This announced comprehensive inspection took place on 29 March 2018.

Broadpark House is a ‘care home’ for up to three people with a learning disability. The registered provider lives in the home and together with her husband they provide the care. At the time of our inspection there were two people living at Broadpark House. The two people living at the service were independent and only required occasional prompting and support. 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.

At our last inspection in November 2016 we found breaches of legal requirements. These were regulations:

• Regulation 17 – Good governance. Due to the unusual nature of the service there were no formal systems and processes in place to assess the quality and safety of the service and there was a lack of policies and procedures in place relevant to the planning and delivery of care and treatment.

• Regulation 18 – Staffing. Staff had not received any up to date training to enable them to carry out their roles in line with best practice guidance.

• Regulation 20 A – Requirement as to display of performance assessments. The provider had not displayed their CQC rating, which is a legal requirement of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

As a result the service was rated as ‘requires improvement.’ This inspection found that these three breaches remained. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question(s) effective and well-led to at least good. However, we did not receive any action plan.

When we visited we met with the registered provider. A registered provider is a person who has registered with the Care Quality Commission to run the service. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations. A registered manager is not required as the provider is registered as an individual person.

Staff had still not received up to date training specific to people’s needs; this was also identified at both our inspections in 2015 and 2016. The provider explained at both these inspections, they would contact the relevant professionals if they noticed changes in a person’s physical or mental health.

There were still no policies and procedures for us to view during our inspection, this was the same in 2015 and 2016. For example, a policy on safeguarding vulnerable adults, risk management and infection control. We also found that the home did not have a Mental Capacity Act (2005) policy in place to provide the legal framework to work within to ensure the protection of people in their care. However, the registered provider knew to contact relevant professionals if any concerns became evident which impacted on people.

The service was unusual in so far as it was more of a family home. There were still no formal systems and processes in place to ensure quality for people. The service is run in an informal way through on-going discussions with people on a constant basis.

The provider was not keeping up to date with training, changes in practice, regulatory requirements and had no quality monitoring systems. Therefore they were unable to assess whether or not they were meeting the required standards or provide evidence that risks were being managed.

Prior to our inspection we asked the provider to send us in the Provider I

This announced inspection took place on 21 November 2016. The provider was given 48 hours’ notice because the location was a small supported living unit for adults who may be out during the day; we therefore needed to be sure that someone would be in.

At our last inspection in August 2015 we found the service was meeting the regulations of the Health and Social Care Act (2008) we inspected. However, the service was rated as ‘requires improvement’ due to a lack of up to date staff training, although they would contact relevant professionals if they noticed changes in a person’s physical or mental health; a lack of understanding of the Mental Capacity Act (MCA) (2005) and due to the uniqueness of the service there was no formal systems and processes in place to assess the quality of the service. This inspection found an improved understanding of the MCA, but no further training had taken place and no formal processes or policies had been implemented to assess the quality of the service.

Broadpark House is registered to provide care and support for up to four people with a learning disability. The registered provider lives in the home and together with her husband, they provide the care. At the time of our visit there were two people living at Broadpark House. The two people living at the service were independent and only required occasional prompting and support..

When we visited there was a registered manager in post. 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.

Staff had not received up to date training specific to people’s needs. However, as the registered manager explained at our inspection in 2015, they maintained they would contact the relevant professionals if they noticed changes in a person’s physical or mental health.

There were no policies and procedures available for us to view during our inspection. For example, a policy on safeguarding vulnerable adults. We also found that the home did not have a Mental Capacity Act (2005) policy in place to provide the legal framework to work within to ensure the protection of people in their care. However, the registered manager knew to contact relevant professionals if any concerns became evident which impacted on people.

Prior to our inspection we asked the provider to complete a Provider Information Record (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider did not respond to our request for information.

The service was unique in so far as it was more of a family home. As a result there were no formal systems and processes in place to ensure quality for people. The service ran in an informal way through on-going discussions with people on a constant basis.

Since April 2015, providers have been required to clearly display their Care Quality Commission (CQC) rating at any premises from which they provide a regulated activity. We found that the provider of Broadpark House had not displayed their CQC rating, which was awarded following our inspection in August 2015.

People felt safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. Staff demonstrated a better understanding of the Mental Capacity Act (2005). This meant people’s rights were protected because the service followed guidance from health and social care professionals.

