La Marsh provides care and accommodation for up to six people who have a learning disability. Five people were living at the service on the day of our inspection.

This inspection was undertaken by one inspector. At the last inspection on 6 January 2015 the service was rated as ‘Good’. At this inspection we found the service remained ‘Good’.

A registered manager was not in post at the time of the inspection. 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. A manager had been appointed and an application was in process to register them with CQC as manager for the service. The team leader was in day to day management of the service with the support of a registered manager and the operational manager from the organisation.

Systems were in place to manage risks to people using the service and to keep them safe. This included assisting people safely with their mobility and whilst out in the community.

There were sufficient numbers of staff on duty to safely assist and support people. The recruitment and selection procedure ensured that only suitable staff were recruited to work with people using the service.

The registered manager who was providing management support to the service understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have choice and control over their lives as much as possible. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s needs were assessed, so that their care was planned and delivered in a consistent way. The management staff and care staff were knowledgeable about the people they supported and knew their care needs well. Staff offered people choices such as how they spent their day and the meals they wished to eat. These choices were respected and actioned by staff.

People experienced a good quality of life because staff received training that gave them the right skills and knowledge to meet their needs. People were supported and assisted with their daily routines, shopping and accessing places of their choice in the community.

People received appropriate support to maintain a healthy diet and be able to choose meals they preferred. People had access to a range of health care professionals, when they needed them.

Staff were clear about the values of the service in relation to providing people with compassionate care in a dignified and respectful manner. Staff knew what was expected of them and they supported people in a respectful and dignified manner during our inspection.

The provider had processes in place to assess, monitor and improve the service. People had been consulted about how they wished their care to be delivered and their choices had been respected. People, their relatives and staff were provided with the opportunity to give their feedback about the quality of the service provided.

Further information is in the detailed findings below.

his unannounced inspection was carried out on 06 January 2015. The last inspection took place on 19 December 2013, during which we found the regulations were being met.

La Marsh is registered to provide accommodation for persons who require nursing or personal care for up to six people who have physical and learning disabilities. Nursing care is not provided. There were five people living in the home when we visited.

At the time of our inspection a registered manager was 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.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that people’s rights were being protected as DoLS applications were in progress where required and had been submitted to the relevant local authorities.

We saw that people who lived in the home were assisted by staff in a way that supported their safety and that they were treated respectfully. People had health care and support plans in place to ensure their needs were being met. Risks to people who lived in the home were identified and plans were put into place to enable people to live as safely and independently as possible. There were sufficient numbers of staff available to meet people’s care and support needs. Medication was safely audited, stored and administered to people.

We saw that staff cared for people in a warm and sensitive way. We saw that staff were assisting people with personal care, eating and drinking and going on trips out in the local community throughout our visit to the home.

Members of staff were trained to provide effective and safe care which met people’s individual needs and wishes. Staff we met understood their roles and responsibilities and they were supported by the registered manager to maintain and develop their skills and knowledge through ongoing support and regular training.

Arrangements were in place to regularly monitor health and safety and the quality of the care and support provided for people living at the home.

During our inspection of La Marsh on 19 December 2013, we found that people who lived there were involved in setting their own personal goals and in planning how their care needs were met. One person we spoke with told us: "This is my home. They look after me".

We found that care records were current and reflected the needs of people who lived in the home.

The provider had a recruitment procedure in place to ensure that staff employed were suitable to work for the provider.

There were systems in place to check that people were satisfied with the care and support they received and regular audits in place to monitor the quality of the services provided.

There was an effective system in place to deal with any complaints or concerns people who lived in the home or their relatives might raise.

We met all the people living at the service during our visit and, although not all could not communicate easily, we saw by their body language, facial expressions and their own words, that they were settled and happy in their home.

We talked to people’s family members, all of whom told us they would recommend the service. They reported that their relatives received good quality care from skilled, caring and patient staff. One person told us, “Staff are very good at cheering my brother up, and he always enjoys his yearly holiday with them”. Another stated that, “I can’t fault the place and you can really tell it’s not just a job for staff, but that they really care about people. Staff have worked so hard to get my daughter her new wheelchair”. However this person told us that they had requested that staff ring them once a month to give them an update of what was happening with their relative, but that staff sometimes forgot to do this.

Visiting health and social care professionals we spoke with told us they had no concerns about the service and reported that staff were good at following their recommendations. One health care professional told us, “There is very little changeover of staff, which means good consistency of care for people”.

All evidence indicated that the provider was compliant in all outcomes we assessed.

During our visit to the home we spoke with two people who used the service. People spoken with did not share many comments with us about the support they receive, however we did observe interactions between staff and people using the service noting that they were appropriate and supportive. One person told us about activities that they had been engaged in during the week of our visit and we noticed that staff provided reassurance to people using the service when they became anxious.