Agape Annexe 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.

Agape Annexe is registered to accommodate four people, with learning disabilities and mental health needs; at the time of our inspection there were four people living in the home.

At the last comprehensive inspection in March 2016, the service was rated good. At this unannounced inspection undertaken on 25 April, 3 and 8 May 2018, we found the service remained overall ‘good’.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last comprehensive inspection.

Some people’s personal rooms and the main bathroom was not visibly clean and some items of furniture required replacing. However, the provider who is also the registered manager had addressed these concerns by the end of the inspection.

Audits to monitor the quality and safety of the service undertaken by the provider required improving to ensure that all rooms in the home where assessed for general decoration and cleanliness on a regular basis.

Staff followed the procedures for safeguarding people from the risks of harm or abuse. Risk management plans were in place to safeguard people's personal safety and manage known environmental risks.

Staffing arrangements met people's individual support needs. The recruitment procedures ensured only suitable staff were employed to work at the service. Medicines were appropriately managed and staff followed infection control procedures to reduce the risks of spreading infection or illness.

Staff had comprehensive induction training and on-going refresher training that was based on following current best practice. Staff supervision and appraisal systems ensured staff had regular opportunities to discuss and evaluate their learning and development needs and their work performance.

Staff supported people to follow a nutritious, varied and balanced diet. The staff supported people to access health appointments as required so that people's continuing healthcare needs were met.

Staff understood the principles of the Mental Capacity Act, 2005 (MCA) and ensured they gained people's consent before providing personal care. People were encouraged to be involved in decisions about their care and support and information was provided for people in line with the requirements of the Accessible Information Standard (AIS).

People had their privacy, dignity and confidentiality maintained at all times. People experienced positive relationships with staff and received care that respected their diversity as staff supported people to maintain relationships with family and friends and make new friends. The care people received from staff was kind, caring and compassionate.

The provider operated an open and transparent culture. Events such as safeguarding matters, accidents and incidents had been reported to the Care Quality Commission (CQC) and other relevant agencies as required. Complaints brought to the provider's attention had been dealt with in accordance with the complaints procedure.

The inspection took place on 10 March 2016 and was unannounced.

Agape Annexe provides accommodation and personal care for up to four people with a learning disability and mental health needs. At the time of our inspection, the service was providing support to four people.

The service had a registered manager. 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 felt safe. Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse and people had risk assessments in place to enable them to be as independent as possible.

Effective recruitment processes were in place and followed by the service and there were sufficient numbers of staff available to meet people’s care and support needs

Medicines were stored, handled and administered safely within the service.

Staff members had induction training when joining the service, as well as regular ongoing training.

Staff were well supported by the registered manager and had regular one to one supervisions.

People’s consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met.

People were able to choose the food and drink they wanted and staff supported people with this.

People were supported to access health appointments when necessary.

Staff supported people in a caring manner. They knew the people they were supporting well and understood their requirements for care.

People were involved in their own care planning and were able to contribute to the way in which they were supported.

People’s privacy and dignity was maintained at all times.

People were encouraged to take part in a range of activities and social interests of their choice.

The service had a complaints procedure in place and people knew how to use it.

Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed

Our inspection was carried out by one adult social care inspector who visited the service unannounced on 4 August 2014. At the time of our inspection four people lived at the service. We spoke with people who used the service and they told us that they were happy living at Agape Annexe. We also spoke with the service provider and staff on duty. We reviewed records relating to the management of the home which included, care plans, daily care records, staff training records and records relating to the monitoring and assessment of the quality of the service. We also watched how staff supported people who used the service.

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

Is the service safe?

People who used the service told us that they felt safe. One person told us they would be able to contact someone if they had any concerns about themselves or others. Staff received training in safeguarding vulnerable adults and were aware of their responsibilities for reporting any concerns about the treatment of people.

Care plans and risk assessments were in place which identified any specific risks for people who used the service and the actions staff should take to minimise the risk.

We found that medication was stored and administered safely.

Is the service effective?

People's health and care needs were assessed and plans of care developed according to their needs. Information about things that were important to people and how they wanted to be supported was identified in care plans, which helped staff to provide appropriate care. From our observations and discussions with staff, we concluded that staff had a good knowledge of each person's care needs and preferences. This meant that staff were able to support people effectively.

Is the service caring?

We saw that people were treated with dignity and respect by the staff. People who used the service were relaxed in the presence of staff and responded positively to them. People who used the service told us that they got on well with the staff and we heard staff talk about people in a caring and supportive manner.

Is the service responsive?

We saw that staff were responsive to people's needs. For example, staff understood the importance of checking for any signs that people may need additional reassurance following the recent move of two people to Agape Annexe.

Is the service well-led?

We found that the service was well managed. Managers were involved in the day to day running of the service and discussion with people who used the service confirmed that they had confidence in them.

Contact details for managers were available to people who used the service and staff. One person who used the service said they could contact managers at any time if there was a problem.

We found that the Provider had made improvements since our last visit to the service in May 2013.

We saw that the Provider had purchased appropriate, lockable, filing cabinets for the storage of files which contained sensitive personal information.

We looked at care plans and other information and we saw that this was up-to-date and appropriately structured in the new files.

We saw that the Provider had implemented improved storage facilities for archived information. New retention and destruction arrangements meant sensitive and personal information was managed safely.

We spoke to the manager about the management of the home and we saw the policies and procedures for the home. The policies were comprehensive and were regularly reviewed. The manager approached the work in a caring and supportive manner. He was able to explain the responsibilities to us and understood their role to ensure people were cared for appropriately.

We saw how people in the home were encouraged to lead independent lives and spoke to one person who lived at the home and family members. The people who lived in the home told us about their daily activities.

Family members told us they were happy with the care and support provided by Agape Lodge. One family member told us, “We do try to visit X regularly. He is well looked after.”

We reviewed the record keeping and security and storage arrangements in the home. We were told that care files for the people who lived in the home were kept at Agape Lodge, another home owned and managed by the provider. When we looked at the care plans we found that they were not always up dated routinely following a review of care and support needs.

We looked at the archived records and care plans for people who lived in the home and found that they were not stored securely or confidentially.

There were two people living at the service when we visited on 2 May 2012. We spoke with one person who said he liked living at the home. He said that he enjoyed going to day centre on week days and also went out for weekly trips to the pub.