Appletrees is a care home without nursing that provides a service to up to eight people with a learning disability. At the time of our inspection there were seven people living at the service aged between 36 and 53. The home is a large detached building within a rural area of West Berkshire. People have their own bedrooms and use of communal areas which includes a large enclosed private garden.

At the last inspection on the 16 June 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good:

There is a registered manager running the service. 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 remained safe. Staff had a good understanding of how to keep people safe and protect them from abuse. Personal and environmental risks to the safety of people, staff and visitors had been assessed and actions had been taken to minimise those risks. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. There were sufficient numbers of staff and medicines were stored and handled safely.

The service remained effective. People benefitted from a staff team that was well trained and supervised. 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 were supported to eat and drink enough and their health and social care needs were met.

The service continued to be caring and responsive. People received care and support that was personalised to meet their individual needs. They were encouraged and enabled to live as full a life as possible, maintaining their independence where they could. The staff team were caring and respectful and provided support in the way people preferred. Their right to confidentiality was protected and their dignity and privacy were respected.

The service continued to be well-led. People were relaxed and happy and there was an open and inclusive atmosphere at the service. Staff were happy in their jobs and there was a good team spirit. They felt supported by the management and said the training they received enabled them to meet people's needs choices and preferences. Quality assurance systems were in place to monitor the quality of service being delivered and the running of the service.

Further information is in the detailed findings in the full report.

People living in the home had individual communication and behavioural needs. We spoke with five people who used the service. One person was able to respond that they “like it here and I like going to the pub”. We saw that people were involved with their care and the running of the home as far as they were able.

We were told that independence and individuality were promoted within the home. People living there were supported and enabled to do things for themselves as far as they were able. They were encouraged to express their views and to participate in making decisions relating to their care and treatment.

We looked at a range of records, spoke with the manager and two members of staff in private. We saw the communal areas of the home and spent some time observing interactions between staff and people living in the home.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs. This meant only one person was able to tell us about their experiences. We observed interactions between staff and people who used the service. We also observed staff interacting with people using various forms of sign language. People were able to understand because they responded with a smile or nods.

We observed several staff members interacting with people and they all treated people with dignity and respect.

We observed a staff member encouraging and involving a person using the service to choose their own breakfast. We observed staff provided a person with a plate guard to help them manage their meal independently.

People living in the home had individual communication needs and were unable to provide their views about their experiences of living in the home. However we saw that people were involved with their care and the running of the home.

This inspection took place on the 15 and 16 June 2015 and was unannounced.

Appletrees is a care home which is registered to provide care (without nursing) for up to eight people with a learning disability. The home is a large detached building within a rural area of West Berkshire. People have their own bedrooms and use of communal areas that includes an enclosed private garden. The people living in the home needed care from staff at all times and have a range of care needs.

There is a full-time 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 recruitment and selection process helped to ensure people were supported by staff of good character. There was a sufficient amount of qualified and trained staff to meet people’s needs safely. Staff knew how to recognise and report any concerns they had about the care and welfare of people to protect them from abuse.

The service had taken the necessary action to ensure they were working in a way which recognised and maintained people’s rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. DoLS provide a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them from harm.

Staff were supported to receive the training and development they needed to care for and support people’s individual needs. People received good quality care. The provider had an effective system to regularly assess and monitor the quality of service that people received. There were various formal methods used for assessing and improving the quality of care.

With the exception of one person people had limited verbal communication skills and used methods of sign language and pictures to communicate their needs and wishes and these were understood by staff.

People were provided with effective care from a dedicated staff team who had received support through supervision, staff meetings and training.

People’s care plans detailed how the person wanted their needs to be met. Risk assessments identified risks associated with personal and specific behavioural and or health related issues. They helped to promote people’s independence whilst minimising the risks.

Staff treated people with kindness and respect and had regular contact with people’s families to make sure they were fully informed about the care and support their relative received. People were encouraged to live a fulfilled life with activities of their choosing. Their families were encouraged to be fully involved at the reviews of their support needs. People’s families told us that they were very happy with the care their relatives received.