West House - 3&4 Glebe Lane

3 & 4 Glebe Lane is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The care home can accommodate up to eight people in a bungalow and a small house that are next to each other but have separate adapted facilities. there were seven people living in the home when we visited. People in the service were living with a learning disability and, in some instances, with a physical disability and complex health needs. The home does not provide nursing care.

The home had a suitably qualified and experienced registered manager who had a background in social care and in management. 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.

The staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and spoke to us about how they would identify any issues and report them appropriately. Risk assessments and risk management plans supported people well. Good arrangements were in place to ensure that new members of staff had been appropriately vetted and that they were the right kind of people to work with vulnerable adults. Accident and incident management was of a good standard.

The registered manager kept staffing rosters under review as people's needs changed. We judged that the service employed enough support staff by day to meet people's needs. Staffing levels at night were being changed to meet people's needs.

We made a recommendation about continuing to review staffing at night.

Staff were appropriately inducted, trained and developed to give the best support possible. We met team members who understood people's needs and who had suitable training and experience in their roles.

People had reviews of their medicines on a regular basis. Medicines were stored safely. We noted that some, but not all, staff did not always sign the records in a timely manner but this was being addressed by the provider under their quality monitoring, supervision and disciplinary processes.

People in the home saw their GP and health specialists whenever necessary. The staff team had good working relationships with local GP surgeries, community nursing services and specialist health care professionals.

Good assessments of need were in place, and the staff team reviewed the delivery of care for effectiveness. They worked with health and social care professionals to ensure that assessment and review of support needed was suitable and up to date.

People told us they were satisfied with the food provided and we saw suitably prepared meals being served. Good nutritional planning was in place. Special diets and support needed to take enough nutrition and hydration were in place.

The home is situated in a quiet residential cul-de-sac and consists of a four bedroom house and a four bedroom bungalow. The bungalow is adapted to accommodate up to 4 people who have complex physical needs. Both buildings were clean, homely and suitable for diverse needs. There were suitable adaptations and equipment in place.

Where possible people were consulted about their preferences and choices. Where people lacked capacity advocates were used or, if appropriate, relatives were involved in decision making. We saw records of 'best interest' meetings held where people were unable to make their own decisions.

The staff team were aware of their responsibilities under the Mental Capacity Act 2005. 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.

People who lived in the home told us that the staff were caring. We also observed kind and patient support being provided. Staff supported people in a respectful way. They made sure that confidentiality, privacy and dignity were maintained.

Risk assessments and care plans provided detailed guidance for staff in the home. Some of the people in the service were aware of their care plans and had influenced the content. The management team had ensured the plans reflected the person-centred care that was being delivered. The registered manager was reviewing the format of care planning to simplify the process.

Staff could access specialists if people needed communication tools like sign language or braille but no one in the service used specialised ways of communication.

Staff encouraged people to follow their own interests and hobbies. We saw evidence of regular activities and outings.

The service had a comprehensive quality monitoring system in place and people were asked their views, where possible, in a number of different ways. Quality assurance was used to support future planning.

We had evidence to show that the registered manager and the operations manager were able to deal with concerns or complaints appropriately .

Records were well organised, easy to access and stored securely. Staff were being reminded about the importance of signing when they recorded interactions.

3 Glebe Lane is a four bedroomed bungalow which provides care for four people in single rooms. 4 Glebe Lane is a four bedroom house where four people live. The service cares for people with a learning disability who may also have a physical disability. Both houses have suitable shared spaces and small gardens. The staff care for people in both properties and the people who live in both houses visit each others buildings as they are next door to each other. The houses are in a quiet residential area of Distington within easy access of the village amenities and public transport.

The home has an experienced and suitably qualified registered manager who has been in post for a number of years. 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.

People in the home were protected from potential harm and abuse because staff understood their responsibilities and had received suitable training in safeguarding matters. Both houses were safe and secure and the registered manager had ensured that maintenance was on-going and that there was a suitable emergency plan in place.

Every person in the home had a risk assessment that covered their care needs and risks around activities. There were suitable risk assessments in place regarding the building and the grounds. Accidents and incidents were minimal and suitable risk management in place to lessen or prevent any accidents.

Staffing levels met the assessed needs of people in the service. The registered manager changed the rosters when people's care and support needs changed so that staffing met these needs.

Staff were suitably recruited and West House had human resources policies and procedures in place. The organisation had grievance procedures and less formal ways of staff being able to 'whistle blow' if necessary.

Medicines were suitably managed with staff receiving training and checks on competence.

Both buildings were clean and tidy and staff had training in prevention of infection. They understood how to use personal protective equipment.

Staff received good levels of support through supervision, appraisal and checks on competence. We saw that new staff had a thorough induction and then received both formal and informal supervision. More experienced staff had support that helped with their overall personal development. Records showed that the staff team discussed best practice issues in supervision and in team meetings as well as informally during their shifts.

The registered manager had a good understanding of the Mental Capacity Act 2005 and staff had received training on making decisions in people's best interests, Deprivation of Liberty authorities and on consent. There had been no incidents where restraint had been used but staff had receive suitable training on behaviours that challenge and how to manage them.

Staff supported people to prepare their own snacks and to help with meal making wherever possible. People received good quality food that was home cooked in the service. People also went out for meals. Staff were trained to support people who had difficulties managing a normal diet.

Both buildings were of a domestic nature but the provider had made suitable adaptions where people had problems with their mobility. Some parts of the buildings looked a little tired but the registered manager told us of plans to continually upgrade the environment. Staff supported people to keep their homes neat and tidy. Both buildings were warm, comfortable and homely.

Staff explained things to people with care and patience, They helped and supported people both physically and emotionally. People were encouraged to 'have a go' and do things for themselves. People were given options and choices and helped to make decisions. It was obvious that there was genuine care and affection between the staff and people who lived in the home.

Each person in the home had a detailed care plan and a health care plan. People also had their own person centred plan where their hopes, needs, strengths and wishes were recorded. These were of a very high standard.

People told us that they enjoyed a wide range of activities. They went to discos and swimming, shopping and on holidays. They were involved in the local community. Staff encouraged people to be part of the day to day work of the houses and where possible people were involved in shopping and cooking, tidying and cleaning the house.

There had been no concerns or complaints about the service but people had the right level of support to raise these if necessary.

We had evidence to show that good planning was in place if people had to go into hospital or if they had to move to a different service.

The home had an experienced and suitably qualified registered manager. Staff and people in the home told us that the manager was supportive and caring. We judged that the service reflected the values of the provider and that the manager had created an open atmosphere and a caring culture.

The provider had a suitable quality monitoring system and we saw evidence to show that this was in place. Senior officers of the provider's organisation visited regularly to ensure that good standards were being met.

We were able to see that people were supported to lead active and meaningful lives and had frequent access the local community. We observed people being supported by staff to undertake meaningful tasks and activities. Some people told us they liked to do their own chores and help with the housework. There was a relaxed and homely atmosphere with a friendly rapport between staff and people living in the home.

We saw that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. The home had developed good links with healthcare professionals to ensure that people's health needs were being well met.

People were supported to play a central part in decision-making. One person told us, 'Staff have been brilliant at helping me with my illness and I'm starting to keep hold of my own medication.'

The home was well designed and equipped to effectively and safely care for people with limited mobility and more complex healthcare needs.