People’s experience of using this service:

Relatives were very happy with the quality of care and support provided by the home. Feedback included, “I am ecstatic about the care; the staff are wonderful and my relative is content.”

People were protected from harm through robust risk assessments and staff took a clear and consistent approach to reduce the risks to people. People received their prescribed medication at the right time and medicines were stored and managed safely.

Managers investigated any incidents thoroughly and ensured plans were put in place to reduce the risk of further harm.

People were supported by staff who were skilled and well trained for their role. People lived in a spacious and well decorated home which allowed them to choose where to spend their time and enabled them to take part in activities they enjoyed.

People’s capacity had been assessed and where people lacked capacity to consent to support, care was taken to ensure decisions were made in people’s best interests. This included involving advocates and relatives in decision making processes.

We saw that staff spent time with people and took part in activities that people enjoyed. Staff knew people’s likes and routines well and ensured that people’s preferences for care and support were followed.

Staff and relatives were happy with the way the service was led and managed. Comprehensive audits and checks were carried out on a regular basis and action was taken to address gaps in practice and staff performance.

Rating at last inspection:

At the last inspection, the service was rated Good (10 February 2016)

About the service:

Cole Bank Road is a residential care home that provides personal and nursing care for people with learning disabilities, autism and/or mental health difficulties. At the time of the inspection there were seven people using the service, although two people were in hospital at the time of the inspection.

The care service has been developed in line with the values that underpin Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism can live as ordinary a life as any citizen.

Further details about the service can be found in the full report.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Enforcement:

No enforcement action was required.

Follow up:

We will continue to monitor the service through the information we receive.

Most people could not give us their views of the service because of their complex needs and conditions. We used a variety of ways to understand their experience of the service including spending three hours in the communal areas of the home observing how people were cared for. We found that people's needs were assessed to establish the care that they needed and care was planned and delivered in a way that was intended to ensure people's safety. One person told us "Yes I'm well, I'm always well."

One relative told us "The staff were able to answer all of my questions straight away...I was able to bring my [relative] for a good few visits before they came in so that they could adjust to the new environment and meet the other residents... All the staff were so kind and considerate and this had made it easier for my [relative] to feel relaxed about the move."

People were supported to eat and drink sufficiently and we found that people's nutritional needs were clearly addressed. Staff received the necessary training to support people's ability to take nourishment safely.

People were cared for in a clean, hygienic environment and were protected from the risk of infection because appropriate guidance had been followed.

Records, including people’s personal records were accurate and fit for purpose. Care files were well structured and clearly organised with up to date and relevant information. Records were kept securely and could be located promptly when needed.

We visited the service on 9 November 2012 and met all of the people living in the home at that time. Most people were not able to give us their views on the service because of their complex needs and conditions. We used a variety of ways to understand their experience of the service including spending three and a half hours in the communal areas of the home observing how people were cared for. One person was able to speak with us and they told us that care workers always asked them what they wanted to do and helped them to do it.

There were sufficient numbers of staff on duty to meet people's needs and people looked at ease with their care workers. One person told us that they liked living at the home and that staff gave them a lot of help and were friendly.

People's needs were assessed and support plans covered a wide range of their needs. Plans included agreed strategies for managing identified risks to their welfare. People were supported to access other health and social care services and records were kept of contact and appointments. Families were encouraged to continue to contribute to the care of their relative. Clear strategies were in place for care workers to follow in order to protect people who were at risk of specific harm.

The design and layout of the premises was suitable for people who used it, enabled their independence and people moved around the home comfortably.

This inspection took place on 17 and 26 November 2015 and was unannounced.

This home provides accommodation and care for up to seven people with learning and/or physical disabilities. At the time of the inspection there were six people living in the home, the majority of whom had lived there for several years.

At the time of the inspection, the home had 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.

We found that this home had a homely atmosphere. The people who lived there moved around freely and chose how they wanted to spend their time.

People indicated by gestures and body language that they felt safe in this home. Staff demonstrated that they knew how to keep people safe and they knew how to report allegations or suspicions of poor practice.

People were protected from possible errors in relation to their medication because there were good arrangements for the storage, administration and recording of medication. There were good systems for checking that medication had been administered in the correct way.

People who lived in this home told us, or indicated by gestures that they were happy. People’s relatives told us that they were pleased with the care provided and they found the staff approachable and helpful.

People had opportunities to participate in a range of activities and educational opportunities inside the home and in the community. People were encouraged to develop independence skills and were helped to maintain contact with relatives and friends.

Throughout our inspection we saw examples of and heard about good care that met people’s needs. People and, where appropriate, their relatives were consulted about their preferences and people were treated with dignity and respect.

Staff working in this home showed that they had a good understanding of the needs of the people who lived there. We saw that staff communicated well with people living in the home and each other. People were enabled to make choices about how they lived their lives.

Staff were appropriately trained, skilled and supervised and they received opportunities to further develop their knowledge. The registered manager and staff we spoke with demonstrated that they understood the principles of protecting the legal and civil rights of people using the service.

People were supported to have their mental and physical healthcare needs met. Staff made appropriate use of a range of health professionals and encouraged people to maintain a healthy lifestyle.

People were provided with food which they enjoyed and which met their nutritional needs and suited their preferences.

There was effective leadership from the registered manager to ensure that all members of the staff team were competent. The registered manager played an active part in the home and operated an open culture, where staff and people in the home felt valued and supported.

The registered manager and other managers in the organisation assessed and monitored the quality of care through observation and regular audits of events and practice. The registered manager consulted people in the home, their relatives and professional visitors to find out their views on the care provided and used this information to make improvements, where possible.

The registered manager checked to see if there had been changes to legislation or best practice guidance to make sure that the home continued to comply with the relevant legislation.