About the service: Lucy Glyn Residential is a residential care home that also provides support to people living in their own home. People receiving support from this service have a diagnosis of a learning disability or an autistic spectrum disorder. At the time of our inspection the service was supporting six people within the residential care home and seven people who were living in their own homes.

Rating at last inspection: Good overall with outstanding for responsive. The last report for Lucy Glyn Residential was published on 14 April 2016. At this inspection we found that the provider remained extremely responsive to people's individual needs and this key question remains outstanding

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

What life is like for people using this service:

• People received a personal service that was tailored to meet their individual needs.

• Outcomes for people were consistently better than expected because staff knew people well and promoted their individuality.

• People were supported to enjoy a wide range of activities which reflected their individual interests and enhanced their lives.

• Staff sought innovative ways for people to continue to do things they liked, whilst maintaining their safety.

• Staff had received a comprehensive induction and had on-going training to develop the skills they needed to care for people's varying and complex needs.

• People were happy with the support they received from Lucy Glyn Residential. They told us that staff were kind and understood them as individuals.

• Systems were in place to identify people’s risks and the service promoted people’s safety.

• Staff administered people’s medicines safely and people received medicines as prescribed. People’s medicines were regularly reviewed and people had access to the healthcare they needed.

• People, their relatives, staff and other health and social care professionals worked together to assess people’s needs and plan their care. This was done so people’s needs and preferences would be met, and they would enjoy an enhanced sense of well-being.

• People were supported by staff to make decisions about their care. Staff used their knowledge of people’s preferred ways of communicating, to assist people to make their own choices.

• Staff promoted people’s right to independence, dignity and respect.

• People received support to keep in touch with family and friends who were important to them and to express their individual lifestyle choices.

• The provider and registered manager checked the quality of care provided and developed plans to improve people’s care and support.

• We found the same level of care and support had been maintained since the last inspection and the service met the characteristics of a “Good” rating. The service showed an exceptional level of responsiveness and this area also remains rated as “Outstanding”.

More information is available in the full report

Lucy Glyn Residential provides accommodation and personal care for up to six people with learning disabilities or autistic spectrum disorder. There were six people staying at the service at the time of our inspection.

We inspected the service on 8 December 2015. The inspection was announced. This was to ensure the registered manager and staff were available when we visited, to talk with us about the service.

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.

The registered manager was dedicated to providing quality care to people. They had used guidance and research to provide an environment that stimulated people and kept people safe. They followed good practice initiatives and worked alongside other organisations and health care agencies to develop innovative ways of supporting people. The service had won a national award for innovative practice in positive behaviour support involving service users, from the British Institute of Learning Disabilities (BILD) in 2015.

The registered manager maintained an open culture at the home and was visible and accessible to people. There was good communication between staff members and staff were encouraged to share ideas to make improvements to the service.

Staff shared a common vision to provide an environment where people were enabled to live their lives, pursue their interests and maintain their independence. Staff took a positive approach to risk management and supported people as far as possible to do the things they chose to do.

People’s health needs were monitored and they were referred to external healthcare professionals when a need was identified. Healthcare professionals were positive about the care provided by staff.

People spoke highly of the level of commitment and care provided by the registered manager and staff. There were enough staff on duty to meet people’s needs. The recruitment process checked staff’s suitability to deliver care safely and included the views of people who lived at the home. Staff received training and support that ensured people’s needs were met effectively. Staff supported people with kindness and compassion, and treated people in a way that respected their dignity and promoted their independence.

People were encouraged and involved in planning how they were cared for and supported. Staff used different methods to obtain feedback from people, which were tailored to meet the individual needs of each person. Care was person centred and was planned to meet people’s individual needs and preferences. People were supported and enabled to participate in activities that were meaningful to them.

Management and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and supported people in line with these principles. The registered manager had made DoLS applications where potential restrictions on people’s liberty had been identified. The applications had not yet been authorised. Where people did not have capacity to make decisions, decisions were made in people’s best interests.

People and their relatives told us they felt safe using the service. Staff demonstrated they understood the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding potential abuse. Risks to people’s health and welfare were assessed and support plans gave staff instructions on how to minimise identified risks, so staff knew how to support people safely. Some improvements were needed in the recording of medicines within the home to ensure they were always managed safely.

People told us they would raise

On the day we visited Lucy Glyn Residential we spoke with the registered manager, who was also the provider and two senior support workers. There were five people living at the home and we spoke with two people about their experiences of the service. We read the care records for three people who used the service, observed care practice and staff's interaction with people when they were delivering care.

On the day of our visit, people who lived at the home engaged in different activities throughout the day. For example two people were supported to go to college to study. Another person went out to town for breakfast. Another person was using the computer in the meeting room.

We saw staff demonstrated they understood people’s personal needs and the ways they communicated those needs.

We saw that people’s care plans were person centred and reflected their individual needs. We found the members of staff supported people as detailed within their care plans.

We found that the service had a complaints process that was accessible for people in the home. People who lived in the home told us they felt able to make a complaint is they wished and were supported to do this by staff.

We saw the provider ensured that the appropriate checks were undertaken before a new member of staff was employed. Staff we spoke with told us about their induction and were enthusiastic about training they had received.

The five people who lived at Lucy Glyn Residential were not able to able to talk in detail about the quality of the care and support they received, because of their complex needs. We observed that care staff engaged effectively with people as individuals. We saw records that demonstrated how people’s needs were assessed at meetings with their families and health and social care professionals. Care staff we spoke with described each person’s unique needs and how they supported them.

The provider had nominated an infection control lead person, who had implemented infection control procedures and guidance for all staff. Care staff we spoke with told us it helped them to have a written cleaning schedule for the house, because they knew what was expected of them.

Care staff told us about the support they received, that helped them to deliver effective care and support. Care staff said their training helped them to understand people better and guided the actions they took to help people develop and lead more fulfilling lives. They said they felt well supported by their supervisors and the manager.

We saw that the manager recorded the checks they made on the quality of the care and support people received. They recorded their findings, raised issues with staff and took action to make sure changes were made when necessary. People’s records were kept in the staff office so people’s confidential information was kept securely, but was accessible to staff when needed.