Clayton House 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 home is a registered location of Outreach 3-Way. The home specialises in providing care to people who have a learning disability. There were six people at the home at the time of the inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on- going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People felt safe at the service and staff and the registered manager were aware of their responsibilities for ensuring that people were kept safe and that any concerns were reported. Checks such as identity and criminal records checks were carried out on new staff as part of the recruitment process. Staffing levels were suitable to meet the needs of people who used the service. Medicines were managed safely and staff were assessed to ensure they were competent to support people to take their medicines.

At the last inspection, Mental Capacity Act (MCA) assessments were not clear in people’s records and the registered manager was in the process of applying for DoLS authorisations. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

At this inspection we found clear MCA assessments to support people’s DoLS applications. People can only be deprived of their liberty so that they can receive care and treatment when this is in their best interests and legally authorised under the MCA. The authorisation procedures for this in care homes are called the Deprivation of Liberty Safeguards (DoLS).

People are 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 had their needs assessed and care was planned using best practice guidance. People said they were involved in reviewing their care and relatives were invited to attend reviews. People were observed making choices and were supported to maintain a healthy lifestyle. Staff received training and support which allowed them to provide care to people in a safe way.

Staff were observed being kind to people and respecting their dignity and independence. People’s views were collected and people were able to voice their opinions about the service. Staff were aware of how people communicated and were sensitive to how some people needed more time to communicate. People told us they liked the staff and got on well with them.

People’s preferences and choices were reflected in their care plans. The service took account of people’s individuality and supported them to maintain their individual interests. People knew how to raise concerns and were provided with information in a way they understood.

There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. People told us they liked the registered manager and staff and were comfortable at the service. Staff felt they were able to approach the manager and felt listened to. Governance structures had been put in place by the provider so that information could be shared and lessons learned in

We inspected Clayton House on 11 November 2015. This was an unannounced inspection. Clayton House is a residential care home that provides accommodation and support for six people. The people living there are people with learning disabilities. On the day of our inspection there were six people living at Clayton House. Clayton House is a detached house spread over three floors. People’s bedrooms were situated on the first floor. The house is set within a garden. Homes to the side and back are also managed by the same provider.

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. The registered manager was also the registered manager for the two other of the organisation’s locations adjacent to Clayton House.

People felt safe living at the home. Assessments of risk had been undertaken and there were clear instructions for staff on what action to take in order to mitigate the risks. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe from harm and abuse. The registered manager made sure there was enough staff on duty at all times to meet people’s needs. When the provider employed new staff at the home they followed safe recruitment practices.

Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

People were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Although the registered manager and staff understood the principles of the mental capacity act clear consideration of capacity was not clearly recorded in people’s files and DoLS referrals were identified as needing to be made. This was an area that needs improvement.

Staff received training to support them with their role on a continuous basis to ensure they could meet people’s needs effectively. The training records we saw demonstrated that staff had completed a range of training and learning to support them in their work and to keep them up to date with current practice and legislation.

People told us they liked living at Clayton House. One person told us “I like this place, I’m glad I moved in”. Relatives and health and social care professionals spoke positively of the service. They were complimentary about the caring, positive nature of the staff. We were told, that staff were “most definitely kind” and “It’s a very happy home”. Staff respected people’s privacy and dignity and their individual preferences. Our own observations and the records we looked at reflected the positive comments people made.

People had access to and could choose suitable educational, leisure and social activities in line with their individual interests and hobbies. These included day trips, shopping and attending a day centre. We observed and were told about the activities people liked to do which included playing football, trips to the cinema and going to car boot sales. Each person had a personal timetable for the week. These detailed what activities they were involved in. The provider had forums that consulted and included people in the running of the organisation.

There were clear lines of accountability. The home had good leadership and direction from the registered manager. Staff felt fully supported by their manager to undertake their roles. Staff were given regular training updates, supervision and development opportunities. Peoples relatives, staff and professionals who knew the service spoke positively about the registered manager and said they led by example. A relative said about management “there’s nothing we feel we can’t discuss with them”.

We were unable to speak with people who lived at the home on this occasion as they were not present during the course of the inspection. We gathered evidence of people's experiences by speaking with two relatives on the telephone, two staff members and by reviewing care records and relevant policies and procedures.

A relative told us, "The home is excellent. They really care and keep me well informed". We noted that the home provided a wide range of social, educational and work opportunities.

We saw that people's consent was sought, wherever possible, before care and support was provided. We found evidence that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and their preferences were taken into account.

People were protected from the risks associated with poor medication management. We noted that medicines were properly handled and administered in line with the provider's policy. We found evidence that there were sufficient numbers of experienced staff to provide good care. We also found that systems were in place for people and relatives to make a complaint about the service if necessary.

We were not able to speak to people using the service because they were not available during our inspection. We gathered evidence of people’s experiences of the service by speaking with two staff members, a person’s parents who had come to see the manager and by reviewing care records, staff training records and policies and procedures.

Visitors told us that communication was excellent and that they had full involvement in the care of their relative.

We saw that people's privacy and independence were respected, people experienced safe and effective care based on detailed care plans and risk assessments that met individual needs.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding vulnerable adults.

We saw evidence that staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of people.

The Provider had effective systems in place to monitor quality assurance and compliance.