The inspection took place on 28 and 29 November 2018 and was announced.

Care at Stennings is registered to provide accommodation for persons who require nursing or personal care, for a maximum of eight people. At the time of the inspection eight people with a learning disability were living at Care at Stennings. Accommodation is provided in eight single bedrooms within two houses which are linked together by a conservatory. Each house has a shared kitchen, dining room and lounge. The gardens at the front and rear are secluded and accessible to the people living at the home.

Care at Stennings 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.

The service was built and registered before the publication of the Registering the Right Support best practice guidance. However, it is 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.

There was a registered manager in post at the time of the inspection. One of the providers was also registered as a registered manager at Care at Stennings. 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 provider had not ensured that we were notified of all safeguarding incidents, which they are required by law to do.

People were supported to have choice and control in most aspects of their lives and staff them in the least restrictive way possible; the policies and systems in the service had not always supported this practice. However, this was addressed by the registered manager following the inspection.

Quality assurance systems and the actions taken were variable. Areas highlighted for improvement, had not always been acted on. However, other quality assurance completed had been used to improve the service.

People told us that they felt safe at Care at Stennings. Risks to people and about the environment were considered and managed. Risks around infection control were mitigated.

There was a positive and person-centred culture. People were treated with kindness, compassion and respect. One person’s relative told us, “He loves going back there.” People’s privacy and dignity was protected. People knew how to make complaints and felt confident to talk to staff or the registered manager if they needed to.

People’s health, social, physical and emotional needs were assessed for each person and their support planned for. People were involved in reviewing their support and setting goals to achieve or maintain. People were encouraged to be independent where possible and take part in household tasks.

People were supported to access regular healthcare support as needed. Medicines were managed safely.

People took part in activities which matched their interests. One person told us, “I go out on the bus, to the cinema and shopping.” Some people attended colleges and day centres. Some people took part in voluntary work.

Staff were recruited using safe recruitment practices. New staff were supported with an induction training programme. Staff received regular training and supervision to ensure they had the right skills to support people. One person told us, “I like them, I get on well with staff.” Staff worked well together and in partnership with other professionals and agencies.

People, their relatives and staff’s views of the service provided were sought. The provider regularly visited the se

The comprehensive inspection took place on 9 and 15 February 2016. Care at Stennings is a care home that is registered to provide accommodation, care and support for up to eight adults with learning disabilities. Accommodation is provided in 8 single bedrooms within two houses that are linked together by a conservatory. The garden at the front and rear are secluded and accessible to the people living at the home. The home is located in the village of Copthorne with access to public transport, local convenience shops, chemist and the local community. People living at the service, relatives and staff referred to the service as “Stennings.” At the time of the inspection there were eight young adults with learning disabilities living at the home.

The service has 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, relatives and staff spoke highly of the registered manager.

Some key principles of the Mental Capacity Act 2005 (MCA) were not being consistently applied. Staff were not always clear about how to ensure that proper consideration was given to matters of consent to empower people to make their own decisions in line with the MCA. Staff had received training and demonstrated a good understanding of the principles of the MCA however there were some inconsistencies in their practice regarding assessing people’s capacity in relation to managing some or all of their medicines. In other areas of practice staff were working within the principles of the MCA and Deprivation of Liberty Safeguards (DoLS).

People told us they felt safe living at Stennings, one person said, “I feel safe because they don’t just let strangers come in.” Staff had a clear understanding of their responsibilities in regard to keeping people safe from harm and abuse, and risks were identified and managed appropriately. A relative told us, “I’m really happy with the care, we know (person’s name) is safe and well cared for and that’s such a relief.” Staff had been recruited through a safe and robust process with appropriate checks made to ensure they were safe to work with people. There were sufficient staff to ensure people were safe and had their needs met. Staff were knowledgeable and well supported. Training opportunities were good; one staff member said “The manager is always offering and suggesting training for us.” Staff were knowledgeable about the needs of people with learning disabilities.

Medicines were stored and managed safely and people were supported with their health care and dietary needs. People were supported to be as independent as possible in choosing and preparing their meals. One person told us, “I usually decide myself when to eat, I sometimes need a bit of help from staff but I can do quite a lot on my own,” There were regular opportunities for people to eat out and they told us they looked forward to these occasions.

People were supported by staff who were caring and compassionate. People’s relatives spoke highly of the caring nature of the staff. One relative told us, “I feel blessed that (person’s name) is able to live there, the staff do so much, I can’t fault the care.” Staff spoke about their roles with enthusiasm and commitment, one commented, “I love helping the service users, if you don’t feel that way you wouldn’t work here.” Throughout the inspection we saw positive interactions between people and the staff with numerous examples of staff listening to people and consistently responding in a positive way. People told us they liked the staff and appeared happy and relaxed in their presence.

Staff were clearly focussed on providing personalised care and had a good understanding of people’s needs and how to supp

During our inspection at Stennings we spoke with the manager, members of staff and four of the people living at the home. We found arrangements were in place for making sure that people were asked for their consent in relation to their care and treatment. We found that staff had the relevant training that enabled them to uphold people’s rights where deemed appropriate.

People we spoke with told us that they were happy at the home and said; “staff are very supportive”, “my keyworker help me a lot”, “I make my own decision”, “I go home at weekend”. One person said, “I enjoyed my holiday at Disneyworld Paris”.

We found that there were an array of meaningful activities both in house and outside on offer to the people living at the home. We observed the enthusiasm of individual getting ready to go the gym in the morning and same for swimming in the afternoon.

We found that there was a robust recruitment process in place and staff were well supported by management. The manager said that the selection process for staff recruitment was to reflect the needs of the young adult who used the service.

We found that there were appropriate arrangements for making sure that medicines were stored, administered and recorded properly. There were evidence that staff had training in the administration of medication.

There were effective systems in place in term of records management at Stennings. All records were securely locked and accessible to designated members of staff only.

We found people’s dignity and privacy was respected by staff in the way in which people were cared for. We found people were involved in the decision making of the home and they were supported by staff to engage in community activities.

The provider told us people were pre-assessed prior to admission to the home. To support people to make the move to living at the home overnight visits were provided to ensure people experienced a smooth transmission to their new environment.

During the visit we observed staff engaged with people in a warm and supportive manner. We noted information was displayed in different forms to meet the needs of the people living in the home. For example we noted information was displayed in pictures and other visual aids.

We found people were protected from the risk of abuse as staff were trained in safeguarding. We found the staff were knowledgeable and knew how to raise a safeguarding alert if there were concerns about people safety.

Staff told us they were supported to deliver care and treatment to people at an appropriate standard. We reviewed records and saw staff were regularly supervised and they were appraised annually.

The provider had a system in place to monitor and assess the quality of the service they delivered.