Laurel End is a residential home which provides accommodation and care to up to nine people with learning disabilities. At the time of our inspection visit, there were eight people living there.

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

A new registered manager was in post. 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 took over from the previous manager in January 2017.

People and relatives were at the heart of making care decisions and reviewing their care to ensure it continued to meet their needs. The service was extremely responsive to people’s needs, and comments made to us were universally positive. Care plans contained accurate and detailed relevant information for staff to help them provide the individual care people required. Plans were in place for the provider to enhance how it helped people achieve their aims and aspirations, to enhance people’s well-being.

People and relatives were very complimentary and satisfied with the quality of care they received. People received care that enabled them to live their lives as they wanted and were able to make choices about maintaining their independence. People were encouraged to make their own decisions about the care they received and care was given in line with their expressed wishes. People were supported to maintain relationships with people who were important to them.

For people assessed as being at risk, care records included information for staff so risks to people’s health and welfare were minimised. Staff had a good knowledge of people’s needs and abilities which meant they provided safe and effective care. Staff received essential training to meet people’s individual needs, and used their skills, knowledge and experience to support people effectively and develop trusting relationships.

Medicines were stored and administered safely and as prescribed.

People’s care and support was provided by a caring staff team and there were enough trained and experienced staff to be responsive to meet their needs. People told us they felt safe living at Laurel End and relatives agreed. Staff knew how to keep people safe from the risk of abuse. Staff and the registered manager understood what actions they needed to take if they had any concerns for people's wellbeing or safety.

People were supported 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 received a choice of meals and drinks that met their individual dietary requirements at times they wanted them.

People, relatives and staff were encouraged to share their views of the service through regular meetings and surveys. Plans were in place for the provider to enhance the way they gathered feedback so the service could improve. The registered manager had an ‘open door’ policy for people, relatives, staff and visitors to the home.

Further information is in the detailed findings below.

We inspected this service on 3 March 2015 as an unannounced inspection.

The service is required to have a registered manager as part of their registration with us. 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 service provides personal care and accommodation for up to nine adults who have a learning disability. On the day of our inspection there were seven people living in the home.

People told us they felt safe living at the home. Staff understood their responsibility to protect people and how to raise concerns both internally and externally if necessary. People were provided with information and contact details so they could contact external agencies if they felt unsafe.

Risks to people’s health and welfare were assessed. People’s care plans included guidance for staff on managing risks and supporting people positively.

There were sufficient staff to meet people’s physical and diverse social needs. Staff had access to advice and support outside of office hours because there were on call arrangements in place.

The provider’s recruitment process ensured staff were suitable to provide personal care to people.

There were processes to ensure the environment was maintained to minimise risks for people. Medicine storage, administration and recording was managed effectively and safely so that people received their prescribed medicine.

Staff received training to provide the skills they needed to care for people. Staff were supported by the registered manager and provider to discuss their work and personal development.

The provider understood their responsibility to comply with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). No one had a DoLS in place during our inspection. The provider reviewed people’s risk assessments in response to safety concerns, to enable people to live with as few restrictions as possible. People who lacked the capacity to make important decisions for themselves, were supported by staff acting in their best interest.

People were supported to have positive, sociable mealtimes. People were offered a choice of nutritious food which met their individual preferences and health needs.

People were referred to other healthcare professionals to support and maintain their health.

Staff were kind and encouraged people to remain as independent as possible. Staff knew people well and were able to interact with people who could not communicate or express themselves verbally.

People were supported to review their care regularly with staff, to ensure it met their individual preferences and needs. Staff recognised people’s diversity and supported them as individuals. There were opportunities for people to voice their opinions about the service and engage with the community they lived in.

The provider, registered manager and staff worked together as a team to provide people with a positive life experience.

When we visited Laurel End we did so unannounced which meant that no one who lived at or worked at the service knew we were coming. During our visit we met five of the people that lived in the home and two visiting relatives. We also spoke with the manager, two members of support staff, the cook and a member of domestic staff.

We found that people appeared happy and relaxed in their surroundings and were able to engage with staff in a friendly and open manner. One person told us, "‘I would never live anywhere else," whilst another nodded, smiled and said "Yes" when we asked if they were happy in their home.

We observed acts of kindness and caring from staff towards people. We saw good alternative methods of communication were used where people were not able to communicate well verbally.

People had care plans in place that contained information to assist staff with meeting their care and support needs. Staff we spoke with knew about people's needs.

We saw that there were processes in place to ensure that medication was managed safely on people's behalf.

We saw that there were processes in place for monitoring the health safety and welfare of people and assessing the quality of the service provided.

During our inspection visit of Laurel End Care Home we spoke with three people who lived there, four staff members and the registered manager.

We reviewed information about two people’s care and found that their care needs were being planned for. We found that the staff understood people’s care needs and how to protect them from harm.

We saw there was clear sensitive communications between the staff and people using the service. We noted staff took time to listen and wait for responses during conversations.

People told us they liked living at Laurel End and were happy with the care and support they received. They said staff were kind and helped them when they needed it. One person commented, "I really like living here.”.

People said they chose what to do during the day. We found that people had the opportunity to be involved in a wide variety of activities both within the service and in the community.

We saw that the service was clean and tidy and that it was maintained and decorated to a high standard. One person told us they were asked how they wanted their room decorated. The said, “This is just the way I like it.”

We spoke with three people who live at Laurel End. They told us they liked the staff and liked living at the home. We were unable to communicate with all the people who live at the home so we watched the way they interacted with staff on duty and how staff interacted with them. We saw that staff were patient, attentive and kind in their approaches with people.

We asked people about the care and support they received and they confirmed they were happy living at the home. Comments included, "I'm very happy with everything," and "All the staff are brilliant, you couldn't wish for anything better."

People also told us they would talk to the staff if they had any worries or complaints. One person commented, "I can talk to any of the staff."

People living at the home had been there for many years and because of this staff had developed their knowledge and an understanding of people’s care and support needs. We saw that staff interacted with people who use the service in a friendly, courteous and respectful manner. Care workers demonstrated they were aware of people’s care and support needs. We observed staff providing support in the home and saw people were treated with respect. Personal care issues were discussed sensitively and discreetly.

People were dressed in a style of their choosing and were supported by staff to take a pride in their appearance. We saw that people were very relaxed and at ease with staff and within their home environment. The atmosphere was calm, relaxed and very homely.

We looked at care records for two people living at the home. There was information about people’s care needs including their preferences and how they wanted care provided. People told us they were involved in decisions about their care. We saw information in the care plans that confirmed this.