Foxglove Care Limited - 32 Rivelin Park is a residential care home for up to two younger adults with learning disabilities and/or autism. It is situated in one of the Kingswood housing developments to the north of Kingston Upon Hull. The house is a three-storey property with a utility room, a small cloak/toilet and a small office on the ground floor. There is a lounge and a dining room on the first floor, and two single bedrooms (one with ensuite shower and toilet) and a bathroom on the second floor. There is a garden to the rear of the house.

At the last inspection, the service was rated Good. At this announced inspection on 17 May 2017 we found the service remained Good.

There was a registered manager employed at the service.

There were safeguarding procedures in place. Staff were knowledgeable about what action they should take if abuse was suspected. The local authority informed us there were no on-going matters regarding the service.

Medicines were managed safely.

Recruitment checks were robust. There were sufficient numbers of staff deployed to meet people’s needs. Records confirmed that training was available to ensure staff were suitably skilled. Staff were supported though supervision.

People's nutritional needs were met and they were supported to access healthcare services when required.

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.

We observed positive interactions between staff and people who lived at the service. Staff promoted people's privacy and dignity. There were systems in place to ensure people were involved in their care and support.

Personalised care plans were in place for people. Arrangements for social activities met people’s individual needs.

There was a complaints procedure in place. No complaints had been received since our last inspection.

There was an effective quality assurance system. Audits and checks were carried out to monitor all aspects of the service. Action plans were developed to highlight any areas which required improvement. Staff were positive about working for the provider and the registered manager. They said they felt valued and enjoyed working at the service.

A person who used the service told us, “It’s ok living here and we all get looked after by the staff” and “I like to go into the shops during the day on my own but my key worker stays outside the shop to help me if I need it.”

During our visit one of the people who used the service was attending their annual care review. The meeting was attended by the person who used the service, the relative of the person, team leader, key care worker and care co-ordinator. All the attendees gave signed consent to attend the meeting including CQC. This ensured that any decisions made were in the person’s best interest.

Records we looked at included instructions and information from other health care professionals for example; best interest meetings, mental capacity assessments carried out by the local authority, GP and dentist appointments. We saw that these were directly entered into a person’s care plan record.

The first floor consisted of a comfortable main lounge area and kitchen and dining area. The decoration was pleasant and tidy. All areas of the property were free from clutter and obstructions which meant that people were protected from trip hazards and self-harm.

The complaints procedure provided easy to understand steps by asking people who used the service if they were feeling angry, worried or sad. It included pictorial formats for ease of understanding.

We spoke with two people who used the service, two staff, the manger and two relatives.

One of the people who used the service told us that; “I now have a job in a charity shop and help them make money by helping out with sales.” People's comments also included: “Staff are very good and I feel very safe here.” “Staff treat me with respect and I can get up and go to bed what time I like.”

Relatives we spoke with commented positively about the care and support their relative received. Comments included: “Staff listen to my views and are really good and I am involved with decisions about care." Further comments received from a relative included: "The service is a god send for my daughter and she has made a lot of progress.” and “She is calm and relaxed and she benefits greatly from that and the service constantly consults with me.”

We spoke with two members of staff and they were able to describe the procedures in place to report any safeguarding incidents they may witness or become aware of. Staff received training about the specific needs of people who’s behaviour may challenge the service; for example challenging behaviour, epilepsy and autism.

Staff told us about the weekly meeting to decide menus for the week ahead, leisure activities and allocation of tasks which promoted independent living skills: “We meet every Sunday to prepare the weekly menu choices.” and “We discuss activities people would like to do during the week.”

People told us that they were happy in the home and with the support they received from the staff. They felt included in decisions and were able to live their lives as they wished.

32 Rivelin Park is situated in one of the Kingswood housing developments just to the north of Kingston Upon Hull. The house is a three-storey property with a utility room, a small cloak/toilet and a small office and lounge on the ground floor. There is a lounge and a dining room on the first floor, and two single bedrooms [one with en-suite shower and toilet] and a bathroom and bedroom on the second floor. There is a garden to the rear of the house. It is registered with the Care Quality Commission [CQC] for a maximum of two people.

We undertook this inspection on 23 and 24 March 2015 and the inspection was unannounced, which meant the registered provider did not know we would be visiting the service. The service was last inspected on 13 November 2013 and was meeting all the regulations assessed during the inspection.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC); they had been registered since August 2010. A registered manager is a person who has registered with the Care Quality Commission to manager the service and has the legal responsibility for meeting the requirements of the law; as does the registered provider.

Personalised programmes of care enabled people to learn to live as independently as possible with the minimum of support.

Staffing levels were structured to meet the individual needs of the people who used the service. There were sufficient numbers of staff on duty to meet people’s needs. Staff received training and support to enable them to carry out their work in a skilled and confident way.

Recruitment practices were safe and relevant checks had been completed before staff commenced work.

People were able to discuss their health needs with staff and had contact with their GP, attend routine health checks and access other health professionals as required. The service made appropriate and timely referrals to healthcare professionals and their recommendations were followed.

People’s nutritional and dietary needs had been assessed and people were supported to plan, shop for ingredients and prepare their own meals. The people we spoke with told us the choice and quality of food available was very good.

CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. DoLS are a code of practice to supplement the main Mental Capacity Act 2005. These safeguards protect the rights of adults by ensuring if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. The registered manager had good understanding about these and when these should be applied. Documentation in people’s care plans showed that when decisions had been made about a person’s care, when they lacked capacity, decisions had been made in the person’s best interests.

People who used the service were supported to make decisions about aspects of their daily lives.

Each person had an activity plan which had been discussed and arranged with them at their weekly meetings. Activities undertaken included; holidays, day trips, shopping, gardening, going to discos and the cinema.

People lived in a safe environment. Staff knew how to protect people from abuse and they ensured equipment used in the service was regularly checked and maintained. Risk assessments were carried out and staff took steps to minimise risks without taking away people’s rights to make decisions.

The registered provider had policies and systems in place to manage risks, safeguard vulnerable people from abuse and for the safe handling of medicines. Medicines were ordered, stored administered and disposed of safely. Only member of staff who had received training in the safe handling of medicines was involved in the administration of medicines.

Care plans had been developed to provide guidance for staff to support the positive management of behaviours that may challenge the service and others. This guidance supported staff to provide a consistent approach to situations that may be presented, which protected people’s dignity and rights.

People who used the service spoke positively about the care they received. They told us, comments and complaints were responded to appropriately and there were systems in place to seek feedback from them and their relatives about the service provided. A complaints policy was in place which was also available in easy read format to make it more accessible for the people who used the service. We saw that when complaints had been made, appropriate action had been taken to resolve these.

A quality monitoring system was in place that consisted of stakeholder surveys, reviews, assessments and audits.