Abberley House is registered to provide respite accommodation and personal care for up to nine people with a learning disability, autism, dementia, people with sensory impairment or physical disability, people with mental health needs, older people or younger adults. At the time of our inspection three people were using day care services and three people were using overnight respite. Our inspection was unannounced and took place on 24 August 2018. The service had been previously rated as ‘Good’ at our inspection in January 2016.

Abberley House 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.

There was a registered manager in post and they were present. 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 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.”

Staff were aware of safeguarding procedures and knew what action to take if they had any concerns. Staff supported people in a safe manner. Recruitment of staff was carried out appropriately. Administration and recording of medicines given were carried out safely.

Staff had the skills and knowledge required to support people using the service effectively. Staff received an induction prior to them working for the service and they felt prepared to do their job. Staff could access ongoing training to assist them in their role. Staff could access supervision and felt able to ask for assistance from the registered manager. Staff knew how to support people using the service in line with the Mental Capacity Act and gained their consent before assisting or supporting them. Staff encouraged people to eat healthily and supported their healthcare needs.

Staff members treated people with compassion and kindness. People using the service were involved in making their own decisions about their care as far as possible. Staff ensured that people were able to maintain their privacy and dignity and encouraged them to retain an appropriate level of independence.

People’s preferences for how they wished to receive support were known and considered by the care staff. Staff understood people’s needs and provided specific care that met their preferences. Relatives knew how to raise complaints or concerns and felt that they would be listened to and the appropriate action would be taken.

Quality assurance audits were carried out and provided the registered manager and the provider with a clear overview of the service. Relatives and staff felt the service was led in an appropriate way. Staff were supported in their roles. Staff felt that their views or opinions were listened to. We received notifications of incidents as required.

Abberley House is registered to provide respite accommodation for up to nine adults with learning disabilities who require temporary accommodation and personal care. At the time of our inspection two people were using the service overnight and two people were using a day centre facility. Our inspection was unannounced and took place on 7th January 2016. The service was last inspected on the 13 May 2013 where it met all of the standards.

The manager was registered with us as is required by law. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us that they were kept safe.

People received medicines appropriately.

We observed there were a suitable amount of staff on duty with the skills, experience and training in order to meet people’s needs. Relatives told us that they were able to raise any concerns they had and felt confident they would be acted upon.

People’s ability to make important decisions was considered in line with the requirements of the Mental Capacity Act 2005. Staff interacted with people in a positive manner and used a variety of communication methods to establish their consent and/or understanding.

People were supported to take food and drinks in sufficient quantities to prevent malnutrition and dehydration. People’s health needs were met.

Staff maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible.

People and their relatives were involved in the planning of care and staff delivered care in line with what was considered to be people’s preferences and wishes.

The complaints procedure had been given to people and their relatives in a clear and understandable way.

People, their relatives and staff spoke positively about the approachable nature and leadership skills of the registered manager. Structures for supervision allowing staff to understand their roles and responsibilities were in place.

Systems for updating and reviewing risk assessments and care plans to reflect people’s level of support needs and any potential related risks were effective.

Quality assurance audits were undertaken regularly by the provider.

There had been no instances where notifications were required to be sent to us, but systems were in place to do so if required.

There were four people using the service on the day of our inspection. Two people were living there on a long term basis whilst appropriate future placements were being found. They had been admitted to the home as an emergency due to changes in their family circumstances. We spoke with two people using the service, six members of staff and the manager. Due to their needs some people were unable to tell us their experiences of using the service so we spent time observing how staff supported and interacted with them. We spoke with two relatives on the telephone following our inspection.

People who used the service were supported to ensure their health needs were met. A relative said, “I know my relative is safe when they stay there."

People told us and we saw that regular activities were organised that met people's needs. One person said, “I can do the things I want to do here.”

We saw that people were supported to eat their meals and have their drinks to ensure they had a balanced and nutritious diet.

People had their medicines as prescribed by their doctor to ensure their well being.

People were supported by staff who had the skills and knowledge to meet their individual needs.

People were asked for their views about the home and audits of the quality of care that people received were completed. Improvements were made as a result of these. One relative told us, “We are really happy with the service provided but I wouldn’t hesitate to say if we weren’t.”

The people that use the service have a learning disability and not everyone was able to tell us about their experiences. To help us to understand the experiences people have we used our SOFI (Short Observational Framework for Inspection) tool. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences. Some people using the service were able to tell us about their experiences and we also spoke with staff and visitors to the service.

The service is for people to have a break from their home. However, three people had been there for a longer period of time due to their family circumstances. We saw that plans were in place to enable these people to move on to more appropriate placements. Staff recognised the emotional difficulties that people may have faced with other people coming into and going home from the service regularly and had supported individuals with this.

We saw staff spending time with people and supporting them in the way they wanted to be supported. There was a good, happy atmosphere in the home. People told us and we saw that they were able to do the things they wanted to. One person said, "If I need any help with anything, I ask staff, I like everything here. The staff are nice and friendly." We saw that staff helped people to be as independent as possible, so increasing their skills and promoting their self esteem.

Staff told us what they would do if they saw abuse happening to make sure that people were safeguarded from harm. We saw that systems were in place to ensure that the risk of people being abused was reduced.

Staff said they were well supported in their role. We saw that they had the training they needed so they knew how to support the people using the service.

The views of the people who used the service and their relatives were listened to and action was taken to ensure the service met their needs.