Ravensknowle Road is a small care home providing accommodation and support for up to eight people with learning disabilities. It is part of the Bridgewood Trust; a charity organisation which provides residential, domiciliary and day services to people with learning disabilities.

This inspection took place on 6 December 2017 and was unannounced. The service was previously inspected on 27 August 2015 and was at that time not meeting the regulations related to consent. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question effective to at least good. We found improvements had been made at this inspection to meet the relevant requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Ravenskowle Road 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.

The home 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.

On the day of our inspection there were eight people living in the home.

The care 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.

People told us they felt safe and happy. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence. Robust emergency plans were in place in the event of a fire or the need to evacuate the building.

A system was in place to ensure medicines were managed in a safe way for people. Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse.

Sufficient staff were on duty to provide a good level of interaction, and safe recruitment and selection processes were in place.

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 home supported this practice.

Staff told us they felt supported. Records showed they had received an induction, role specific training, plus supervision and appraisal.

People told us they enjoyed their meals. People’s nutritional needs were met and they were supported to access a range of health professionals to maintain their health and well-being. The service worked in partnership with community professionals and used good practice guidance to ensure staff had the information they needed to provide good quality care.

People we spoke with were delighted with recent improvements in their independence which had been promoted by the registered manager. This had improved people’s sense of control and autonomy.

People and relatives told us they were very happy with the care and we saw the home had a warm and happy atmosphere where mutual respect and friendship were promoted.

Self-advocacy and involvement was promoted within the home. People were involved in arranging their care and support and staff facilitated this on a daily basis.

Individual needs were assessed and met through the development of detailed personalised care plans which considered people’s diverse needs and preferences.

People had access to social and leisure activities in line with their preferences and interests, and were therefore supported to live fulfilling lives.

Systems were in place to

The inspection of Ravensknowle road took place on 28th August and was unannounced

Ravensknowle Road is a small care home providing accommodation and support for up to eight people with learning disabilities. It is part of the Bridgewood Trust; a charity organisation which provides residential, domiciliary and day services to people with learning disabilities.

The service is required to have 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. In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time. The current manager had submitted their application to commence registration with CQC. At the time of our inspection this was not finalised.

Staff had a good understanding about safeguarding adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

There were enough staff to provide a good level of interaction

The provider had effective recruitment and selection procedures in place.

People’s capacity was not always considered when decisions needed to be made. This was a breach of Regulation11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff had received an induction, supervision, appraisal and specialist training to enable them to provide support to the people who lived at Ravensknowle Road. This ensured they had the knowledge and skills to support the people who lived there.

People enjoyed the food and were supported to eat a balanced diet. A range of healthcare professionals were involved in people’s care.

Throughout our inspection we observed staff interacting with people in a caring, friendly, professional manner. Staff were able to clearly describe the steps they would take to ensure the privacy and dignity of the people they cared for and supported. People were supported to be as independent as possible throughout their daily lives.

Individual needs were assessed and met through the development of personalised care plans and risk assessments. People and their representatives were involved in care planning and reviews. People’s needs were reviewed as soon as their situation and needs changed

People were able to make choices about their care. Peoples care plans detailed the care and support they required and included information about peoples likes and dislikes

People engaged in social activities which were person centred. Care plans considered people’s social life which included measures to protect people from social isolation.

People told us they knew how to complain and told us staff were always approachable. Comments and complaints people made were responded to appropriately.

The culture of the organisation was open and transparent. The manager was visible in the service and knew the needs of the people in the home.

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of the people were met and that the service provided was to a high standard.

You can see what action we told the provider to take at the back of the full version of the report

On the day of our visit eight people were living at Ravensknowle Road, three of these people were away from the home attending a day centre.

The manager of the home was on holiday when we visited the home. During our visit we spoke with three support workers, and five people who lived at the home.

We heard staff asking people who lived at the home what they would like to do and explaining what was happening.

People looked well dressed and cared for, the atmosphere in the home was calm and relaxed.

We looked at two people’s care records and found that showed people using the service received additional support when required for meeting their care and treatment needs.

During our visit we observed people looking comfortable when interacting with staff.

We found staff were knowledgeable about local safeguarding procedures and knew what actions to take if they suspected abuse was taking place.

We looked at three sets of staff records and found that effective recruitment and selection processes were in place.

Documentation also showed the home had effective systems for auditing the quality of service.

People living at Ravensknowle Road told us they were happy with the quality of care and support they received. People were familiar with their care record and told us they were involved in making decisions about what support they required.

People told us that the staff were nice and that there privacy and dignity was always upheld. We noted that some people chose to have a key to their room which they liked to keep locked.

We observed how staff interacted with people and it was evident that they knew peope well. They were friendly and listed to people when they spoke.