Forty4 provides accommodation and personal care for up to six people living with a learning disability, physical disability, autism and/or mental health needs. The home is set back off a main road within walking distance of local shops and amenities. The accommodation comprises a large lounge/diner overlooking the garden and a kitchen. Bedrooms are split across the ground and first floor which are accessed by a central staircase and wheelchair accessible lift. At the time of our inspection six people were living at the home.

The inspection was unannounced and was carried out on 13 December 2017 and 5 January 2018 by one inspector.

Forty4 is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People were protected from abuse. Staff had received safeguarding training and understood their responsibilities to report any concerns. Relatives, staff and healthcare professionals told us they felt the home was safe.

People’s medicines were managed safely by staff who had been trained and assessed as competent in administering medicines. People received their medicines as prescribed.

Sufficient staff were deployed to meet people’s needs and keep them safe, including one to one and two to one support in the community. Robust recruitment procedures ensured only suitable staff were employed.

Individual and environmental risks relating to people’s health and welfare had been identified and assessed to reduce those risks. Contingency plans were in place to manage emergencies and evacuation procedures were in place and understood by staff if required.

People’s rights were protected because staff understood and followed the Mental Capacity Act 2005. Deprivation of liberty safeguards had been submitted to the local authority for authorisation when required.

People were supported to maintain their health and well-being and had access to health care services when required. People had a choice of nutritious food and drink that met their specific dietary needs and preferences.

Staff received training, supervision and appraisal which ensured they had the skills and competencies necessary to support people effectively.

Staff knew people well and empowered them to make choices and take control of their lives. People took part in a wide range of activities in line with their interests and which increased their skills and independence.

The provider met the Accessible Information Standards because staff communicated with people and provided information in a way they could understand, such as signs, pictures and symbols which helped them to make informed choices.

Staff were kind and caring, treated people with dignity and respect and ensured their privacy was maintained. People were encouraged to maintain family relationships and visitors were welcome at any time.

People and their relatives were involved in planning their care. People had up to date and detailed support plans which provided guidance for staff.

Systems were in place to monitor and assess the quality and safety of the care provided. There were opportunities for people and relatives to feedback their views about their care and this was used to improve the service.

Complaints procedures were available and displayed throughout the home in picture format. People and relatives knew who to speak to if they had a complaint.

There was a positive, supportive and open culture within the home. Staff felt supported and liste

Forty4 is a small residential home for up to six people with a learning disability . The home is set in a quiet road and is an ordinary house in an ordinary street. It has a large open plan living area with a conservatory leading out into an very large enclosed garden. There was a large shed at the bottom of the garden that could be used for activities. The garden provided a lot of space for people. The home is wheelchair accessible. There is a through floor lift.

The home had a registered manager. 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 understood how to recognise the signs of abuse and how to report any concerns within the service and to external agencies such as CQC and the Local Authority. There was a safeguarding and whistleblowing policy in place which included relevant contact details and telephone numbers for reporting concerns.

Training and supervision was in place to support staff and ensure they were competent to carry out their role.

Recruitment practices were robust and staff were checked for suitability to support people in an adult social care setting before starting work.

Staff interacted with people with kindness and respect and promoted their independence and wellbeing.

People had person centred plans which helped to ensure that people’s wishes and skills were recorded along with their support needs.

People's health needs were responded to in a way that protected their rights and ensured they were supported and their wishes listened to.

Risks to people were managed effectively and enabled them to participate in life in the community.

Medicines were managed, stored and disposed of safely and administered by staff who had been trained to do so.

Systems were in place to assess and monitor the quality of the service such as medicines audits, staff surveys and gaining feedback from people using the service. Regular checks were carried out in relation to the environment and equipment, and procedures were in place to report any defects and take necessary action.

We spoke with three people who used the service, two relatives, the manager and two members of staff. Care and support were observed to be respectful and responsive to individuals’ needs. People told us they were very happy and liked living at the home. They gave examples of how they got to do what they wanted and were supported to make their own decisions and choices. One person told us “here is my home.” Another person told us they got to go out and do the things they enjoyed, such as swimming and shopping. A third person told us they got support from “good staff,” and from a manager who “helps other people, as well as me.” A relative of a person who used the service told us they had been “happy from day one” with the care and support their relative received. They said the staff were “great,” and the service’s manager “bends backwards to help us.”

Staff practices ensured people were enabled to give their consent to care and support whenever possible. Where people did not have capacity to consent, effective systems ensured their rights and well-being were protected in line with legal requirements.

People who lived at the service and staff knew and got on well with each other. We reviewed care plans and they were detailed, up-to-date and person-centred. The provider had effective systems in place for assessing, planning and delivering care and support.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place for obtaining, storage, administration and recording of medication. Effective recruitment and selection processes were in place and appropriate checks were undertaken before staff began work. There were appropriate systems for recording and responding to complaints, and people’s issues were addressed and complaints answered to their satisfaction.

At this inspection we spoke with the manager, the training development manager, the nursing director, two members of staff and two people who lived in the home.

We observed that care workers and people living in the home were relaxed with each other, patient and sensitive. We saw care workers knew the people who lived in the home well and could anticipate their needs as required.

People’s diversity, values and human rights were respected.

We found that care plans were detailed, person centred, accurately reflected people’s needs and had been drawn up with their involvement where possible.

People were supported by staff who were supported to deliver care and treatment safely and to an appropriate standard.

People lived in an environment that was suitably designed and adequately maintained.

One person we spoke with told us “I love it here”.

People told us they liked living at the home. They got on well with staff. Staff understood their wishes and did all they could to support them. They told that staff helped with their daily routines and personal care needs. Staff supported them in their choice of leisure and social activities.