Lavanda Villa is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service can accommodate up to four people living with a learning disability or autistic spectrum disorder. The accommodation is arranged over two floors with accessible outside space. At the time of this inspection there were four people living at the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the overall rating of good although we found improvements were needed to safeguard the way people’s finances were managed. However, 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.

Why the service is still rated good:

People were protected from abuse and avoidable harm. Staff had been trained to recognise signs of potential abuse and knew how to keep people safe. Processes were also in place to ensure risks to people were managed safely.

There were enough staff, with the right training and support, to meet people’s needs and help them to stay safe. The provider carried out checks on new staff to make sure they were suitable and safe to work at the service.

Systems were in place to ensure people received their medicines in a safe way and people were protected by the prevention and control of infection.

The service responded in an open and transparent way when things went wrong, so that lessons could be learnt and improvements made.

People received care and support that promoted a good quality of life and was delivered in line with current legislation and standards.

People were supported to eat and drink enough. People were actively involved in choosing what they ate and helped to prepare meals for each other. Risks to people with complex eating needs were being managed appropriately

Staff worked with other external teams and services to ensure people received effective care, support and treatment. People had access to healthcare services, and received appropriate support with their on-going healthcare needs.

The building provided people with sufficient accessible space, including a garden, to meet their needs. The service operated 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.

The service generally acted in line with legislation and guidance regarding seeking people’s consent. More work was planned however, to ensure best interest decisions were recorded for financial expenditure where people did not have capacity to understand or manage their own money.

Staff provided care and support in a kind and compassionate way. People were enabled 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.

People’s privacy, dignity, and independence was respected and promoted. They received personalised care and were given opportunities to participate in activities, both in and out of the service.

Systems were in place for people to raise any concerns or complaints they might have about the service. Feedback was responded to in a positive way, to improve the quality of service provided.

Work was underway to develop new care plans that would support people at the end of their life to have a comfortable, dignified and pain free death, if the need arose.

There was strong leadership at the service which promoted a positive culture that was person centred and open. Arrangements were in place to involve people in developing the service and

This inspection took place on 10 December 2015 and was unannounced.

Lavanda Villa provides care and support for up to four people with a learning disability and autistic spectrum disorder. There were four people living at the service when we visited.

The service has 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.

Staff had been trained to recognise signs of potential abuse and how to report them. People felt safe living at the service.

There were processes in place to manage identifiable risks. People had risk assessments in place to enable them to maintain their independence.

The provider carried out recruitment checks on new staff to make sure they were fit to work at the service.

There were suitable and sufficient staff with the appropriate skill mix available to support people with their needs.

Systems were in place to ensure people were supported to take their medicines safely and at the appropriate times.

Staff had been provided with induction and ongoing essential training to keep their skills up to date. They were supported with regular supervision from the registered manager.

Staff ensured that people’s consent was gained before providing them with support.

People were supported to make decisions about their care and support needs; and this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of the guidance and followed the correct processes to protect people.

People were supported to maintain a balanced diet and were able to make choices on what they wished to eat and drink.

If required people were supported by staff to access other healthcare facilities and were registered with a GP.

Positive and caring relationships had been developed between people and staff.

There were processes in place to ensure that people’s views were acted on; and staff provided care and support to people in a meaningful way.

Where possible people were encouraged to maintain their independence and staff ensured their privacy and dignity were promoted.

To ensure people’s identified needs would be adequately met; pre-admission assessments were undertaken before they came to live at the service.

A complaints procedure had been developed in an appropriate format to enable people to raise concerns if they needed to.

There was a positive, open and inclusive culture at the service; and the leadership was transparent and visible, which inspired staff to provide a quality service.

Effective quality assurance systems were in place to monitor the quality of the service provided and to drive continuous improvements.

During our inspection in October 2013, we identified areas of non-compliance in respect of the cleanliness and infection control processes within Lavanda Villa. We found the service did not have an effective system in place to maintain appropriate standards of cleanliness and hygiene. We also found two malodorous carpets and observed that some of the seals around sinks and showers were cracked.

This meant that the provider could not fully evidence the service had effective processes in place to promote effective infection control.

We imposed a compliance action and told the provider they needed to make improvements. The provider submitted an action plan in December 2013, which stated they had implemented improved systems to ensure the identified areas had been addressed and that compliance would be achieved by the end of December 2013.

When we visited the home on 8 January 2014, we spoke we spoke with the registered manager who told us what improvements had been made to address the standards of cleanliness and hygiene. We also saw evidence of the work that had taken place to address the identified issues. There was new flooring within the lounge area, which continued through to the hallway, stairs and up into one of the bedroom areas. We saw that seals around sinks and shower trays had been replaced and that the home appeared clean and free from odour. This meant that people were better protected against the risks of infection within the home.

When we inspected Lavanda Villa we saw that people were happy and at ease, living in a calm and relaxed atmosphere. The four people who currently lived at this home had various levels of verbal communication. We therefore used different methods to help us understand people's experiences, and observed the interactions between people and the staff they were supported by.

The two most vulnerable people we observed, clearly communicated through their body language or Makaton (sign language) that they were satisfied with the care and support they received. We observed that all were offered support that ensured their individual needs were met and independence encouraged. Staff were friendly and respectful in their approach and interacted confidently with people, respecting the individual's dignity and skilled at communicating effectively with them.

However we found the service did not have an effective system in place to maintain appropriate standards of cleanliness and hygiene. We found two malodourous carpets and found seals around sinks and showers were cracked.

We saw that people’s bedrooms had been personalised with pictures and objects of each person’s interests and taste. One person told us they were happy. One member of staff said, “lately there have been improvements to maintenance which has been very positive.” We noted that regular safety checks were carried out and recorded in relation to the building, including fire drills.

When we visited Lavanda Villa on 20 December 2012, we used different methods to help us understand the experiences of people using the service. We observed that people were offered support at a level that supported their independence and ensured that specific needs were appropriately met. The atmosphere within the home was calm and relaxed and people were observed to be happy and were engaged in activities of their choice. Staff were attentive to the needs of the people they were supporting which meant that people's needs were met in a timely manner.

The staff on duty were polite and respectful in their approach to people and engaged effectively with them, supporting them in planning care needs and making decisions about how they spent their time. One person said "I'm allowed to go swimming which I really enjoy." It was evident from the care records and our discussions with staff, that there was an appreciation of the need to be flexible in providing care to allow for people to make alternative choices at times.

We spoke with one person currently living at the home and observed a further two people. One person said, "I like everything about being here, they look after me really well." We observed that other people were settled and relaxed, engaged in arts and crafts or listening to music.

When we visited Lavanda Villa on 01 February 2012 we met two of the four people living there. Neither person used words to communicate. One person’s understanding was good and they made it clear they preferred not to speak with us. The second person arrived home later in the day, having been out shopping with staff. Both people showed with their body language and vocal sounds that they were happy with the support they were being given by the staff.

People were given opportunities to air their views about the quality of the service being provided.