Care files were personalised to reflect people’s personal preferences. People were supported to maintain a balanced diet, which they enjoyed. Health and socia

We gave very short notice of inspection time and date as they service only provides care and support for three people and we wanted to ensure we would have an opportunity to speak with everyone.

We spoke with all three people living at the service. All of these people have resided at the home for many years and regard themselves as ''part of the family''. Two people were able to give us their views about life at the home. We heard how people were involved in everyday life within the home, helping with shopping, preparing meals and doing light housework. One person told us ''I enjoy helping where I can, it makes me feel like I am helping and doing my bit.'' We heard how people choose what time they got up and retired to bed, where they spent their days and how they were supported to access the local community. One person told us ''I still enjoy going to the local day service to meet my friends once a week.'' One person is much frailer and tends to spend most of their time in their own room. We spent time with them, they appeared comfortable and content in their room. They told us they had ''just had a nice wash and breakfast.''

People told us they were well cared for, had a good range and choice of meals and were involved in making their own decisions. We heard how people could make their concerns known.

We heard from the registered provider how she now employed two people to assist with care and support for one person.

We carried out this unannounced inspection over three hours and spoke with all three people who live at the home. We also spoke with one care staff and the husband of the registered provider. We looked at some key records, these included care plans, risk assessments and monthly reviews of people’s needs. This helped us to make a judgement about how well the home was being run.

We found that people’s care was being well planned. People were involved in making decisions about their care and treatment. People we spoke with said that they were happy with their care and support. Comments included ‘’Liz (registered provider) looks after us well, this is my home.’’ ‘’I have been here a long time, we are like family and we are always treated well.’’

We saw that only one person was on medication and they had been assessed as being able to self medicate. There were systems in place should people need more assistance with medications.

There were enough qualified and competent staff to meet the needs of people living at the home. Most people have lived at the home for over 20 years and see themselves as ‘’very much part of the family.’’

We saw that records were well maintained, with any accidents or incidents being monitored as well as changes to people’s needs and wishes.

During this unannounced inspection we spoke to all three people living at the home. They all said they remained happy living there. Comments included

'had a lovely shower this morning, this is the best place I have lived. It's really good here.' 'yes I am quite happy, we enjoy living here' 'I have been here a very long time, this is my home and I am quite happy.'

We saw that plans of care had been developed and reviewed that show how peoples needs were being met and that risks had been identified. There were daily records kept to show what people had been doing each day and how their health is monitored.

We were told that two of the three people have regular opportunities to go out and about in the local community, both on their own and with carers. One person told us they no longer wished to go out as they were 'too old' and found they got out of breath and did not enjoy the outings.

We saw that meals and drinks were offered on a regular basis and that people could use the kitchen for drinks and snacks at any time. One person was unable to use the stairs unaided, but we saw that drinks and food were offered to them on a regular basis.

People we spoke to said that they felt safe and comfortable and had no complaints, but that if they had any concerns they would feel able to discuss them with the provider, 'Liz'.

The registered provider and her husband provide all of the care and support and know the people very well, having cared for them for 20 plus years. They provide care and support in a caring and respectful way, encouraging independence as much as possible. For example they encouraged people to get involved in the shopping, cooking and light household duties if they wished.

We saw that all three people's placements had been reviewed by the funding authority in the last six months and they were happy with the care and support provided by Broadpark House.

As the home was very small they had informal systems in place to review the quality of care and support provided. All three people said they were involved in the everyday decisions about their lives and how their care was provided.

This unannounced inspection took place on 28 August 2015. We returned on 7 September 2015 as arranged with the registered manager.

Broadpark House is registered to provide care and support for up to four people with a learning disability. The registered provider lives in the home and together with her husband, they provide the care. At the time of our visit there were two people living at Broadpark House.

When we visited there was a registered manager in post. 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.

Staff had not received up to date training specific to people’s needs. However, they would contact the relevant professionals if they noticed changes in a person’s physical or mental health.

Staff could not demonstrate an understanding of the Mental Capacity Act (2005). However, they would contact professionals if they were concerned about a person’s ability to make decisions. We found the service did not meet the requirements of the Mental Capacity Act (2005).

The service was unique in so far as it was more of a family home. As a result there were no formal systems and processes in place to ensure quality for people. The service ran in an informal way through on-going discussions with people on a constant basis.

People felt safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom.

Care files were personalised to reflect people’s personal preferences. People were supported to maintain a balanced diet, which they enjoyed. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were strong, caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate.