This comprehensive inspection took place on 15 January 2019 and was unannounced.

Hobbs Field is a care home for 15 adults with a learning disability and or autistic spectrum disorders. Autism is a lifelong, developmental disability that affects how a person communicates with and relates to other people, and how they experience the world around them. At the time of our inspection there were 14 people living at the service. The service is made up of two detached houses situated in a residential area of Horsham. The properties had level access throughout and adapted communal bath and shower rooms. The houses are linked by a shared patio area and surrounded by shared gardens.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

The care service had not originally been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. At the time of inspection, consultations were in progress to change the use of the building. Registering the Right Support is CQC guidance on how to register learning disability services in line with accepted best practice. However, the provider had taken steps to ensure people and relatives were involved in the process and adaptations had been made to ensure people received personalised care. Despite the building type, the provider managed to ensure these values were displayed including choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection in May 2016 we rated the service as good overall. We found the provider's quality assurance systems had not identified shortfalls in records relating to the delivery of care. This limited the rating for well-led to requires improvement. At this inspection we found improvements to the quality assurance systems and the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had 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 person’s'. 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.

Relatives told us they felt their family members were safe living at Hobbs Field. Staff described procedures that were in place to safeguard the people they supported. They fully understood the safeguarding policies and procedures, felt confident to raise a concern and thought they would be listened to. Risks to people's safety had been assessed and care records contained risk assessments to manage identified risks.

Recruitment systems at the home continued to be safe and robust. There were sufficient trained and competent staff to meet people's individual assessed needs. The staff were supported by the management team through on-going supervision and team meetings.

People received their medicines as prescribed and staff knew how to manage medicines safely.

People received care that was personalised and responsive to their needs. People's needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process. 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 pract

Hobbs Field is registered to accommodate up to 15 people who require support with personal care. It specialises in supporting younger adults and older people with learning disabilities some of whom also have autism. Autism is a lifelong, developmental disability that affects how a person communicates with and relates to other people, and how they experience the world around them. At the time of our inspection, there were 15 people using the service.

The service is made up of two detached houses situated in a residential area of Horsham. The properties had level access throughout and adapted communal bath and shower rooms. The houses are linked by a shared patio area and surrounded by shared gardens. There is parking on site for several vehicles.

This inspection took place on 26 May 2016 and the provider was given one days’ notice. This was to enable the provider to arrange for sufficient numbers of staff to be available to facilitate the inspection without disrupting the daily routines of the people who lived there.

A registered manager was 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 2008 and associated Regulations about how the service is run.

There was a high level of satisfaction with the management and leadership of the service and there were systems in place for the provider to assess the quality of the service provided. However the provider’s checks to ensure the completeness and accuracy of medication records relating to ‘as and when needed’ medicines had not always been followed. This had meant that errors in the records had not been identified and corrective action taken. The providers own systems for monitoring the service had identified shortfalls in relation to the content of people’s care plans and this issue was being addressed. However there were no systems in place for checking the quality and content of the care plans on an on-going basis. Albeit we did not assess any harm had occurred as a result of these shortfalls, they are areas of practice we identified as areas for improvement.

People were supported by kind, caring staff that knew them well. A relative told us they felt that the staff had built up a good relationship with their loved one and commented that since moving to Hobbs Field “They are a different person altogether, and very happy”. A health care professional reported to us they felt the service was ‘Very person centred in providing care for individuals that live at Hobbs Field, creating a happy and warm place for people to live and receive care’.

Staff understood the importance of supporting people to live the life of their choice and follow their daily routines. People were supported to participate in a range of activities of their choice such as going to the pub or a café for lunch, attending a local day centre, going to church, going to the gym, going on holiday and attending clubs and classes.

Staff had a good understanding of each person’s communication needs and took steps to ensure that explanations about choices in relation to their care and treatment were provided in a way that individuals could understand. Staff were able to recognise when people were feeling anxious or upset and took appropriate action to reduce their anxieties and provide emotional support to comfort them.

People’s independence was promoted. Where possible people were supported to clean their own rooms, lay the table and do their own laundry. Some people went out independently and staff supported others to arrange taxis so they could travel without staff support.

People were supported to have a nutritious diet that met their individual preferences for particular foods and dietary needs such as a soft textured diet.

People were supported to maintain relati

We spoke with nine members of staff who worked at the home and another three health care professionals who were visiting. We also spoke with a person who lived in the care home and we read feedback from relatives. We found that the staff were very happy and enthusiastic in their work and this created an open atmosphere of trust and confidence. One member of staff said “I love it, every day is different”. Professional colleagues said that they appreciated the high standards of care and a relative said, “it couldn’t be better”.

We inspected six care plans and found them to be well compiled and maintained and suitable for the management of the complex needs of some of the people living in the home. The staff were taking advice from external healthcare professionals and preparing to meet the additional needs that would emerge in the future. The care and treatment was appropriate and the people living in the home were enabled to attend to their own care where they could, and occupied with other meaningful activities. We found that staff respected the dignity of the people living in the home and provided a high standard of care.

A social worker gave feedback as part of the quality audit and said: "Care is excellent at Hobbs Field, people living there are treated as individuals". We spoke to staff and they commented on the "very individualised care". One of the cooks we spoke with said the people who live here are "entitled to live their own lives."

When we visited six people were out in the community attending a day centre. Two people were at home. We gathered evidence of people’s experiences of the service by reviewing surveys the provider had carried out with people and their representatives. We saw from this that people were satisfied with the service provided at Hobbs Field.

We saw general cleaning of the surroundings and maintenance of the building was taking place. We saw two bedrooms being refurbished.

We reviewed a sample of care records and found people’s needs were assessed and care and treatment was planned and delivered in line with individual care plans. We found evidence that the multidisciplinary team worked together and delivered person centred care to people.

We observed staff treated people with respect and dignity. People were offered choices and staff respected the choices they made. We observed people engaged with staff in a warm and friendly manner.

We reviewed the training records and found staff were appropriately trained for their roles. Staff told us they were supported through performance development reviews that allowed them to set goals and work towards achieving them.

We found people were protected from abuse as staff knew how to recognise abuse and knew what steps to take to ensure abuse was reported..

We saw safety information displayed through out the home. We found the provider had a system in place to monitor and assess the quality of the service provided.