Cheshire House

Cheshire House offers residential care for up to eight individuals with mental health needs or learning disabilities, each in their own self-contained flat. This report from the Care Quality Commission (CQC) details the findings of an inspection conducted in November 2019. The inspection assessed the service against key areas of care quality, focusing on safety, effectiveness, how caring the service is, its responsiveness to needs, and how well it is led. Overall, the report highlights significant improvements and a positive environment for residents.

In terms of safety, the home has a comprehensive risk management system, and staff are trained in physical intervention. While one plan lacked specific detail on physical intervention techniques, this was immediately addressed. The service effectively learns from incidents, with a clear system for recording and reviewing them, leading to a significant reduction in their number and severity. Robust safeguarding procedures are in place, and staff are recruited through a thorough system, with residents sometimes involved in interview panels. Medication is administered safely by two staff members, and regular audits are conducted.

Regarding effectiveness, the service excels in supporting individuals transitioning between services, with thorough assessments and collaborative planning. Staff feel well-supported, receiving regular supervision and tailored training, including from specialists in positive behaviour support. Residents are actively involved in planning their meals, and the home has adapted its environment to meet individual needs, such as a ground-floor flat with a private entrance for one resident, which significantly reduced incidents. Residents have continued access to healthcare, with proactive arrangements like home visits when needed, and close collaboration with community health teams. Decisions are made in line with the Mental Capacity Act, ensuring people have maximum choice and control.

On caring, the inspection found staff to be exceptionally kind and knowledgeable about residents' needs and preferences. Residents and their families spoke very positively about the staff, describing them as polite, helpful, and respectful. A unique approach involves matching staff with residents based on shared interests and personalities, fostering genuine enthusiasm for activities. The service prioritises privacy, dignity, and independence, breaking down personal goals into manageable steps and empowering residents to develop new skills, leading to excellent outcomes and increased autonomy.

The service is exceptionally responsive, with a deep understanding of residents' diverse needs and histories. Staff are adept at tailoring support, as demonstrated by matching staff to residents with similar interests, which enhances engagement and encouragement. The adapted living spaces, like the ground-floor flat, show a proactive approach to addressing individual anxieties and improving quality of life. Residents are actively encouraged to increase their independence, with positive risk-taking managed in a supportive and structured manner to help them achieve their goals safely.

In terms of being well-led, the management team has fostered an ethos of resident involvement and goal achievement. There is clear oversight of the service, and staff are empowered through roles like keyworkers and champions, participating in quality monitoring and care planning. The service operates in line with best practice guidance, ensuring residents can live as full a life as possible with control, choice, and independence. People are supported to have maximum choice and control, with care provided in the least restrictive way possible and always in their best interests.