Crawford Care Home is a residential care home for up to 11 people living with a learning disability and/or other mental health and physical needs. At the time of our inspection, the home was fully occupied. Crawford Care Home is situated close to the seafront at Bognor Regis and public transport. The home forms part of a Victorian terrace and accommodation is provided over three floors. The ground floor communal areas comprise a kitchen, dining room, sitting room and quiet lounge. All rooms are of single occupancy.

At the last inspection, the service was rated Good. At this inspection, we found the service remained Good.

A creative and innovative approach had been developed to ensure that people received care that was centred on them. People were actively encouraged to be involved in all aspects of their care. Systems had been implemented to ensure people understood information relating to their care and that enabled them to be actively involved in reviewing their care plans with staff. Care plans were drawn up in an accessible format in line with the Accessible Information Standard. Where people displayed behaviour that might be perceived as challenging, staff supported them by deflecting their attention and diffusing the situation. A system of positive rewards had been put in place whereby people could gain gift certificates resulting in a choice of a particular additional activity that they would like to engage in. Activities were organised in line with people’s preferences. People could choose which staff they would like to support them as they had access to staff profiles which provided information about staff, their interests and hobbies. People were actively involved in developing the service and helped interview new members of staff. People were encouraged to engage with communal activities and information to assist people with this was being drawn up by staff.

People felt safe living at the home. Staff had been trained to recognise the signs of potential abuse and knew what action to take if they had any concerns. Risks to people were identified, assessed and managed appropriately. Care plans provided detailed guidance for staff on how to mitigate risks. Staffing levels were sufficient to meet people’s needs. New staff were recruited to ensure they were safe to work in the care industry. Medicines were managed safely. The provider had an accessible complaints policy in place. No complaints had been received or recorded recently.

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. Staff had completed training on the Mental Capacity Act (2005) and understood the requirements of this legislation and under the Deprivation of Liberty Safeguards. Staff completed training in a range of areas to enable them to support people safely. Regular supervision meetings took place, together with staff meetings. People were encouraged to maintain a healthy lifestyle with support from healthcare professionals. Their nutritional needs were met appropriately.

People were looked after by kind and caring staff who knew them well. Positive, caring relationships had been developed. As much as they were able, people were involved in decisions relating to their care. People were treated with dignity and respect and their spiritual needs were recognised and catered for.

People were asked for their feedback and suggestions about the service through residents’ meetings. Feedback was also obtained through formal surveys and a separate questionnaire was completed by family and friends. All responses rated the service as either excellent or good. Staff were involved in the service and some were responsible for taking the lead in certain areas such as safeguarding and infection control. Staff felt supported by management. A range of audits had been put in place t

An adult social care inspector carried out this inspection. 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 spoke with seven of the 11 people who use the service, the registered manager, the registered provider and four members of staff. We also reviewed records relating to the management of the home which included four care plans, daily care records and the accidents and incidents logs.

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

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

The home had policies and procedures in place in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant people were safeguarded as required.

Staff were well supported to carry out their duties and were encouraged to participate in ongoing training opportunities Staff we spoke with had been.working at the home for a number of years and were happy in their work. This meant people were supported by a staff team who were suitably qualified and able to provide continuity of care. One member of staff told us; "It's not like coming to work, it's more like having a second family".

People's health and care needs were assessed with them and they were involved in the development of their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said they had been involved in the planning of their care and care plans reflected their current needs and wishes.

The premises were found to be in a poor state of repair and did not meet required standards of repair, safety and cleanliness. A compliance action has been set for this and the provider must tell us how they plan to improve.

Is the service effective?

There was an advocacy service available if people needed it, this meant people could access additional support when they required it.

People's health and care needs were assessed with them and they were involved in the development of their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said they had been involved in the planning of their care and care plans reflected their current needs and wishes.

Is the service caring?

People were supported by kind and attentive staff. We saw staff were patient and gave support and encouragement to people. One person said; "The staff are my friends, they help me with my arts and crafts and take me out lots". Staff treated people with dignity and respect.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support was provided in accordance with people's wishes.

Is the service responsive?

People had access to a range of daily activities both inside and outside of the home and were encouraged to make suggestions regarding the activities they wished to participate in.

People knew how to make a complaint if they were unhappy and details of the complaints procedure was easily accessible to people. People we spoke with told us they had no complaints to make. We saw there was a complaints log, but no entries had been made since the last inspection. The manager told us regular house meetings ensured people and staff had the opportunity to discuss issues or concerns before they became a complaint. This showed us people were happy with the service they received.

Is the service well led?

We saw systems were not in place to help ensure managers and staff learn from events such as accidents and incidents, complaints and concerns. This increased the risk to people and demonstrated systems were not in place to continually improve the service. A compliance action has been set for this and the provider must tell us how they plan to improve.

