The inspection took place on 2 February 2017 and was announced. At the last inspection in July 2014, the service was rated Outstanding. At this inspection we found the service remained Outstanding.

There was a registered manager in post at the service. 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.

Derwent Cottages is a care home for four adults with a learning disability and/or autistic spectrum disorder. It is part of a group of services known as Voyage Care which is a UK wide organisation. The service is a family home over two floors. There is a lift to enable access to the first floor. Each person had their own bedroom and bathroom. There were four people living at the service at the time of the inspection.

Staff worked within the principles of the Mental Capacity Act in every aspect of their work with people. 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.

We saw that people were safe and a relative and professionals confirmed this. Staff had an excellent understanding of safeguarding and were aware of types of abuse and how to report incidents. They knew the people they supported extremely well which resulted in people feeling safe and behaving in a confident way around staff.

There were robust recruitment processes in place to assist the registered manager in making safe decisions about who they employed. Each person had one to one support. The registered manager chose to work two shifts a week which allowed them to maintain their relationship with people and to be able to supervise practice. They were usually supernumerary. This means they worked in addition to support staff.

Staff received a thorough induction when they started working at the service which gave them the skills and knowledge to care for people. This was based around the people who used the service. Staff then went on to complete further training relevant to their roles. They were supported through supervision and appraisal.

People’s medicines were managed safely. Staff had received specialist training in order to be able to administer emergency medicines for certain health conditions.

Risks to people’s health and safety had been identified and extremely detailed risk assessments and management plans were in place to guide staff. These were linked to well written and personalised care plans.

People’s nutritional needs were identified and supported by staff. Where further input was required by healthcare professionals the staff had requested referrals.

The environment supported people’s needs and their personal space reflected their preferences and personalities. Specialist equipment was checked regularly to ensure it was safe. Regular servicing of equipment and checks of services such as gas, electric and water took place.

We saw that people mattered to staff and staff respected their privacy and dignity. People’s preferences were taken account of when planning their care and they could choose how that care was delivered.

People’s care plans were extremely detailed and reflected the person’s needs exactly. Each area of the individual’s life had been examined and detailed records made about the way in which they liked to spend their days. This included social interactions and activity. People had activities they took part in that were individual to them. Where they had friends or family they were supported to maintain those relationships in a meaningful way.

No complaints had been received at this service since the last inspection. Compliments reflected our findings.

The quality of the service was asse

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was announced twenty four hours prior to our visit because we wanted to ensure that people were at home. When we inspected Derwent Cottages in June 2013 we did not ask for any improvements to be made.

Derwent Cottages is a small care home which provides accommodation and personal care for four people with learning disabilities or autistic spectrum disorder in the village of Seamer. The service is part of a company called Voyage 1 Limited. Derwent Cottages provide a service for younger adults and older people. The service has a vehicle for people to use to get out into the community. There were four people living at this service on the day of our inspection.

There is a registered manager at this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider

We found that this service was safe. Staff had developed positive relationships with people who used the service and were skilled at communicating with them. This meant that people were listened to and understood. An advocate, healthcare professionals and families said when asked that they all believed the service to be safe. Staff recognised different types of abuse and received training and updates to ensure that they followed good practice guidelines if they saw that someone was at risk of harm.

Medicines were managed safely and the risk of infection was minimised by practices followed by staff.

People at this service received care and support from people who were properly trained and supported which meant that the service was effective.

People who were unable to make their own decisions were protected because staff followed Mental Capacity Act 2005 guidance. Staff understood how to apply for an authorisation to deprive someone of their liberty if this was necessary and in their best interest.

People were supported to have enough to eat and drink and their environment was adapted to meet their needs in relation to areas such as moving and bathing. People had their own rooms and had chosen how they were decorated and furnished.

Staff were caring and compassionate. People were able to maintain contact with families with staff support and sometimes with the use of technology. Peoples care needs were recorded in detail. They had patient passports which contained relevant information in case they needed to visit a healthcare professional.

The service had no complaints in the last year and had made notifications as required to the Care Quality Commission.

Leadership at this service was demonstrated at all levels. The culture was open and transparent and people felt supported. The registered manager was knowledgeable and very proactive. They were committed to developing and improving the service.

We visited Derwent Cottages to carry out a scheduled inspection in June 2013. We observed the way that people who used the service were supported and looked at care plan files which we found to be very person centred and detailed. We saw evidence that people were supported to lead individual lives based on their interests and likes.

We looked at the consideration given to nutrition and support with regard to people’s dietary intake and found this to be considered and individualised.

The service had robust procedures in place for identifying and dealing with safeguarding and staff showed a good understanding of the correct ways to follow the processes in place.

We looked at the support mechanisms in place for staff, which were focussed on person centred working and reflective practices. Staff were given opportunities and support to allow them to develop professionally within their roles.

Quality assurance systems were in place for various elements of the service and these were used effectively. Paperwork and records were up to date, detailed and were stored and destroyed appropriately.

We used a number of different methods to help us understand the experiences of people who used the service, as most of the people who used the service had complex communication needs which meant they were not able to tell us about their experiences. We spent some time observing daily life within the home, and we spoke with two people whose relative used the service. We spoke with several staff and the manager about the care and well being of people who used the service. We also gathered evidence of people’s experiences of the service by reviewing care records and quality assurance documentation.

One person told us "I am happy living here".

One relative told us "The care is very good, my relative is as happy as they have ever been". Another told us "The atmosphere is relaxed, and they have supported my relative to set up his greenhouse which is important to him".

We found on our visit that a recent permanent recruitment of a registered manager has settled the service down well, and improvements were clear as a result of this.

Most of the people living at the home did not communicate verbally. During a visit to the service, people indicated that they were happy with their care through their body language and the way they interacted with staff. Staff encouraged people to make choices and be involved in their care using individual communication methods such as Makaton, (a method of communication using sign language), pictures or photographs. Relatives and advocates had completed questionnaires prepared by the home. People indicated in the questionnaires that they thought the home promoted person centred planning. Person centred planning considers the person as the focus to all care offered and emphasises consultation and involvement. All people who returned the home’s survey agreed staff were caring and courteous and treated people as individuals. One person wrote on behalf of their relative:

‘If I am unhappy my body language tells staff, they are aware of my likes and dislikes and activity plans are in place to ensure I do the things I do. Staff understand my communication methods.'

A visitor to the home wrote: 'Well done for supporting (the person) on the choice of presents for Christmas and birthday, they were all amazing.'

People were observed in the home environment interacting with staff according to their communication methods and appeared well cared for. People were dressed in a way which reflected their gender and personality. Some spent the day on several short trips; others remained at the home engaged in individual pursuits. The atmosphere within the home was relaxed and friendly and the people living at the home were attended to by staff according to the written plans of care. This ensured each person had the right care for their needs. Relatives indicated in written surveys that they were happy with the care. One relative wrote: 'Always receives excellent care and attention.'

A midday meal was observed. Some people used adapted cutlery and crockery to enable them to enjoy their meal independently. Staff were assisting people in an unhurried and friendly way and the atmosphere was calm and relaxed. People appeared to enjoy their meal.

People were observed enjoying the home environment and moving around it with ease.