The inspection of Low Laithes took place on 13 and 15 November 2017. The service was previously inspected in June 2015.

Low Laithes 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.

Low Laithes is registered to provide accommodation for up to a maximum of 35 children or younger adults with learning disabilities or autistic spectrum disorder, who require personal care. The home does not provide nursing care.

The accommodation comprises of self-contained maisonettes, which include a kitchen/dining area, living area and a bedroom with en-suite facilities. The location also has communal areas and a number of activity areas and gardens on site.

At the last inspection, the service was rated good.

At this inspection we found the service remained good.

Staff understood how to keep people safe through their knowledge of safeguarding procedures and people’s individual risk assessments. Medicines were managed and stored safely. Effective monitoring systems helped to keep the premises safe and emergency procedures were in place. We observed sufficient numbers of staff were deployed in order to provide safe care and support to people.

Staff received appropriate induction and training to enable effective care and support to be provided. Ongoing supervision was evident. People were supported to have maximum choice and control of their lives and we observed staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.

Positive relationships between staff and people who lived at Low Laithes were evident. Staff were respectful and mindful of ensuring people’s privacy was respected. Diversity was embraced and human rights were upheld.

Care plans were person-centred and this enabled personalised care and support to be provided. Appropriate referrals were made to health care professionals when this was appropriate.

Systems and processes for improving the safety and quality of the service were in place and were effective. People and staff told us they felt the home was well-led. Staff were clear of their responsibilities.

Further information is in the detailed findings.

Low Laithes is registered to provide accommodation and personal care for up to thirty people with a learning disability or autistic spectrum disorder. Low Laithes is a purpose built location and the accommodation comprises of self-contained maisonettes, which include a kitchen/dining area, living area and a bedroom with en-suite facilities.

There was a registered manager at the service. 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.

Our last inspection at Low Laithes took place on 10 June 2013. The service was found to be meeting the requirements of the regulations we inspected at that time.

This inspection took place on 23 June 2015 and it was an unannounced inspection. This means the registered provider did not know we were going to carry out the inspection. On the day of our inspection, there were 27 people living at the home.

People told us they were well cared for and they felt safe.

We saw the staff were kind and compassionate. Staff understood people’s needs and treated them with respect.

Relatives said they found people had positive relationships with the staff and they trusted the staff at Low Laithes.

There were over 30 members of support staff and other staff on site and all were highly visible. There were sufficient staff that were available and responded to people’s needs and kept people safe.

We found the home was clean with no obvious hazards noticeable such as the unsafe storage of chemicals or fire safety risks.

We found systems were in place to make sure people received their medicines safely.

Staff had an understanding of their responsibilities to protect people from harm. Incidents were assessed and monitored by the registered manager to try to prevent and reduce potential re-occurrences of similar incidents.

Staff recruitment procedures were thorough and ensured people’s safety was promoted.

Individual support plans and risk assessments were in place in order to identify people’s needs and manage risks to people.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. Staff were very positive about the frequency and quality of training and induction available.

Staff were provided with regular supervision and appraisal for development and support.

The service followed the requirements of the Mental Capacity Act 2005 Code of practice and Deprivation of Liberty Safeguards. This helped to protect the rights of people who may not be able to make important decisions themselves. People had access to advocacy services.

People had access to a range of health care professionals to help maintain their health. People had a choice of meals, so people’s individual preferences could be respected.

People and their relatives told us they could speak with staff if they had any worries or concerns and they would be listened to. Bespoke complaints procedures were provided to people, according to their individual abilities.

People knew the registered manager and freely approached them during our visit.

We saw people participated in a range of daily activities, which were meaningful and promoted independence both within Low Laithes and in the community.

There were comprehensive systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure procedures to maintain safe practice were adhered to. People and their relatives had been asked their opinion of the quality of the service by both the registered provider and manager via surveys and by the regular forum meetings.

We found there were effective processes in place to ensure people’s capacity to make decisions had been adequately assessed and managed.

We found people experienced care, treatment and support that met their needs and protected their rights. We talked with three parents during our inspection visit. Some comments captured from two sets of parents included “We love it …staff have done everything they can to support [X] …staff have been absolutely wonderful”, “have had concerns lately, can address these with the staff …[who] are approachable and we can talk to them”.

One parent explained how they were kept informed and involved about aspects of their child’s care. For example, they stated “I’m more than happy we are listened to and things are addressed” and “staff understand care needs, we give them an excellent rating”.

We found there were effective recruitment and retention processes in place.

We found there were effective systems to regularly assess and monitor the quality of service that patients receive.

We found there was a complaints process in place.

People with learning disabilities are not always able to tell us about their experiences. We were able to observe how staff members interacted positively with people in a warm and friendly manner. People who used the service were observed to have their physical and emotional needs met by staff.

On the Wentworth unit we talked to one parent of a person using the service who told us how positive their son’s experience had been at Low Laithes Village. They told us there was “good communication” between themselves and members of staff. The parent explained how their son’s behaviour had improved and how they had “come on in leaps and bounds since living at Low Laithes”. Some other comments made by the parent included, “The care [son] gets is exemplary”, “Staff give fantastic care”, “Has a fantastic active life….a quality of life he deserves” and “I would praise them [staff] to the hilt”.

It was difficult to obtain direct views of people who use services at this location due to the nature of resident’s learning disabilities at this location. On the site visit conducted 29 March 2011 one resident was able to communicate positively about her care and accommodation at the location. They ‘liked’ the staff and care and were enthusiastic about the activities they took part in. For example, when asked about their favourite activity this was “bowling!” and were looking forward to going horse riding on the day of our visit.

The provider also submitted information which had captured relatives views. For example:

“Parents praised Low Laithes Village for input and progression that had been made over last 12 months”.

“The parent partnership is vital”

“We reflected on all the efforts the staff had made to make it [Christmas] special and homely for “Y” with a tree, decorations, lights, presents, and tons of the universal currency – Chocolate!”

“Were now working with the care team as they outline their developing plans for “Y” on their life journey and it’s very exciting”.