Hannahwood Transitions is a residential care service providing accommodation and support to young adults with physical disabilities and associated sensory, communication and learning difficulties.

The service is registered to provide support with accommodation and nursing care for a maximum of 23 people within five purpose built bungalows. Hannahwood Transitions is located on the same site as Dame Hannah Rogers’ school and is run by the Dame Hannah Rogers Trust which is a charity organisation supporting children and adults with physical and learning disabilities.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We carried out a previous inspection of this service on 13 October 2014 where we rated the service as ‘good’.

This inspection took place on 22 and 28 February 2017 and was unannounced for the first day of the inspection. At the time of our inspection there were 13 people living in Hannahwood Transitions. The service met people’s different needs by offering full time residential care, including some nursing care, temporary respite care and day services. People using the services had a range of needs. All the young adults who were living at Hannahwood Transitions at the time of our inspection had learning disabilities and complex physical disabilities. Some people required more significant support than others and almost all people were wheelchair users. People living at the service were widely referred to by relatives, staff and the registered manager as ‘young adults’ and we have therefore used this on a number of occasions through the report.

Strong values underpinned the work carried out at Hannahwood Transition. The Trust’s mission statement was “Our mission is to empower, advocate and enrich the lives of children and adults with disabilities”. Their core values included “Providing education, training, advocacy, work opportunities, care and other support services for children, young people and adults in needs, their families, carers and associated professionals”.

Some comments made by relatives included “It couldn’t be any better” and “Dame Hannah Rogers is an amazing place for young adult with complex needs, (Name of loved one)'s life has just taken off since (they) went to live there, (they) absolutely love all the opportunities, the great staff & the bungalow & other young people” and “As a parent this is a wonderful comfort to know that your child is cared & looked after as you would do yourself is a peace of mind one can only imagine”.

The service achieved these values through the constant striving for excellence and improvement, through continually seeking people’s views and enabling people to have happy lives filled with activities and the promoting of skills development. The service had cultivated a warm, welcoming and inclusive culture where people and staff felt encouraged to express themselves and share their views. All levels of staff focussed on delivering a clear vision of working alongside people to enrich their lives.

The Trust worked hard to create strong links with the local community in order to increase awareness and integration. The Trust held strong values relating to providing people with disabilities with as many opportunities as possible in order to improve their lives. For example, they had identified a lack of opportunities in relation to the education of young adults with physical and learning disabilities so had worked with the head teacher of the school on site to design a teaching package bespoke to these people’s needs. This package was available for people who had either finished the available college courses or who were not accessing them. This enabled p

The people living at Newberry and Gilleys required a high level of support from the staff team. Most people being supported had limited verbal communication therefore it was difficult for them to tell us about their experiences of the service. The service consisted of four separate purpose built bungalows. We spent time in each of the bungalows during the inspection, speaking to staff and observing the care being provided.

Staff we spoke to understood that people needed to be involved in decisions about their care. Records confirmed that when people lacked the capacity to make decisions the service made appropriate arrangements to ensure that people’s rights and best interests were taken into account and protected.

We saw that people appeared happy and relaxed within their environment. People were supported by a skilled and motivated staff team to develop their skills and to access a range of social and educational opportunities.

Staff we spoke to felt well supported by their colleagues, senior staff and management. Opportunities were available for staff to discuss the needs of people they supported as well as their particular job role and training requirements.

Some of the arrangements for handling, administering and recording medications did not protect people who used the service.

Some of the records we looked at were poorly organised and did not in all cases provide staff with clear, up to date and detailed information about people’s needs.

We ( the Care Quality Commission) carried out this inspection as part of our scheduled plan of inspections to check compliance with the Health and Social Care Act 2008.

We reviewed all the information we held about this provider and carried out a visit on the 3 and 4 of July 2012.

People using this service had very complex care need. This meant that it was difficult for people to tell us what they thought of the service and the care they received.

We used a number of different methods to gather information about people's views and experiences of the service.

We spent time observing people and the support being provided by staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experiences of people who could not talk to us.

We observed many examples of positive interactions between staff and the people using the service. We saw people's privacy and dignity being respected and staff using their skills and knowledge to encourage people to make choices and maintain their skills wherever possible.

