About the service:

Laburnum Cottage is a residential care home, providing accommodation and personal care to seven people with different health and care needs at the time of the inspection. The service specialises in the care for people with autism and/or learning disabilities, as well as people with mental health conditions. Laburnum Cottage is one of the provider’s several homes on the New Hall campus in Fazakerley, a short walk away from local shops and public transport.

People’s experience of using this service:

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Under each key question we ask about the service, we found some very positive examples, but also some development needs. We identified issues with regards to notifying the Care Quality Commission (CQC) of certain events. Some planning and learning aspects to promote consistent, safe care required development. This meant we rated Well-Led as Requires Improvement on this inspection. However, the service continued to meet the characteristics of good in most areas we looked at.

People felt safe living at the service. People told us staff were supportive and helped them to be more independent. One person said, “When I moved in I thought they will kick me out after two days, but they did not. They never stopped believing in me.” People told us they were happy living at Laburnum Cottage.

People and the staff team were actively involved in the design and delivery of care. Although Laburnum Cottage is part of a campus-style setup, staff supported people to get involved in the community. People told us staff encouraged them to try new things, which made a difference to their quality of life. Care was person-centred and promoted people’s independence. Good outcomes were achieved with a view to people moving into their own tenancies.

The registered manager led a warm, caring and compassionate culture by being a good role model to their team. We heard good examples of how the service embraced and promoted people’s equality and diversity. People told us they liked the staff team. Managers were well respected by people living at the service and the staff. There were enough staff to meet people’s needs and staff were flexible around people’s wishes. Staff felt well supported. Staff told us everyone worked well together to provide a good service for people with at times complex needs.

Rating at last inspection:

At the last inspection we rated the service as Good (30 September 2016).

Why we inspected:

This was a planned inspection that was scheduled based on the previous rating. We inspected to check whether the service had sustained its Good rating.

Follow up:

We will follow up on this inspection through ongoing monitoring of the service, through conversations and notifications.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 22 August 2016 and was unannounced.

Laburnum Cottage is a residential service which provides accommodation and personal care for a maximum of six people with complex health and care needs. At the time of the inspection six people were living at the home. The accommodation consists of six self-contained flats and a shared kitchen and lounge.

A registered manager was in post. However they were in the process of transferring to a new location and the manager of the home was in the process of applying to become the new 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.

At the previous inspection we identified concerns relating to the currency and accuracy of risk assessment documentation. At this inspection we looked at risk assessments for two different people and found that improvements had been made immediately following the previous inspection. These improvements had been maintained.

At the previous inspection we identified that the home’s policy and procedure relating to missing person’s did not accurately reflect current practice. We looked specifically at the procedure and saw that it had been revised appropriately.

People told us that they felt safe living at Laburnum Cottage.

Accidents and incidents were recorded in appropriate detail and assessed by the manager. The manager was required to submit a copy of the information to the provider. The information was then analysed to identify patterns and triggers.

The home had sufficient staff to meet the needs of the people living there. People received different levels of support based on their needs and the activities that they were involved in. Staff were recruited safely subject the completion of appropriate checks.

People’s medicines were stored and administered in accordance with good practice. We spot-checked Medicine Administration Record (MAR) sheets and stock levels. Each of the MAR sheets had been completed correctly. Stock levels tallied with the figures recorded on the MAR sheets.

Staff had the skills and knowledge to meet the needs of the people living at the home and were well supported. They spoke positively about the training that was available.

Applications to deprive people of their liberty had been submitted appropriately and in accordance with the Mental Capacity Act 2005 and had been made in people’s best-interests.

People living at the home were actively involved in choices about food and drink and had free access to the shared kitchen. Each person also had a well-equipped kitchen in their own flat.

People were supported to maintain good health by accessing a range of community services. We also saw evidence of health action plans which detailed a range of healthcare needs and other important information.

Throughout the inspection we observed staff interacting with people living at the home in a manner which was kind, compassionate and caring. We saw that staff involved people in discussions and decisions about their own care and in general conversation. We saw that people had choice and control over their life and that staff responded to them expressing choice in a positive and supportive manner.

The majority of people were actively involved in assessment and review processes. We saw that a number of people had signed their care records and other important documents to indicate their involvement and agreement.

At the previous inspection we identified a concern relating to the completeness and accuracy of person-centred plans. At this inspection we saw that people’s plans were sufficiently detailed to inform staff of people’s needs and preferences and had been regularly reviewed.

The home had a complaints proce

This unannounced inspection took place on 5 and 7 October 2015. Laburnum Cottage is registered to provide personal care and a transitional service to young people aged 16 – 24 who are moving on from children’s services, foster care, hostels and youth offenders institutions. They may also have a diagnosis of learning disability, mental health illness, challenging behaviour or a combination of these. The home can accommodate six people however three were living there at the time of our inspection.

A registered manager was in post. 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.

People felt safe and staff knew what actions to take if they thought that anyone had been harmed in any way. People told us they were happy with the care they were receiving at Laburnum Cottage

People received their medicines as prescribed and safe practices had been followed in the administration and recording of medicines.

People and staff we spoke with confirmed that there were enough staff available to meet the needs of the people living at the home.

Staff were knowledgeable, kind and compassionate when working with people. They knew people well and were aware of their history, preferences and dislikes. People’s privacy and dignity were upheld. Staff monitored people’s health and welfare needs and acted on issues identified. People had been referred to healthcare professionals when needed.

Staff were only appointed after a thorough recruitment process. Staff were available to support people to go on trips or visits within the local and wider community.

People who lived at the home were not applicable to be accessed under the Mental Capacity Act 2005 legislation as they were under eighteen years of age, however the manager did demonstrate a good understanding of the Mental Capacity Act 2005.This is legislation to protect and empower people who may not be able to make their own decisions. We could see that the provider had obtained consent from people who had the capacity to do this, other consent had been obtained from people’s family’s, or other professionals involved in their care. The people living at laburnum cottage were able to make informed choices about day to day decisions, such as what to eat, what to wear and who visits their home. One person was unable to make these decisions and we could see there was no documented decision maker in that persons records. We highlighted this to the manager at the time of our inspection.

Deprivation of Liberty Safeguards (DoLS). DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests. At the time of this inspection, there was no one living in Laburnum Cottage who was over eighteen years of age, so this safeguard did not apply.

People’s bedrooms were individually decorated to their own tastes. People were encouraged to express their views and these were communicated to staff verbally.

People were supported to purchase and prepare the food and drink that they chose. People who lived at the home, their relatives and other professionals had been involved in the assessment and planning of their care. Care records were in place, however these did not fully explain the complexity of some people who lived at the home or how they should be supported.

There was a complaints procedure in place and people felt confident to raise any concerns either with the staff, the deputy manager or the registered manager.