Fleetwood House is a service which is registered to provide care and accommodation for 11 people living with a learning disability. It is also able to provide care for people who may have additional conditions, such as autism, epilepsy and other complex needs. Accommodation is provided over three floors and there was a lift available to provide access to all floors. On the day of our visit 11 people were living at the home.

At the last inspection carried out on the 24 November 2014 the service was rated Good. At this inspection we found the service remained Good.

We carried out this inspection as part of our routine schedule of inspections and to check that people were still receiving a good standard of care and support.

People told us they felt safe with staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.

Potential risks to people had been identified and assessed appropriately. There were sufficient numbers of staff to support people and safe recruitment practices were followed. Medicines were managed safely.

Staff had received training and there were opportunities for them to study for additional qualifications. All staff training was up-to-date. Team meetings were held and staff had regular communication with each other at handover meetings which took place between each shift.

People were supported to have as much choice and control of their lives as possible. Staff supported people in the least restrictive way and the policies and systems in the service support this practice.

People were supported to have sufficient to eat and drink and to maintain a healthy diet. They had access to healthcare professionals. People’s rooms were decorated in line with their personal preferences.

Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and these were respected by the staff who supported them. People were involved in decisions about their care as much as they were able. Their privacy and dignity were respected and promoted. Staff understood how to care for people in a sensitive way.

Care plans provided information about people in a person-centred way. People’s personal preferences and their likes and dislikes were documented so that staff knew how people wished to be supported. There was a variety of activities on offer which people could choose to do. Complaints were dealt with in line with the provider’s complaints procedure.

Weekly and monthly checks were carried out to monitor the quality of the service provided. There were regular staff meetings and feedback was sought on the quality of the service provided. People and staff were able to influence the running of the service and make comments and suggestions about any changes. Regular one to one meetings with staff and people took place. These meetings enabled the registered manager and provider to monitor if people’s needs were being met.

Further information is in the detailed findings below.

This inspection was unannounced and was carried out on the 25 November 2014. Fleetwood House is a service which is registered to provide accommodation for 11 people with a learning disability. It is also able to provide support for people who may have additional conditions, such as autism, epilepsy, chromosome disorders, complex needs and people who may present challenging behaviours. The registered providers are Aitch Care Homes (London) Limited. Accommodation is provided over three floors and there was a lift available to provide access to all floors. There were a total of 23 members of staff employed including the deputy manager and the registered manager. On the day of our visit 10 people were living at the home.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

People told us they felt safe. Relative’s told us they had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of harm.

Care records contained risk assessments to protect people from any identified risks and helped to keep them safe. These gave information for staff on the identified risk and guidance on reduction measures. There were also risk assessments for the building and emergency plans were in place to help keep people safe in the event of an unforeseen emergency such as fire or flood.

Recruitment checks were carried out on newly appointed staff to check they were suitable to work with people. Staffing levels were maintained at a level to meet people’s needs. People told us there were enough staff on duty and this was also confirmed by staff.

People told us the food at the home was plentiful and of good quality. They were involved in planning meals and staff provided support to help ensure meals were balanced and encouraged healthy choices.

People were supported to take their medicines as directed by their GP. Records showed that medicines were obtained, stored, administered and disposed of safely.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Two people living at the home were currently subject to DoLS. We found the manager understood when an application should be made and how to submit one. We found the provider to be meeting the requirements of DoLS. People were able to make day to day decisions for themselves. The manager and staff were guided by the principles of the Mental Capacity Act 2005 (MCA) regarding best interests decisions should anyone be deemed to lack capacity.

Each person had a plan of care which provided the information staff needed to support people and staff received training to help them meet people’s needs. Staff received regular supervision including observations by management of staff carrying out their duties. Monitoring of staff performance was undertaken through annual staff appraisals.

Staff were supported to develop their skills by receiving regular training. The provider supported staff to obtain recognised qualifications such as National Vocational Qualifications (NVQ) or Care Diplomas (These are work based awards that are achieved through assessment and training. To achieve these awards candidates must prove that they have the ability to carry out their job to the required standard). All staff had completed training to a minimum of (NVQ) level two or equivalent. People said they were well supported and relatives said staff were knowledgeable.

People’s privacy and dignity was respected and staff had a caring attitude towards people. In order to provide additional support, each person was allocated a key worker who was the main point of contact for the individual. We saw staff smiling and laughing with people and offering support. There was a good rapport between people and staff.

The manager operated an open door policy and welcomed feedback on any aspect of the service. There was a stable staff team who said that communication between all staff was good and they always felt able to make suggestions and confirmed management were open and approachable.

A health care professional told us that the manager and staff were very approachable and had good communication skills; they said the staff were open and transparent and worked well with them to meet people’s needs.

The provider had a policy and procedure for quality assurance. The manager carried checks to help to monitor the quality of the service provided. The provider also employed an area manager who carried out monthly monitoring visits to the home to help ensure quality.

People and staff were able to influence the running of the service and make comments and suggestions about any changes. Regular staff meetings took place and also meetings with people, minutes of these meetings were kept. These meetings helped the manager and provider to monitor how the home was meeting people’s needs.

There were ten people who used the service at the time of our inspection. Some of the people had complex needs which meant they could not tell us directly about their experiences. One person told us that they liked living at Fleetwood House.

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

We spoke to two people’s family members and a representative of another person. They told us that they were happy with the care and support provided by the service. A relative told us that the person was, “settled and happy at Fleetwood House”.

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.

We observed the storage, handling and administration of medication. 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.

There were ten people living at the home at the time of the inspection. During our visit we spoke with two people who were using the service and five members of staff. People living at the home said they liked the home and felt safe.

We made observations throughout the visit and saw people being offered choices as to what they wanted to eat and one person told us how they had chosen the colour of paint used to decorate their room. Rooms we looked at were personalised.

We saw people being addressed in a respectful manner. We looked at peoples individual support plans and observed that these were discussed with people who used the service and that these discussions were recorded. We saw that monthly audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Staff told us that they had received training in protecting adults from abuse.and that they felt that they were supported and trained to carry out their roles and meet the needs of people who used the service

Due to the needs of people who use this service it was difficult for us to speak to a number of people about their views of the service.

People told us that they liked the home and are supported to engage in a wide variety of activities.

Staff told us that they felt that they were supported and trained to carry out their roles and meet the needs of people who use the service.