage those risks. The premises were risk assessed and there were processes in place to ensure people’s safety. Accidents or incidents involving people were recorded, analysed and risk assessed and actions taken to minimise any further incidents.

Medicines were managed safely. Where people self-medicated a risk assessment had been completed to ensure they were safe doing so.

People's nutritional needs were supported and people bought and cooked their own food where they were able to as part of their development of skills to support their independence.

The environment was appropriate for the age and needs of people who used the service. It was decorated and maintained to a very high standard. People's bedrooms reflected their personal tastes.

People told us that staff were extremely caring. Relatives and professionals echoed this view. People felt that they mattered.

Staff were highly motivated and displayed the company values in their work. We observed them positively interacting with people ensuring that their conversations were meaningful. Relationships between staff and people were extremely positive. Regular group meetings were attended by people where they were encouraged to express their thoughts and feelings. Staff showed great respect to people.

Information sharing was managed in a variety of ways such as meetings, one to one conversations with staff and a notice board in the main hallway. People were involved in all aspects of their care and some had written their own care plans. People were encouraged to maintain activities and hobbies as part of their development.

Staff worked with community nurses, doctors and other health professionals to provide a seamless service for individuals. Passports were completed which provided the relevant information needed if people moved to other health or social care settings.

Although there had been no complaints at the service people were aware of what process to follow if they had any concerns.

There was an effective quality assurance system in place. Audits and checks of the service ensured people's health and safety was maintained.

Feedback which had been sought through surveys and comments made by people, their relatives and professionals demonstrated the very high regard within which people held the service.