Several people used electronic communication aids and the staff supported them to use this equipment to communicate with us.

One person told us how much they had enjoyed the end of term prom and also how they were being supported by staff to use a new adapted wheelchair, which would help them become more independent.

We spoke to relatives who were visiting the service and following our visit contacted four more relatives by telephone as well as professionals from Social Services and the local Primary Care teams. Comments included;

" I attended a review recently at the service. The young person concerned was actively involved in their meeting, making choices and having control about decisions being made" ( Care Manager- Social Services)

" The service encourages integration into the local community. They help people look to the future and explore options and opportunities" ( Relative)

These comments demonstrated that people were supported to make choices and had control over their care and lifestyle.

We pathway tracked six people who use the service. Pathway tracking means we looked in detail at the care six people received. We spoke to the staff about the care given, looked at records related to them, met them and observed staff working with them. Where possible we also spoke to the relatives of these people and other agencies and professionals involved in their care.

All of the care records we looked at were well organised and included detailed and clear information about people's needs. The staff we spoke to said that the information was accessible to them and easy to understand. Staff were able to tell us about how they support people and said that they had training and guidelines to assist them when required.

We found that people engaged in a range of age appropriate activities inside and outside the service. During our visit we observed people being supported by staff to get ready for the end of term prom. We could see that much thought and preparation had been given to making this a special and memorable event. We were also able to see people using the range of activities available within the service including an art and crafts room, music studio and IT suite.

The staff we spoke to were able to tell us about different types of abuse and what they needed to do to make sure people were kept safe.

We looked at auditing systems within the service. We found that auditing systems had been put in place to check and monitor the quality of the service, and staff also regularly checked that people using the service were happy with the care they received.

Hannahwood Transitions is a care home providing personal and nursing care for up to 23 younger adults with physical disabilities. Accommodation is provided within five purpose built bungalows. Hannahwood Transitions is situated on the same site as Dame Hannah Rogers’s school. On the days of our inspection 20 people were living at the home.

This inspection was unannounced and took place over two days on 13 and 15 October 2014. At our last inspection in August 2014 we found breaches of regulations relating to how people’s care and welfare needs were met, supporting workers, assessing and monitoring the quality of service provision and records. The provider sent us an action plan to tell us what improvements they were going to make. During this inspection, we looked to see if these improvements had been made. Improvements had been made and the regulations were now being met.

There was a registered manager in place. 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 and associated Regulations about how the service is run.

There were sufficient numbers of staff on duty to support people safely and ensure everyone had opportunities to take part in a variety of activities inside and outside of the home.

Staff received a comprehensive induction programme. Staff had completed appropriate training and had the right skills and knowledge to meet people’s needs.

People had access to healthcare professionals to make sure they received appropriate care and treatment to meet their complex health care needs. Staff followed the guidance provided by professionals to ensure people received the care they needed to remain safe.

Care plans included detailed information about people’s daily routines and needs. One staff member said “We add to the care plans as we find out something or get to know people; this really helps us provide good care”. However, it was not evident when reviews took place. The registered manager commented the review process would be formalised as part of the development of care plans and the lead nurse would be responsible for monthly reviews.

Many people who lived in Hannahwood Transitions were not able to fully verbalise their views. People used a range of communication tools. For example, people had electronic communication aids attached to their wheelchair; others also used signs and symbols to aid communication and choice making. Staff had the knowledge of the various communication aids used by people to support them effectively.

Staff were happy working at the service and told us the management team were supportive, kept them informed, listened to them and acted on any concerns raised.

People’s medicines were managed safely. People received their medicines as prescribed and received them on time. Staff understood what the medicines were for. People were supported to maintain good health through regular access to healthcare professionals, such as GPs, social workers, occupational therapist and district nurses.

Staff understood their role with regards to the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS).The MCA is about making decisions and what to do when people cannot make decisions for themselves. Applications were made and advice was sought to help safeguard people and respect their human rights. All staff had undertaken training on safeguarding adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.

There were effective quality assurance systems in place. Any significant events were appropriately recorded and analysed. People knew who to contact if they needed to raise a concern or make a complaint. Feedback was sought from people living in the home, relatives, professionals and staff. Evaluation of incidents were used to help make improvements and ensure positive progress was made in the delivery of care and support provided by the home.