People who used the service, their relatives, friends and other professionals involved with the service completed a satisfaction survey every six months. Actions taken and learning outcomes had not been recorded.

The service had quality assurance systems in place, but opportunities for reflective learning were not included. Records of actions taken and letters of acknowledgement had also not been recorded. As a result, the quality of the service was unable to continually improve.

Systems to maintain the safety, cleanliness and hygiene of the environment were in place, but checks to ensure they had been effectively carried out had not taken place.

Staff told us they were clear about their roles and responsibilities and had a good understanding of the ethos of the home.

During this inspection we spoke with three people who used the service and three members of staff.

People told us they liked living at Crawford Care home and that staff were friendly.

One person told us, "You don't want for anything".

Another person told us, "I like living here. I like the food and the staff".

We observed that people and staff interacted in a relaxed, calm and friendly manner. We observed people being offered choices.

We saw people's individual records and saw that they had been involved in the planning of their support. Staff demonstrated that they knew how care was to be delivered in line with people's wishes and preferences.

We looked at records relating to staff recruitment. They showed us that the provider had effective recruitment and selection processes in place.

Staff told us they liked working at Crawford Care home and felt supported by the management team. One told us, "I love working here, it has a family feel".

We looked at how the provider stored, handled and administered medicines. We saw that there were appropriate arrangements for the management of medicines.

We looked at complaint records and saw that people were supported to make complaints when they were unhappy with aspects of the service. The service had an effective complaints procedure.

During this inspection we spoke with seven people who used the service and three staff members.

People told us that they liked living at Crawford care home. They told us that staff were very supportive and helpful. People said they had a busy and varied activity programme that included going to college and adult education classes, support groups, clubs and trips out.

One person said, “The staff know when I need support and they are there for me.”

Another person said, “I really like it here, I have a nice room and plenty to do.”

Staff told us that they feel supported by the provider to carry out their roles; they enjoyed working at the home and had a wide range of training.

The inspection took place on 2 and 4 June 2015 and was unannounced. At the inspection held in July 2014, compliance actions were set under Regulation 15 – Safety and suitability of premises and Regulation 10 – Assessing and monitoring the quality of service provision. These regulations relate to the requirements under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Since April 2015, this legislation has been replaced with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, we found that improvements had been made and the service was meeting requirements.

Crawford Care Home provides care and support for up to 11 people with a learning disability and/or other complex needs. At the time of our inspection, there were 11 people living at the service. Crawford Care Home is situated within a few minutes’ walk of the esplanade at Bognor Regis and the town centre is easily accessible. The home is a Victorian terraced house with extensive accommodation and a small yard at the back where people can sit. All bedrooms are single occupancy and everyone has access to communal areas which comprise a sitting room, dining room and kitchen.

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.

Premises and equipment were managed to keep people safe. The premises have undergone recent redecoration and refurbishment. People knew what action to take in the event of an emergency and staff were trained in fire evacuation procedures. Risks to people were managed so that they were protected. Assessments provided information and guidance to staff on how to keep people safe whilst still protecting their independence. Staff had been trained in safeguarding and knew what action to take if they suspected people were at risk of harm. Staffing levels were sufficient and the service followed safe recruitment practices. Medicines were ordered, stored, administered and disposed of safely.

Staff were trained in all essential areas and had achieved at least a level 2 qualification in health and social care. They had regular supervision meetings with senior staff and annual appraisals. New staff underwent a comprehensive induction programme and shadowed experienced staff to understand how to deliver care and get to know people. Staff understood the requirements of the Mental Capacity Act 2005 and associated legislation under the Deprivation of Liberty Safeguards. They put what they had learned into practice. Physical restraint was not used with people, but staff had been trained in its use. Appropriate risk assessments in relation to this had been drawn up for people. People were supported to have sufficient to eat and drink and to maintain a healthy diet. They had access to a range of healthcare professionals as needed.

Warm, friendly relationships had been developed between people and staff. People felt relaxed and happy in the company of staff and met with their keyworkers regularly to discuss all aspects of their care. They knew how to report a complaint. People’s dignity and privacy were respected and staff worked with people to promote their independence.

Care plans provided detailed information about people which enabled staff to support them in line with their needs, preferences and choices. People were encouraged to participate in a range of activities which were either organised by the service or they could pursue activities of their choice. People had opportunities to access educational courses to help them to become more independent and build their self-confidence and self-esteem.

Audit systems were in place to measure the quality of care provided at the service. There was a separate audit for medicines management and another for care plans, all of which were fit for purpose. People were involved in developing the service and helped to interview new staff. Staff felt well supported by management who were always on hand when needed.