About the service: Alderwood L.L.A. Limited - The Chestnuts is registered to provide accommodation and personal care for up to six people with learning disabilities and autism. At the time of inspection, six people were using the service.

People’s experience of using this service:

The 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.

Appropriate policies and procedures were in place for the safe handling of medicines. However, the provider needed to ensure that staff consistently followed safe practice in relation to the storage and recording of medicines.

Some aspects of environmental safety management had not been followed by staff and areas that should be locked were accessible to people. Immediate action was taken to rectify this and the high staffing levels in the service reduced some of the risk this had posed to people.

People were comfortable living at the Chestnuts. Relatives told us their family members were supported in a safe way by staff. Staff understood their responsibilities to keep people safe from harm and to report potential risks to their safety.

People's needs were assessed prior to them receiving the service to ensure that staff were able to fully meet their needs.

People were supported to choose their meals and staff encouraged people to have a healthy balanced diet.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, best interest decisions were not always completed where people were found to lack mental capacity. People were encouraged to make decisions about their care, daily routines and preferences and staff worked within the principles of the Mental Capacity Act.

Staff induction training and mentoring was comprehensive and on-going training was provided to ensure that staff had the skills, knowledge and support they needed to complete their roles to a high standard. All staff said that they were well supported by the provider.

The culture of the service was caring, person centred and inclusive. Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Staff encouraged people to follow their interests and people were supported to access many varied activities.

People who used the service and their relatives had the opportunity to feedback on the quality of the support and care that was provided. Any required improvements were undertaken in response to people's suggestions.

Care planning and risk assessments were personalised and mentioned the specific care each person required, including their likes and dislikes. Staff were aware of people's preferences, and supported people in a person-centred manner.

People were involved in their own care planning as much as they could be and were able to contribute to the way in which they were supported. People were listened to by staff.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Staffing levels ensured that people's care and support needs were safely met.

Staff had the appropriate personal protective equipment to perform their roles safely. Staff supported people in a way which prevented the spread of infection. The service was clean and tidy and had a maintenance staff member to carry out any works required.

There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

Rating at last inspection:

Good (report published 20 July 2016)

Why we inspected:

This was a planned inspection based on the rating at t

Alderwood LLA Ltd The Chestnuts provides accommodation, personal care and support for up to six people who have a learning disability and autistic spectrum disorder. It is situated in a residential part of Rushden. The service had been adapted to meet people's needs, such as having ample shower rooms a variety of areas where people could go to spend quiet time and clear pictorial signage to clarify what rooms were used for. On the day of our inspection there were six people living in the service.

The inspection was unannounced and took place on 14 June 2016.

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.

The service was led by a dedicated and passionate registered manager, who was well supported by a strong and positive management structure within the provider organisation. Alongside the registered manager, the service was led by a general manager who led by example and was equally driven, committed and passionate about making sure people were provided with care which fulfilled their needs and made them happy. There was an established culture within the service that put people first and at the centre of delivery of care. The culture was open, enthusiastic and uplifting.

Staff were proud to work for the service and wanted it to be the best it could. As a result, they had strong and firm values and a shared vision, and strived to give people really positive care experiences and to provide high quality care. They were aware of, and understood, the high standards of care expected by the provider and registered manager, and worked hard to ensure that they observed this positive philosophy. We found that they were confident and knowledgeable in their ability to support and care for people. Their passion, motivation and dedication to supporting people live a fulfilled life was evident. They faced up to challenges which arose and used these to learn and move forward. The provider philosophy was that people should be able to access the best of everything in life and have ample opportunities to achieve their goals.

Staff had ample opportunity to share ideas for change, and exchange information about possible areas for improvements to the registered manager. Ideas for change were welcomed by the registered manager and provider, and used to drive improvements and make positive and life enhancing changes for people. Quality monitoring systems and processes were used robustly to make positive changes, drive future improvement and identify where action needed to be taken. All staff told us they wanted standards of care to remain high and so used the outcome of audit checks, review meetings and questionnaires to enable them to provide excellent quality care.

People were safe and were calm and relaxed in the presence of staff. Staff demonstrated a strong awareness of what constituted abuse and had a positive approach towards keeping people safe. They understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police. Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people's freedom and to enable them to live as safely and independently as possible.

Robust recruitment checks took place to ensure that staff were safe to work with people before they commenced employment. There were sufficient numbers of staff available to meet people’s support needs, to keep them safe and to enable them to do the things they enjoyed.

People received their medicines when they needed them. Staff managed medicines in a safe way, and had been