House Martins Care Limited provides specialist residential care and support to people who are deaf and living with a learning disability. Accommodation and support at House Martins Number One is provided from a residential house which is well integrated within the local community. At the time of our inspection visit there were five people living at House Martins Number One.

People who used the service also benefited from being near another residential home owned by the same provider, House Martins Number Two. The two services had a joined-up approach to delivering care and support across both of their locations. This enabled the service to provide a wide range of activities from both locations. Deployment of staff was also flexible between both locations which meant the service was well equipped to respond to people’s individual needs. Throughout this inspection report there will be similarities in the content to that of the inspection report for House Martins Number Two, which we also inspected alongside House Martins Number One.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

We were assisted throughout the inspection by 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.

This inspection took place on 18 and 19 October 2018. The service was last inspected on 25 and 26 January 2016 and received an overall rating of good. At this inspection we found the evidence continued to support the rating of good and 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.

We found people were cared for by sufficient numbers of suitably skilled and experienced staff who were safely recruited. Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely.

Staff were aware of their responsibilities to safeguard people from abuse. Risks to people's safety were assessed and medicines were administered safely.

Infection control policies continued to protect people from the risk of infection.

There was an open learning culture and staff felt supported in their roles. This was reflected in a low turnover of staff and this benefited the quality of care that was provided.

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.

The service continued to work within the principles of the Mental Capacity Act (2005) and associated Deprivation of Liberty Safeguards (DoLS). Staff understood the importance of involving people as much as possible in their care and acted in their best interests if decisions needed to be made on their behalf.

Staff spoke about people with genuine empathy and compassion and demonstrated a commitment to providing good care. Staff were observed to interact with people and each other in kind and caring ways. The service had clear values in relation to supporting people to maintain their privacy, dignity and respect.

Key workers were knowledgeable about people’s needs and people told us that they were happy with the care they received.

Care and support plans were regularly reviewed. People were supported to maintain

We carried out a comprehensive inspection of this service on 25 and 26 January 2016. We last inspected this location on 23 September 2013 and found the service to be compliant with all regulations we assessed at that time.

House Martins Care Limited provides specialist residential care and support to people who are deaf and living with a learning disability. Accommodation and support at House Martins Number One is provided from a residential house which is well integrated within the local community. At the time of our inspection visit, five people who used the service were living at House Martins Number One. People who used the service also benefited from being in close proximity to the services other residential home, House Martins Number Two. This enabled the service to provide a wide range of activities from both locations. Deployment of staff was also flexible between both locations which meant the service was well equipped to respond to people’s individual needs.

At the time of our inspection there was a registered manager in post. 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.

The service had systems and procedures in place which sought to protect people who used the service from abuse. This included an appropriate safeguarding policy and associated procedures. Staff we spoke with demonstrated a good understanding of local safeguarding procedures and how to raise a concern. However, we found safeguarding information was not available in a format which would help people who used the service to understand how to raise a safeguarding concern. We spoke with the registered manager about this and immediate positive action was taken by obtaining information from the local authority website and then clearly displaying this information within the service.

We looked at recruitment and selection procedures and found safe recruitment practices were in place. This was evidenced through our examination of employment application forms, job descriptions, people’s proof of identity, written references, and Disclosure and Barring Service (DBS) checks. These helped to ensure potential employees were suitable to work with vulnerable people.

Accidents and incidents were appropriately recorded and included details of preventive strategies used by the service to reduce the likelihood of such events occurring in the future.

Information was readily available which detailed how people’s individual support needs should be managed in the event of an emergency evacuation from the premises.

Medicines were stored, administered, recorded and disposed of safely. This included a sample signature list of staff responsible for administering medicines being available. A photograph of each person who used the service receiving medication was displayed on their file to reduce the risk of medication errors. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

Health and safety records relating to buildings and premises were complete and up to date. Fire equipment was maintained and checked. Emergency lighting was checked and a first aid kit was readily available. Gas and electrical safety certificates were up to date. Emergency contact information was also readily available in case of a domestic emergency such as; flood, fire or loss of power.

People’s care plans included a wide range of up to date and relevant personal and health information. Risk assessments were completed and up to date. We found holistic assessments in place for each person who used the service which included comprehensive information detailing: ‘about me’, ‘my circle of support’, and ‘my daily routine’. Health action plans were

We spoke to people who lived at the home about how they made choices. People told us they were able to make choices about day to day activities and were able to tell staff if they did not want to do something.

We looked at a sample of people's support plans. The support palns were detailed but information was difficult to find. The manager told us the plans would be reviewed and information drawn together in a single document to make the plans easier to use.

We saw that support staff encouraged people to have a healthy lifestyle. On the day of our inspection people had been swimming and cycling. One person told us they enjoyed going out with a member of staff to walk his dogs. Another person told us they liked to go shopping and could go out whenever they wanted. Comments included: “I like living here the staff are nice.” “I can make choices.”

We saw interactions between people who lived at the home and support staff were positive. People had lived at the home for a long time and were encouraged to maintain their hobbies and interests.

There was an 'open door policy' at the home and people were encouraged to express their opinions. The manager made time to speak with people who lived at the home, their relatives and support staff.

On the day of our visit to House Martins Number One there were five people living at the home and we spoke with three of them to find out what it was like to live there and how they were supported by the staff. As the people who lived at the home were deaf we spoke to them via members of staff who used BSL (British Sign Language) to communicate.

Comments from people who used the service included;

“I have lived here for a long time and I like it. I get to visit my mum and dad at the weekend which is nice”.

“I feel safe living here as a result of my support”.

“The staff help me to make and attend my appointments”.

“The staff help me to manage to my money. I get some spending money each week and I just need to ask the staff when I want it”.

We found that people living at the home were supported by the staff to live as independent a lifestyle as possible which was centred around their hobbies, interests and personal preferences.

None of the people we spoke with had any concerns about the service provided but the people we spoke with said they would feel quite comfortable in raising any concerns with the manager of the home if anything ever did arise.

During our visit we met a number of people who live at the home. Whilst residents didn’t make any specific comments about the standards we were inspecting, we saw that they appeared relaxed and happy in their surroundings and clearly got along well with their support staff.

We made contact with a number of residents’ families to ask them how they felt about the service provided at House Martin Number One. Without exception, everyone we spoke with expressed extreme satisfaction with the service and spoke very highly of staff and managers.

Comments we received included;

‘’The care couldn’t be any better.’’

‘’We have a lovely life because we know he is so well looked after.’’

‘’We cannot fault them in anyway.’’

‘’He’s in the best place and I bless them all for taking such good care of him.’’

‘’The accent is on dignity.’’

‘’We leave the house elated knowing he’s so well cared for.’’

People were very complimentary about the activities provided and felt that their loved ones were being supported to enjoy fulfilling lives. One parent commented ‘’He has lots of interests which they have helped him develop. They even taken them on holiday and if he wants to go somewhere different to everyone else, then that is where he goes!’’

Parents told us that they enjoyed good communication with the home and felt fully involved in decisions about their loved ones’ care. People also said they felt able to approach staff and managers at any time. ‘’We know that any problems at all will be sorted out,’’ commented one person. Another parent said ‘’They are all so supportive.’’

None of the people we spoke with had any concerns about the service provided but everyone said they would feel quite comfortable in raising any concerns with the manager of the home. One parent said ‘’I am absolutely certain that they would do everything in their power to sort out any problems.’’