About the service:

Dove House provides accommodation and care for up to nine people with a learning disability. The home is located in a semi-rural area in Rake, Hampshire. At the time of the inspection nine people were living at the home. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

Good (published 24 September 2016).

Why we inspected:

This inspection was a scheduled inspection based on the previous rating.

People’s experience of using this service:

People told us they were happy, felt safe and that staff had a good understanding of their needs and preferences. Staff listened to what people wanted and acted quickly to support them to achieve their goals and aspirations. Staff were innovative and looked to offer people solutions to aid their independence and develop their skills.

People had good community networks which were personal to them. This included, day services and supporting people to access the local amenities and maintaining regular contact with family and friends. Equality, Diversity and Human Rights (EDHR) were promoted and understood by staff.

Staff were well trained and skilled. They worked with people to overcome challenges and promote their independence. The emphasis of support was towards enabling people to learn essential life skills. Staff encouraged positive risk taking so people could experience new things and develop. This had led to people feeling fulfilled and living an active life.

People and their families described the staff as caring, kind and friendly and the atmosphere of the home as relaxed and engaging. 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.

Leadership was visible and promoted good teamwork. People, professionals and staff spoke highly about the management and staff had a clear understanding of their roles and responsibilities. The registered manager and staff team worked together in a positive way to support people to achieve their own goals and to be safe. Checks of safety and quality were made to ensure people were protected. Work to continuously improve was noted and the registered manager was keen to make changes that would impact positively on people's lives.

The service met the values that underpin the 'Registering the Right Support' and other best practice guidance such as 'Building the Right Support'. These values include choice, promotion of independence and inclusion. Also, how people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A full description of our findings can be found in the sections below.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection was carried out on 23 and 24 August 2016 and was unannounced.

Dove House provides accommodation and personal care for up to nine people who have learning disabilities. The home specialises in providing support and care to people who sometimes demonstrate behaviour which may challenge others. Although under one registration, the home is separated into two separate areas of accommodation; Dove House which provides support for up to five younger people and Dove Lodge which provides support for up to four older people. At the time of our inspection nine people were using the service.

Dove House has 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.

Staff had received safeguarding training and were able to describe sources and signs of abuse and potential harm. Staff were aware of how to protect people from abuse. Relatives told us their family member felt safe.

Risk assessments were in place for each person on an individual basis. People using the service were living with a learning disability and had complex needs. Risks had been identified in relation to people’s conditions and behaviours, such as epilepsy and self-injurious behaviour. Staff were aware of the risks and knew how to mitigate them.

Incidents and accidents were recorded appropriately and investigated where necessary. Any learning or changes to support plans or support guidelines were discussed at staff meetings.

There were enough staff on duty to meet people’s needs. The registered manager explained how staffing was allocated based on the assessed needs of people using the service. Emergencies such as sickness were covered by staff picking up extra shifts and sometimes agency staff. The registered manager told us the home was currently recruiting for extra care workers. Recruitment was carried out safely to ensure that potential members of staff were suitable to work in the home.

Medicines were administered safely by staff who had been trained to do so. Competencies in relation to the administration of medicines by staff were checked by the registered manager annually. Medicines Administration Records (MAR) were kept for each person and were checked weekly. Medicine stock levels were monitored. The supplying pharmacy carried out an annual audit of medicines in the home.

People were asked for their consent before care or support was provided and where people did not have the capacity to consent, the provider acted in accordance with the Mental Capacity Act 2005. This meant that people’s mental capacity was assessed and decisions were made in their best interest involving relevant people. The registered manager was aware of her responsibilities under the Deprivation of Liberty Safeguards (DoLS) and had made appropriate applications for people using the service.

Relatives told us they were very happy with the care provided by the service. Staff understood people’s preferences and knew how to interact and communicate with them. People behaved in a way which showed they felt supported and happy. People were supported to choose their meals. Snacks and drinks were available in between meals. Staff were kind and caring and respected people’s dignity.

Support plans were detailed and included a range of documents covering every aspect of a person’s care and support. The support plans were used to ensure that people received care and support in line with their needs and wishes. We saw this reflected in the support observed during the visit.

There was evidence in support plans that the home had responded to people's health needs and this had led to positive outcomes for people.

There was an open and transparent culture within the h

During our visit we spoke with three people, two relatives, five staff and the manager. As some people had limited verbal communication, we observed their care and interactions with staff. This helped us to understand their experiences of the service and care they received. A person told us they were well looked after and they went out shopping with the staff. Another person said “all very good” when we asked them about living at the home. Two relatives told us they were very happy with the care. Comments included “the happiest she has been”. Another comment was “ you don’t have to worry about her here.” People told us they were offered choices and staff respected their choices with their activities of daily living. We saw the staff were courteous and respectful when providing care and support to people.

Arrangements were in place to ensure people received care according to their needs. Risks assessments were completed and person centred care plans developed. These informed staff’s practices, supported people’s independence and protected their rights.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. A robust recruitment process was in place and records showed this was followed and all necessary checks were completed.

Most of the people at this care home were unable to communicate verbally and were not able to tell us about their experiences. Of those who have verbal skills, responses were limited due to individual levels of comprehension.

During our inspection we used the Short Observational Framework for inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of those people who could not talk with us. During our visit, we observed that staff interacted and communicated with people in an appropriate and respectful manner.

On the day of our visit eight people were living at Dove House. We observed how staff interacted with all the people. We used SOFI to carry out an observation of two of the people living at Dove House.

A recent survey sent to relatives included the comment “I have high confidence that (my relative) is being given the best care by a very positive, up beat and thoughtful team.”

The people we spoke to who were able to express a view told us that they were happy at the home.

Relatives told us that they liked the home and that their relatives were happy living there. They said the staff were good and knew what they were doing.

They told us that staff were very good at communicating with their relatives and with them.

Another relative told us that their relative was a totally different person since moving into the home, and that they had made a number of friends.

Another relative told us that they believed their relative was safe living at Dove House.