Burrow Down Residential Home is a residential care home for up to 14 people with a learning disability, which includes four ‘short breaks’ bedrooms for people on a respite stay. At the time of the inspection there were nine permanent residents and four people on a short break.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good:

People remained safe at the service. There were sufficient staff available to meet people's needs and support them with activities and trips out. Risk assessments had been completed to enable people to retain their independence and receive care with minimum risk to themselves or others. This is particularly important for people whose behaviour may challenge others. People received their medicines safely.

People continued to receive care from staff who had the skills and knowledge required to effectively support them. Staff were competent and well trained. People had the support needed to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice. People's healthcare needs were monitored by the staff and people had access to a variety of healthcare professionals according to their individual needs.

The staff were very caring and people had built strong relationships with the staff. We observed staff being patient and kind. People's privacy was respected. People where possible, or their representatives, were involved in decisions about the care and support people received.

The service remained responsive to people's individual needs and provided personalised care and support. People were able to make choices as much as possible in their day to day lives. Complaints were fully investigated and responded to. People were supported to take part in a wide range of activities and trips out according to their individual interests.

The service continued to be well led. Staff told us the registered manager was approachable. The registered manager and provider sought people's views to make sure people were at the heart of any changes within the home. The registered manager and provider had monitoring systems which enabled them to identify good practices and areas of improvement.

Further information is in the detailed findings below.

Burrow Down provides care and support for up to thirteen people. Burrow Down has nine permanent residents and operates a separate four bedded respite unit. Both units are for people with learning disability.

People were treated as individuals with respect and kindness.

People received 24 hour care and support tailored to their assessed individual need. The standard of service provided was based on peoples’ views, close monitoring of peoples health and by audits.

Staff worked hard to ensure people were supported to maximise their engagement with the local community and to promote peoples choices.

Each person had their own room and had access to either en-suite or shared bathroom facilities.

There were communal kitchen, lounge and dining room facilities, peoples’ nutritional needs and preferences were catered for.

Burrow Down is set in large grounds which people have can access whenever they wish, with support as required.

One person was subject to a Deprivation of Liberty Restriction.

The home had a full time registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. As with registered providers they are registered persons and have legal responsibility for meeting the requirements of the Health and Social Care Act, and the associated regulations about how a service is run.

People were supported by a staff team who were clearly skilled in their work with people who have learning disabilities. A programme of induction and ongoing training was in place. Recruitment of staff was robust. Staff reported the staffing ratios on each shift meant there were enough staff to deliver the care required. They felt well supported by their manager.

Staff knew people well, showing kindness and respect when interacting with them. People had a full programme of activities and made full used of the local community resources.

The registered provider demonstrated that it was responsive to peoples changing requirements, with regular reviews and audits. There were regular meetings for staff and people, and quality audits involving families/friends and advocates. Action from feedback obtained at these meetings was incorporated in ongoing care plans which were regularly reviewed.

We carried out the visit as part of a planned schedule of inspections.

Since the last visit the provider had decided to submit an application to The Care Quality Commission (CQC) to reduce its registered beds in the residential home and short breaks service to one location. The home has been divided into two services. The application to the Care Quality Commission (CQC) will be for the provision of personal care in one location; the residential beds will be reduced to nine from sixteen beds and short breaks six beds incorporating The Lodge which will be four beds and The Cottage two beds.

We arrived early to meet the people who use services and before some people go off for day services.

We met with the deputy manager and manager designate and the three members of staff who were on duty. The member of staff who met us at the door followed the correct procedures for allowing us to enter the home and asked us to sign the visitors' book.

There was a buzz of activity in the dining room and kitchen with people preparing their own breakfast. One person said "I have decided to have cereal and toast for breakfast".

We made contact over the telephone with three parents and one relative. They were very happy to offer their observations about the service. One person said "living at the home has changed X's life".

Management were pleased to show us the new care plans they had been working on. The care plans were person centred.

On our visit we spent time with the people living at the home, talking about their day. We also shared an evening meal with them. People told us they enjoyed living at the home and that the staff supported them well. People told us about the activities they enjoyed and we saw people exercising choice in how they spent their time and with the food they ate. People told us "we can have different things if we want. We can tell the staff what we want." People were happy and confident in the company of the staff on duty, who clearly knew them and their needs well.

We saw that staff were recruited following effective recruitment and selection procedures. We saw there were systems in place for people to raise any concerns they had and to have a say in the way the home was being run. We saw that people had been involved in developing person centred plans, which included their aspirations, wishes and dreams for the future.

We saw that medication was being managed well, and that people received the medication that was prescribed for them when they needed it. People’s healthcare needs were being met, and we saw staff working well to reduce people’s fears around medical treatment.

People told us "I can choose what I want to do. I have my own room and can go there when I want some space for myself. "

We spoke to five people living at the home, and spent time with them while they were eating their evening meal, which was shared with staff.

People that we spoke to, including visiting professionals to the service, told us that the home was good at supporting people through a transition into new services and worked well with relatives and other supporters in a collaborative way.

People living at the home told us: "We get to do things we like. I have friends here" and "Staff listen to what we say, and I help make the food".

People living at the home were clearly comfortable with the staff on duty and felt able to discuss things with them. One person we spoke to told us that they would tell the staff or their family if something happened that they did not like or were uncomfortable with.

We saw evidence that staff had the communication skills to assist people including using supported communication methods, such as Makaton and the use of photographs and symbols. Staff also had clear guidelines and protocols for managing behaviours that challenge, which helps ensure people are supported consistently and in accordance with good practice. On the day we visited two people were unwell and the service had changed plans so that they could spend the day in bed.

People we spoke to told us that the staff supported them well. A member of staff ate their evening meal with people living at the service, which helped to engender a sense of community and encouraged people to talk about their day.