Churchfield Avenue provides accommodation and personal care for up to nine younger and older adults with a learning disability and/or autistic spectrum disorder. At the time of our inspection there were nine people living at the service.

The service had 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.

This inspection was carried out on 26 June 2017 and was an announced inspection. At the last inspection on 7 July 2015, the service was rated as ‘good.’ At this inspection we found the service remained ‘good.’

Staff demonstrated their knowledge of how to report incidents of poor care and harm. Staff helped people in a way that maintained their safety and people were looked after by staff in a kind and patient manner. Staff supported and encouraged people to make their own choices and live as independently as possible. People were treated with respect and people’s privacy and dignity were promoted by staff.

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 looked after by enough, suitably qualified staff to support them safely with their individual needs. Staff enjoyed their work and were supported and managed to look after people. Staff understood their roles and responsibilities in meeting people’s needs and they were trained to provide effective and safe care. Staff were supported to maintain their skills by way of supervision, competency checks, and appraisals.

Staff were only employed to look after people once all pre-employment checks had been completed and were found to be satisfactory.

People’s care arrangements took account of people’s wishes and choices, including their likes and dislikes and future goals. People’s care plans recorded their individual assessed needs and any assistance they required from staff. Risks to people who lived at the service were identified, and plans were put into place by staff to monitor and minimise these risks, as far as possible, without limiting people’s independence.

People were supported to take their medicines as prescribed and medicines were safely managed by staff who were trained, and whose competency had been assessed. Where there had been any errors in the administration of people’s medicines, these had been identified and dealt with to reduce the risk of recurrence.

The service was flexible and responsive to people’s needs. People were encouraged to maintain contact with their relatives and friends when they wished to do so. Staff assisted people to maintain their links with the local community and encouraged them to continue with any hobbies or interests.

People were supported to eat and drink sufficient amounts of food and fluids. People’s choice about what they wished to eat and drink was promoted and supported. Staff monitored people’s health and well-being needs and acted upon issues identified by assisting people to access a range of external health care services.

There was a process in place to manage any concerns and complaints received.

Arrangements were in place to ensure the quality of the service provided for people was regularly monitored. People who lived at the service and staff were encouraged to share their views and feedback about the quality of the care and support provided. Actions were taken as a result to drive forward any improvements required.

Further information is in the detailed findings below.

Churchfield Avenue is registered to provide accommodation and non-nursing care for up to nine people who have a learning and physical disability. At the time of our inspection there were nine people using the service.

A registered manager was not in post at the time of the inspection and there had not been a registered manager since 19 November 2014. 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. Recruitment of a permanent manager was in progress when we visited the home.

At our unannounced inspection on 18 June 2014 the provider was meeting the regulations that we had assessed against. The inspection of 07 July 2015 was unannounced and was carried out by one inspector.

People were safe and staff were knowledgeable about reporting any incident of harm. People were looked after by enough staff to support them with their personal care and safety needs. However, there were times when there were not enough staff to provide people with one-to-one quality care to support them with their individual choices. Pre-employment checks were completed on staff before they were judged to be suitable to look after people who used the service. People were supported to take their medicines as prescribed and medicines were safely managed.

People were supported to eat and drink sufficient amounts of food and drink. They were also supported to access a range of health care services and their individual health needs were met.

People were supported by staff who were trained and supported to do their job, which they enjoyed.

The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Some DoLS applications had been made to the appropriate authorities to ensure that the rights of people’s rights were protected. Other DoLS applications were in progress although people had not had their mental capacity assessed to justify why the DoLS applications were to be made.

People were treated by kind, respectful and attentive staff. They and their relatives were involved in the review of people’s individual care plans.

Support and care was provided based on people’s individual needs and they were supported to maintain contact with their relatives and the local community. People took part in a range of hobbies and interests. There was a process in place so that people’s concerns and complaints were listened to and would be acted upon.

Following the last registered manager, a manager was appointed but they had left before they became registered with the CQC. Interim management arrangements were in place whilst a permanent manager was recruited. Staff enjoyed their work and were supported and managed to look after people in a safe way. Staff, people and their relatives were able to make suggestions and actions were taken as a result. However, due to current staffing numbers, people’s suggestions were not always acted on. Quality monitoring procedures were in place and action had been taken where improvements were identified.

