Voyage 1 Ltd is a large registered provider, having 291 registered locations across the country. Oak House is registered to accommodate up to four people in what is currently an all female service. The service provides support to people living with learning disabilities or other complex needs who need support with personal care. At the time of our inspection there were four people living at the service, which is set in a modern detached house in a residential area of Crawley.

This inspection took place on 7 November 2017. The service was given short notice of our visit. This was to ensure people would be available to support us with the inspection.

We had previously inspected the service on 18 June 2015, when the service was rated as good in all areas. We found this good practice had been sustained. The registered manager was aware of changes to the key lines of enquiry the Care Quality Commission (CQC) uses to assess services, and was prepared for the inspection.

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.

Oak House had a well understood, positive and open culture, with a clear set of values and ethos. The service had a happy, positive and welcoming atmosphere.

There were clear lines of management within the organisation with procedures for escalating any issues. The service received clear feedback from the provider organisation on their performance, including areas for improvement and the service also operated their own series of audits. Actions and their completion were recorded on consolidated plans to ensure prompt action was taken. The service learned from incidents and accidents following a thorough review. We saw evidence of the service and staff reflecting as a team on incidents to develop their practice and support people more consistently.

Risks to people from their care were identified and plans were put in place to minimise these risks. The service took great pains to ensure their response to risks was individual and based on supporting the person. For example one person had been supported to receive treatment in the service rather than having to attend a hospital following an accident, because this would have been very distressing for them. Risks within the environment were addressed, including the security of the service.

People had access to good healthcare services, including ‘well woman’ clinics and regular health action plans. For some people this had involved considerable work to help them understand and be responsive to the services available, such as attending dentists. Staff had for example had to support one person over several visits to become more comfortable attending a dentist for treatment. People received their medicines safely and as prescribed. Medicines were stored safely, and staff had received training in safe administration.

People were able to make their own meal choices and were involved in making decisions over shopping and meal preparation. People could be involved in cooking if they wished, and we saw people being supported to do their own laundry and prepare a lunchtime snack.

People were protected from the risk of abuse. Staff understood signs of potential abuse and how to report any issues, both within or external to the organisation. Staff understood people’s communication needs, and were aware of how each person would communicate if they were unhappy or distressed about something. Information was available for people in assisted or easy read formats to help them understand the principles of safeguarding and ‘keeping safe’. We saw people and staff being involved in positive and caring relationships. We saw people seeking staff out to share their

The inspection took place on 18 June 2015 and was unannounced.

Oak House is registered to accommodate up to four people. It is an all-female service that provides support to women with a learning disability and or other complex needs who need support with personal care. There were four women living at the service at the time of our inspection. The property is a modern, detached house situated on the outskirts of Crawley town centre. It has a rear garden, communal dining area, sitting room and kitchen. All bedrooms have either en-suite facilities or a bathroom next door. All areas are easily accessible to people living at the service. There is a local bus service into town and people can also receive lifts in the home’s vehicle which has been adapted to accommodate a wheelchair.

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 were supported to be as independent as possible and live the lifestyle of their choice. They took an active role in the running of the home by completing their own domestic tasks, and choosing, buying and preparing their own food. They decided for themselves what to wear, when to get up and when to eat their meals and make themselves drinks. A relative said “Staff support X (relatives name) to make all her own meals and to cook for the others sometimes. They support everyone to do everything for themselves”.

People led active lives and supported to try new things like using public transport and to attend classes such as cookery and circuit training. People were supported and encouraged to maintain relationships with people that mattered to them. Relatives told us they could visit at any time and were made welcome by management and staff. One relative said “We can visit any time and are always offered a cup of tea.”

Staff knew the people well and were aware of their personal preferences, likes and dislikes. Person centred plans were in place detailing how people wished to be supported and people and or their representatives were involved in making decisions about their care. Where people lacked the capacity to make specific decisions they were being supported to make decisions in their best interests. They were supported with their healthcare needs and staff liaised with their GP and other health care professionals as required.

Relatives and staff spoke highly of the registered manager and staff. One relative said “Since X (registered manager) has been there things have been really fantastic, she’s made a real difference.” Feedback on the annual service review from June 2015 included the following comments ‘The staff are warm friendly and caring’, ‘A warm friendly atmosphere’, ‘Staff are always kind and approachable’ Two staff members referred to the registered manager as being “Brilliant”, one went on to say “Really helpful to me and to everyone, really supportive”. They described an ‘open door’ management approach, where the registered manager was available to discuss suggestions and address problems or concerns.

Staff were aware of their responsibility to protect people from harm or abuse. They knew the action to take if they were concerned about the safety or welfare of an individual. They told us they would be confident reporting any concerns to the registered manager or the person on call. Relatives felt their loved ones were safe and were confident their loved ones would speak out if something was wrong. When concerns had been raised the registered manager had responded appropriately and the relevant people had been informed. Systems for recruiting new staff made sure they were suitable to work at the home. They included security and identity checks and references from previous employers.

Staff felt supported and received regular training. They had obtained or were working towards obtaining a nationally recognised qualification in care. They were knowledgeable about their roles and responsibilities and had the skills, knowledge and experience required to support people with their care and support needs.

Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed and emergency procedures were in place in the event of fire. Staff had completed training in safeguarding adults and knew what action to take if they suspected abuse was taking place.

The provider had robust quality assurance systems in place to measure and monitor the standard of the service and drive improvement. People, their visitors, health care professionals and staff were all encouraged to express their views and complete satisfaction surveys. Feedback received showed a high level of satisfaction overall. Any areas identified as in need of improvement had been addressed.