The inspection visit took place on 12 December 2016 and they were given 24 hours’ notice. This was because the service was small and we wanted to ensure people were available to talk with.

Draycombe House provides care for a maximum of six adults with a learning disability. It is a large detached property, which is relatively close to shops and local amenities. Accommodation is situated on the ground floor with some en suite facilities available. Private car parking is available in the grounds. There were five people living at the home at the time of the inspection. The service also provides a small personal care service to three people in the local area. This includes one person who lives independently on the premises of Draycombe House.

There was a registered manager in place who also owns 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.

At the last inspection in August 2015 we found the service was rated requires improvement and made three recommendations. These were in relation to risk assessments to people’s health and safety and governance of the home. The provider sent us an action plan saying they would meet the recommendations by November 2015. During our inspection visit on 12 December 2016 we found these actions had been completed.

We looked at two care records of people who lived at the home. Risk management had now been improved and well documented .They contained an assessment of people’s needs, including reviews of any risks associated with receiving care. These related to potential risks of harm or injury and appropriate actions to manage risk. Risk assessments were developed for when people were out in the community in order to keep people as safe as possible.

We found the provider had made improvements in the processes they had to monitor people’s safety and welfare. Audits had been developed to monitor and assess the quality of the service provided. This was so they could continue to develop and monitor their performance. The manager showed us new documentation intended to monitor and improve oversight of the service’s quality assurance.

During this inspection people were kept safe and free from harm. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were able to accommodate last minute changes both at Draycombe House and when out in the community.

We observed people’s medicines were dispensed in a safe manner and they received their medicines on time. Staff had received related training to ensure medicines were administered correctly by knowledgeable staff.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

People were supported to eat their meals where they chose and were offered a variety of meal options. Comments from people who lived at the home included, “We help make the meals so they are always nice”. Also, “Plenty and yes I love the food here.”

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. The registered manager discussed the applications which had been authorised and the restrictions in place to make sure people were safe. We saw staff were working within the law to support people who may lack capacity to make their own decisions.

People who lived at the home and who were supported in the community said staff had a kind and caring approach to care. One person we visited in their own accommodation said, “They come when I need them and they are so kind and caring.”

Staff said the manager was approachable and suppo

The inspection visit took place on 05 August 2015 and they were given 24 hours notice. This was because the service was small and we wanted to ensure people were available to talk with.

Draycombe House provides care for a maximum of six adults with a learning disability. It is a large detached property, which is relatively close to shops and local amenities. Accommodation is situated on the ground floor with some en suite facilities available. Private car parking is available in the grounds. There were five residents living at the home at the time of the inspection.

The service also provides a small personal care service to four people in the local area. This includes one person who lives independently on the premises of Draycombe House.

There was a registered manager in place who also owns 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.

At the last inspection on 14 May 2013 the service was meeting the requirements of the regulations that were inspected at that time.

During this inspection people were kept safe and free from harm. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were able to accommodate last minute changes both at Draycombe House and when out in the community.

We looked at how medicines were administered and records in relation to how people’s medicines were kept. We found medicines were administered at the correct time they should be. This was confirmed by looking at records and speaking with a person who lived at the home.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

Staff knew the people they were supporting and provided a personalised service. Care plans containing risk assessments were in place detailing how people wished to be supported and people were involved in making decisions about their care. People told us they liked the staff and looked forward to the staff coming to their homes. However risk assessments for people had not all been reviewed. This could put people at potential risk if their needs had changed and information was not updated.

We have made a recommendation about reviewing risk assessments.

People were supported to eat and drink and prepare their own meals to ensure staff promoted independence of individuals. One person who lived at the home said, “I enjoy cooking there is always enough to choose from.” Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs.

There was a lack of formal quality assurance and audit systems in place to ensure the service continued to be monitored and developed.

Regular formal meetings for staff and people who lived at the home would benefit the service. This would ensure concerns and issues were discussed and acted upon and continue to involve people so the service developed and quality improved.

We have made a recommendation about the management of quality assurance audits and processes to obtain peoples views.

We spoke with a range of people about the home. They included the owner, staff, and people who lived at the home. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced living at Draycombe House.

Draycombe house also provided a small domiciliary service to people in the community. We spoke with two staff who provided care and two clients who received practical support from the domiciliary service. All comments were positive and included, “The staff are fantastic could not do without them.” Also, “They help me with all my shopping and paying bills. All the staff know what they are doing and are excellent.”

People living at the home said they felt safe and well looked after and they liked living at Draycombe House. One person showed us their room and said, “It’s lovely and I have all my own furnishings.”

Staff told us that training was in place and they were encouraged to attend national care courses. Most of the staff team had completed national care qualifications. One staff member said, “We are always updating training it’s not an issue here.”

We contacted the Lancashire contracts monitoring team. They told us they recently visited the home in May 2013 and currently had no concerns with the service being provided.

We spoke with people during the inspection and they told us they liked living at Draycombe House. We observed staff interacting with people and this was frequent, and friendly. We saw good practice where people were supported sensitively and with respect. Staff spoken with felt that people were treated in a dignified way and with respect.

People said they could decide when to get up and go to bed and when to have personal care provided. We saw one person eating a late breakfast, being encouraged by staff. Other people were out and about or involved in household tasks. One person said, “I like to do the dusting and I look after the fish.” People told us they were encouraged to make choices about what they wanted to do.

We spoke with people who said they were involved in decisions about their care. They told us about the college courses they were on and trips out they went on. Two people talked about their forthcoming holidays and the places they would go when on holiday. People told us that they enjoyed regular pamper sessions in the home and one person showed us her newly painted nails.

People living in the home said they were happy at Draycombe House. One person told us, “I like it here.” Another person said, “I have a nice bedroom and I like going out.”

People said they felt safe and well looked after and they liked living at Draycombe House. One person showed us her room and said, “I like my bedroom. I chose my wallpaper and my bedding.”

Staff told us that training was in place and they were encouraged to do national care courses. Most of the staff team had completed national care qualifications. The staff we spoke with felt the training they were receiving provided them with the skills and knowledge to support people well.

People living in the home said they are able to choose when to get up and go to bed and what they want to do during the day. One person told us “I choose what to do, we sometimes go out or I listen to music, colour or watch TV.” People said that staff treated them nicely and were kind.

One person told us that she didn’t go to college anymore as she didn’t want to. Staff said that she had decided over several weeks that she did not want to continue going to college and they supported her decision. Another person said, “I choose whether to go out or to stay in the house.”

We talked to some people living in the home in a small group and some people individually during our visit. People living in the home were complimentary about the care and support they received. One person said “The staff are good to me. They are kind.” Another person said “I like it here. I like going out. ”

We spoke to staff about safeguarding. They were able to explain what to do in the event of any allegations or suspicion of abuse. People living in the home and staff said they would talk to senior staff if they had any concerns about care in the home.

Staff spoken to said they had good of training. One person said "If we need to know about anything such as dementia care we just have to ask." Another person said, "We get lots of training on important areas of care."