An adult social care inspector carried out this this inspection on 18 June 2014. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

As part of this inspection we met with six people who used the service, two family members of people who used the service, a healthcare professional who was in regular contact with the home, the registered manager and six members of staff. We reviewed records relating to the management of the service which included three care plans, daily records, the premises, staff recruitment records and quality assurance monitoring records.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at

Is the service safe?

Risk assessments regarding people’s individual needs and activities were carried out and arrangements were in place to minimise potential hazards. Staff understood their roles and responsibilities in making sure people were protected from the risk of harm or abuse. The provider ensured that only staff who were suitable to work with vulnerable people were employed. The premises were well maintained and met the needs of people living in the home. Refurbishments and redecoration of some areas of the home were planned and would be completed in the next few weeks. We saw that arrangements regarding Mental Capacity Acts (2005) assessments were in place, where necessary, to ensure that people who could not make decisions for themselves were protectedIs the service effective?

We found that carers were knowledgeable about people’s individual care and support needs. Observations we made during our inspection confirmed that the care staff provided friendly and consistent support when assisting people with personal care. Care and support was regularly reviewed with any changes recorded to ensure that people received up to date care. People were also able to make choices regarding how they wished to spend time during the day either at home, or when accessing facilities in the wider community.

Is the service caring?

Observations made during our inspection showed that people received warm, consistent and friendly support from care staff and they were enabled to make choices and changes when required. One person told us that, “I am very happy living here.” Staff told us that they were very well supported and supervised by the manager and senior staff so that they could provide safe care and support to people.

Is the service responsive?

We saw that people’s personal care and social support needs were assessed and met by staff. This also included people’s individual choices and preferences as to how they liked to be supported. We observed that people could make changes to their support and had been involved in reviews of their support as much as possible. We saw that regular reviews were in place to update people’s care and support needs.

Is the service well led?

The home was effectively managed and staff told us that they felt very well supported and were regularly trained so that they could safely provide care and support. Observations made during our inspection showed that staff were responsive and attentive so that people were supported consistently and safely. Health and safety checks were in place to monitor the safety of the services that were provided. The service gathered opinions from people who used the service, their relatives and staff to identify any improvements that could be made to the service.

The majority of people that we met with during our inspection on 19 June 2013 were not able to tell us about the care and support they received whilst living in the home, due to their complex needs. However, observations made during our visit showed that people were satisfied and happy with the assistance they were receiving from care staff. One person we spoke with told us, “I am very happy living in the home and the staff are kind to me.”

Care and support was regularly reviewed to ensure that peoples’ needs were being met. There was evidence of people’s agreement and involvement in the planning of their care and support.

Staff were trained in safeguarding people from harm and had access to policies and information about how to contact the local authority safeguarding team.

There were regular staff supervision and ongoing training sessions in place to ensure that staff could safely deliver care and support to people.

The home had an effective system to regularly assess and monitor the quality of the service that was provided to people.

During the visit we saw that a sample of care plans were up to date and contained information and guidelines for staff when assisting people with their care and support needs.

We saw that there were thorough processes in place for the administration, storage and stocktaking of medication prescribed for people using the service.

Improvements had been made to the premises and rear garden following the compliance action made during our inspection on 5 May 2012.

There were improved arrangements in place for the regular supervision of care staff so that their work performance and development needs were monitored.

People we spoke with told us that they were involved in discussing their care and support needs with their key worker and other care staff. People told us that they liked their personal bedroom space and were able to choose colours and furnishings and have their own personal belongings.

People told us that they were assisted to go out regularly and receive individual assistance from care staff to meet their needs. We observed people being able to raise any issues with staff throughout the day.

The people at the home were able to communicate verbally but were unable to comment on all aspects of the support provided. They were able to tell us what they had been doing on that day, and talked about planned outings and holidays. We noted that the interactions between staff and the people living in the home were positive, with people involved in making choices about everyday activities. However, we observed that for some people using the service there were long periods of inactivity resulting in boredom and frustration. One person’s attention was engaged by a member of staff and this was positive for the person.