Lansglade House is a residential home providing personal care for up to 31 people with a variety of physical, psychological and social needs. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection 31 people were living at Lansglade House.

The inspection took place on 12 September 2018 and was unannounced. At the last inspection on 28 September 2015 we rated the service 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.

People’s medicines were managed safely by staff who had their competencies assessed. However, there was an area that required improving and this was discussed with the operations manager.

People told us they felt safe living at Lansglade House and staff demonstrated they knew how to keep people safe. Staff received training and appropriate support from managers and seniors to carry out their roles effectively.

Risks to people`s wellbeing were identified and measures to mitigate the risks were regularly reviewed to ensure they were still effective.

The provider had policies and procedures in place to protect people from the risk of infections and staff adhered to these. There were enough staff employed through robust procedures to meet people`s needs effectively.

People, and relatives where appropriate, were involved with their care. People consented to the support they received.

People had opportunities to pursue their hobbies, interests and socialise with other people at Lansglade House.

People`s feedback was positive about the service they received. People felt they could voice their opinions in meetings and one to one conversations they had with staff.

People and staff were positive about the management of the service. There were robust systems in place to ensure the quality of the service was monitored and improved if the need was identified.

Lansglade House is a residential home providing personal care for up to 31 people with a variety of physical, psychological and social needs. On the day of our visit, there were 29 people living in the home.

The inspection took place on 28 September 2015.

The service 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 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 living in the service.

Staff were able to identify different types of abuse and the safeguarding procedures that should be followed to report potential abuse.

Risks to people’s safety had been assessed, with plans in place to mitigate these. Staff had taken into account the risks to which people were exposed.

Accidents and incidents were recorded and the causes of these overviewed, so that preventative action could be taken to reduce the number of occurrences.

People were supported by competent staff that had been recruited using a robust process, to ensure they were safe to work with people.

There were appropriate numbers of staff on duty, at day and night, to ensure that people’s needs were met in a safe and timely manner.

Medication was administered in a safe and appropriate way.

Staff were supported through a system of induction and on-going training, based on the needs of the people who lived at the service.

Staff gained people’s consent to care before any support was provided. The requirements of the Mental Capacity Act (MCA) 2005 and associated Deprivation of Liberty Safeguards (DoLS) were met.

People were supported to have a sufficient amount to eat and drink.

People were referred promptly to other health professionals where this was required to ensure their health and well- being.

Staff knew the people they cared for and supported them in a friendly manner, ensuring their needs were met. They were knowledgeable about how they should support people with their care and support needs.

People were treated with respect by staff, which ensured that their dignity and privacy was maintained.

The choices, likes and dislikes of people were documented within their care records and discussed with those people concerned.

People had opportunities to participate in a variety of activities within the service.

People and their relatives knew who to speak to if they wanted to raise a concern. There were appropriate systems in place for responding to complaints.

The quality and safety of the service was monitored on a regular basis through a system of internal audit checks. Action plans took into account where improvement could be made.

We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Is the service safe?

People told us they felt safe living at Lansglade House. We found they were cared for in an environment that was safe, clean and hygienic. People's needs had been assessed, and risk assessments described how any identified risks to people were minimised. The service had sufficient staff that were knowledgeable about people's care and support needs.

We saw that equipment was well maintained and checked on a regular basis and the premises were fit for purpose and safe for the people who used them. We found that as part of the pre admission information, staff obtained information about people’s needs to ensure that appropriate rooms could be given to them. This was to ensure, that the person’s bedroom was big enough to manoeuvre a hoist safely.

Is the service effective?

People’s health and care needs had been assessed, both pre admission and on a regular basis thereafter. We found that robust care plans were in place. People told us that they were happy with the care that had been provided and their needs had been met with kindness.

We saw that staff had received training to support people with various care needs. Some of the people had complex needs that meant they were not able to understand their care plans, we saw that where appropriate, these had been discussed with relatives so that all planned care and support was understood.

We found that the service provided people with adequate nutritious food and drink that ensured they maintained good health.

It was clear from our observations that staff had a good understanding of the needs of the people who used the service. We found that care plans were written in a ‘person centred’ style which reflected people’s individual personal needs and preferences. Activities were offered on a daily basis and there was a ‘friends’ association which offered additional activities and raised funds.

Is the service caring?

People were supported by kind, courteous and attentive staff. It was clear from our observations and from speaking with the staff, that they had a good understanding of the needs of the people living in the home and knew them well. We saw that staff were able to communicate effectively with people with limited verbal communication and to meet their needs with respect and dignity.

One person who used the service told us, “I cannot be at home, I know that, but being here is the next best thing.” We observed numerous examples of positive interactions between staff and people who used the service. Staff showed patience and understanding and encouraged people to be as independent as possible.

Is the service responsive to people's needs?

We observed that staff responded very promptly to people's needs, both physical and social. We saw that care plans and risk assessments had been updated when people's needs had changed, and that referrals had been made to other health and social care professionals when required. The service took account of individual preferences, and supported them to access a variety of activities.

We spoke with four people who used the service. They were all happy with the care received. One person said, “They always listen, I only have to say something and it is done. You cannot ask for more than that.”

Is the service well-led?

The service had a registered manager in post and we found that they managed the service well. Quality assurance processes were in place to ensure that people received a good quality service. We saw that the provider had effective systems to assess and monitor the quality of the service they provided. They regularly sought the views of people using the service and their representatives by listening to them, and took account of their feedback to improve the service.

Records showed that staff had attended both mandatory and specific training to help them carry out their duties, and were supported with regular supervisions by the manager. We were told that the manager was very approachable to both people and staff. This meant that the service was able to benefit from a well- led team of staff, who worked together to meet the needs of the people who used the service.

During our visit to Lansglade House on 14 May 2013, we observed a friendly environment, with positive interactions between staff and residents. People looked relaxed and well cared for and we saw staff took time to talk with people.

At the time of our visit, 28 people were living in the home although one person was currently in hospital. We spoke with four of the 28 people, although due to some people's dementia needs, not everyone was able to tell us about their experiences. We therefore used a number of methods to help us understand the experiences of people using the service, including observation and talking with people's relatives and care staff.

One person's family said they were extremely happy with the care provided and the homely environment. People who were able to speak with us told us they felt cared for and well supported by staff. One person said the care was "wonderful", and one person said, "I can't speak highly enough of the home, the staff are all lovely."

We observed staff providing respectful care and support to people, and saw this was delivered in line with the care records we reviewed in order to meet people's needs.

We saw that the home had received a number of compliments and thank you letters which were displayed for all people to read. Clear processes were in place to manage any concerns or complaints made.

We visited Lansglade House on 8 October 2012 and spoke with seven people living at the home, two peoples’ relatives and four members of staff.

Everyone we spoke with told us they enjoyed living or working there, and said the staff were very caring. Two people said they “couldn't want for a better place to live” and three others said “the staff are wonderful; they really look after me well”.

We saw that people were involved in decisions related to their care, and their dignity and independence were respected at all times.