Disabilities Trust - 9 Twyford Lane is a residential care home which supports adults with acquired brain injuries. People are supported to live as independently as possible and the service is split into three individual homes which can each occupy up to three people. Each home has a kitchen-diner and communal area for people to use, as well as private bedrooms. When we visited there were eight people living at the service.

This inspection was unannounced and carried out on 07 April 2017. At the last inspection on 07 April 2015, the service was rated Good. At this inspection we found the service remained good.

There were systems in place to keep people safe. Staff knew about abuse and there were procedures in place to record and report abuse or any other incidents which took place. Risk assessments were in place to help staff keep people safe and they were regularly updated. Staffing levels were sufficient to ensure people's needs were met and they were recruited robustly, to ensure they were of good character. Systems were in place to encourage people to manage their own medicines but also to provide support in this area if required.

Staff were provided with training and supervision to ensure they had the skills they needed to perform their roles. 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 able to choose what they wanted to eat and drink and were supported to be as independent as possible with meal preparation. They were also supported to maintain appointments with healthcare professionals when required.

There were positive relationships between people and members of staff. Staff treated people with kindness and took time to get to know them and their interests. People enjoyed the company of staff and were encouraged to be involved in decisions about their own care and the development of the service. Staff worked hard to ensure that people were treated with dignity and respect.

Care was person-centred. People received support which was tailored to their individual needs and the goals which they had set in collaboration with the service. Care plans were reviewed and updated as people's needs and wishes changed and goals were achieved. Staff supported people with social activities and events, as well as work opportunities in the local community. There were systems in place to gather people's feedback, including complaints, about the service. This was used to help the service improve.

There was a positive culture and ethos at the service. Staff were motivated by their roles and felt that they were part of the service. They were well supported by the registered manager and were able to make contributions and suggestions about ways in which the service could develop. Quality assurance procedures were in place to help the registered manager and provider assess, monitor and improve the quality of care being provided at the service.

This inspection took place on 07 April 2015 and was unannounced.

9 Twyford Lane is a residential care home which provides care and support for people with acquired brain injuries. The service supports people to live as independently as possible, helping them with daily living tasks and accessing the community. The service is split into three homes which all occupy one site and share a large garden. Each house has space for three people to live in it.

The service is registered to provide care for up to nine people. At the time of our visit there were six people living at the service, two of whom had gone on leave to visit family.

There was 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.

People felt safe and were protected from abuse by a staff team that were knowledgeable and aware of the potential signs of abuse. Reporting systems were in place and staff were familiar with these.

Risks to people were assessed to reduce the likelihood that harm may be caused.

There were sufficient numbers of staff to meet people’s needs and keep them safe. Staff had been recruited following safe recruitment practices.

There were suitable arrangements in place for the safe storage, management and disposal of medication.

Staff received regular training and refresher sessions. Staff also received support from the registered manager, including formal supervision and appraisal meetings.

People were asked to give consent before being supported by staff. The principles of the Mental Capacity Act 2005 (MCA) had been followed when supporting people who lacked the mental capacity to consent to their care and support.

Where people were deprived of their liberty, this was accordance with the guidelines set out by the Deprivation of Liberty Safeguards (DoLS). This meant that people were only deprived of their liberty in a way which followed legislation.

People were encouraged to prepare their own meals and drinks and had support from staff to ensure they had enough to eat and drink.

Staff supported people to make and attend health appointments in the local community and receive visits in the service from a team of professionals, such as occupational therapists, when required.

People had developed meaningful relationships with staff and felt valued and listened to.

People were encouraged to share their views and opinions and to contribute to the planning of their care.

Staff promoted people’s privacy and dignity whilst providing care.

The service adapted to people’s changing needs and involved them in care planning and review meetings. People were encouraged to take part in meaningful activities which they chose for themselves.

Comments and complaints were encouraged to provide feedback on the service. Satisfaction surveys were also sent to people to seek feedback out.

There was a positive culture at the service. A well established staff team cared for people in a person-centred and empowering way.

There was good leadership in place. People and staff felt well supported by the registered manager.

Quality checks and audits were completed to ensure people were cared for appropriately and safely.

During our inspection visit to 9 Twyford Lane, we spoke with three people using the service and three members of staff and the manager. We examined two people’s care plans and their medication records.

The people we spoke with said that the staff were "very good and supportive" and they “don’t talk down to us” but listen to us. They confirmed that they were aware of their care plans and had been involved in telling staff how they wanted their needs to be met by them. They also told us that they got involved in their review meetings and discussed how they were getting on with meeting their goals. They also told us that they wrote their own menu list and went shopping with staff once a week. We observed this practice on the day of the visit.

One person told us that the “house is well decorated and clean and homely” and “it’s very enjoyable living here”. All the people told us that they knew how to make a complaint to staff or the head office if they were not happy with their care. One person told us that they were able to raise any issues with staff and they would listen to them.

We found that medicines were handled, administered and disposed of appropriately and there were regular audits to ensure that the procedures had been followed correctly. People were supported by sufficient numbers of staff with the appropriate training to meet their needs.

We spoke to three people who used the service and they told us that they were happy living at 9 Twyford Lane and they all got on well with each other. They told us that they did lots of activities in the home and in the community. Some of the activities included getting involved in planning and choosing the meals for their weekly menus and helping with shopping and doing domestic chores such as doing their laundry and cleaning their bed.

Some people told us that they went to work placements and enjoyed going to the place. They told us that they were looking forward to having their Christmas meal at the home on the day of the visit and they had also chosen to go out for a Christmas meal.

People told us that they knew about care plans because they had been involved in developing their care and rehabilitation plans to help them meet their assessed goals.

People told us that they had residents meetings once a month to discuss activities, menus, and any other issues they wanted to discuss about the running of the home. They said they were all aware of the complaints procedure and knew how to make a complaint, if they were not happy. However they told us that they had no complaints to make as they were happy at the home. They told us that they liked the staff because they listened and helped them with activities they wanted to do.

The three people who use the service fed back their views on the service and the care they had received. People said they were happy living at the home; the staff were nice and ‘they actually listen to us’. Should people have concerns they said they would raise them with the manager and information was available to support them through the complaints process.

Two people said there was nothing to improve about the home. People said they had been involved in the general running of the home, for example: help with food shopping, deciding the food menus and in cleaning their own rooms. People said they were involved in making decisions relating to their work experience placements, the types of activities they wanted to pursue and in changes to their care package.

People said they had all been involved in their care reviews during 2010. People said they had been involved in developing their care and rehabilitation plans and had given consent for them to be adopted as part of their care pathway. People said they had key workers.

One person said that he can go out alone; whilst the other two people using the service said they had been supported by staff during trips out.

People said that ongoing and new medical needs had been met and they had attended appointments during 2010/2011 relating to their specific needs.