The inspection took place on 6 December 2017, and was unannounced.

Lindum House is registered to provide personal care to up to 20 adults with learning disabilities. There were 18 people living at the service at the time of the inspection. Lindum House comprises of a detached four-storey building and a detached bungalow within the same grounds.

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.

There was a registered manager 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 Act2008 and associated Regulations about how the service is run.

At our last inspection the service was rated Good. At this inspection we found the service remained Good.

People were safeguarded from potential harm and abuse. Staff undertook safeguarding training. Any issues raised were fully investigated. The service was homely and was maintained to make sure it remained a safe and pleasant place for people to live.

Care and treatment were planned and delivered to help people retain their health and safety. At the day of the inspection there were enough staff to meet people’s needs. Recruitment processes remained robust to protect people from being supported by any unsuitable staff members. Medicines were dispensed by staff who had received training to undertake this safely.

Staff were provided with training to help them care for people. They received supervision and appraisal which helped to develop their skills. People's dietary needs were recognized and people were supported to maintain good nutrition. If staff had any concerns regarding people’s medical needs, people were referred to relevant health care professionals to help to maintain their well-being.

People's rights were protected in line with the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager understood their responsibilities regarding this.

Staff supported people with kindness, dignity and respect. People were supported to undertake a range of activities at the service and in the community.

People received the care and support they required and their needs were kept under review.

People were asked for their views about the service, and the feedback received was acted upon. The registered manager, staff and the management team carried out checks and audits of the service.

Investigations of incidents and accidents took place and any learning from these issues was implemented to help to maintain or improve the service provided.

The inspection took place on 6 December 2017, and was unannounced.

Lindum House is registered to provide personal care to up to 20 adults with learning disabilities. There were 18 people living at the service at the time of the inspection. Lindum House comprises of a detached four-storey building and a detached bungalow within the same grounds.

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.

There was a registered manager 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 Act2008 and associated Regulations about how the service is run.

At our last inspection the service was rated Good. At this inspection we found the service remained Good.

People were safeguarded from potential harm and abuse. Staff undertook safeguarding training. Any issues raised were fully investigated. The service was homely and was maintained to make sure it remained a safe and pleasant place for people to live.

Care and treatment were planned and delivered to help people retain their health and safety. At the day of the inspection there were enough staff to meet people’s needs. Recruitment processes remained robust to protect people from being supported by any unsuitable staff members. Medicines were dispensed by staff who had received training to undertake this safely.

Staff were provided with training to help them care for people. They received supervision and appraisal which helped to develop their skills. People's dietary needs were recognized and people were supported to maintain good nutrition. If staff had any concerns regarding people’s medical needs, people were referred to relevant health care professionals to help to maintain their well-being.

People's rights were protected in line with the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager understood their responsibilities regarding this.

Staff supported people with kindness, dignity and respect. People were supported to undertake a range of activities at the service and in the community.

People received the care and support they required and their needs were kept under review.

People were asked for their views about the service, and the feedback received was acted upon. The registered manager, staff and the management team carried out checks and audits of the service.

Investigations of incidents and accidents took place and any learning from these issues was implemented to help to maintain or improve the service provided.

An adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

As part of this inspection we spoke with seven people who use the service, the registered manager and three staff. We also reviewed records relating to the management of the home which included, people’s records, risk assessments, staff rota, training files and records used to monitor the safety of the home. Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

Is the service safe?

People’s support plans detailed how the person wanted their needs to be met. Their risk assessments identified risks associated with personal and specific health related issues, and recorded guidance for staff to minimise those risks.

People told us they felt safe. They said they would have no hesitation to approach staff if they were worried about their safety or worried about the services provided. Staff had received training as part of their induction and on-going training and development plans to support people’s individual needs.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Staff understood mental capacity, consent, choice and deprivation of liberties safeguards (DoLS). The home had made Deprivation of Liberty Safeguards referrals. We saw that people who had best interests meetings were involved in particular decision-making processes, as appropriate.

Improvements since our last inspection to the home in September 2013 had been made to provide a clean, safe and homely environment for the people who live there.

Is the service effective?

People told us that they were happy with the care and support they received. It was clear from what we saw and from speaking with staff that they understood people’s care and support needs and that they knew them well. One person said, “I can have my own space and do as I please; I go out on trips and walk”. Staff had received training to meet the needs of the people living at the home.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers were patient and gave encouragement when supporting people. People told us they were able to do things at their own pace and were not rushed. Our observations confirmed this. A person told us: “It’s alright; I have my key worker to help me with my washing and staff help me with cooking”.

Is the service responsive?

People’s needs had been assessed before they moved into the home. People told us staff discussed with them what was important to them. Records confirmed people’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. They told us they were clear about their roles and responsibilities and worked well as a team. People told us the manager and staff were approachable and that they felt listened to.

People we spoke with told us they were happy living in the home and felt safe, cared for and listened to by staff. Comments included, “what I like about it is you can have your friends and family visit you here” and “staff make appointments for you at the doctors if you are not well”.

People’s care plans detailed how they wanted their needs to be met and supported choices they had made. We found that some of the choices people had made had not promoted their wellbeing or the wellbeing of others who lived in the home.

Staff were knowledgeable of people’s specific health and personal care needs and how they wanted those needs to be met.

We found that the home was not clean and fresh to promote a hygienic environment and that some of the fabric and furnishings of the home were in need of replacement or repair.

People had opportunities to contribute their views about the quality of the service and knew who to contact should they have a concern or complaint about the services provided.

We last inspected this home in March 2011 and we identified concerns about the suitability of the kitchen area. At this inspection we found that these concerns had been addressed.

We spoke with eight people who lived in the home. They told us they had been involved in planning their care and what they could do each day. People told us they were treated with dignity and respect. We saw that staff were familiar with people's needs and gave them opportunities to make choices.

The care plans we saw provided individual details of people's needs, wishes and preferences. People's healthcare needs were also met. The home sought advice from external healthcare professionals where necessary. A range of activities was provided and people could choose whether they wished to take part.

The home had appropriate systems in place to safeguard people from abuse and staff had been trained about safeguarding.

Staff received an appropriate induction and the home had made good progress in addressing supervision for all staff. Staff were supported through system of appraisals and regular training. The provider and manager had effective systems in place to monitor the performance of the home.

People told us that they feel safe and like living at Lindum House. They told us about the opportunities that living there gives and spoke fondly about the things they do.

People told us that “staff do a marvellous job” and “staff are nice”.

They told us that they have no concerns and know how to make a complaint saying that they would speak with the owners or one of the staff.

People said they are happy with the food and some people said they like to help out in the kitchen.