Reiver House is a residential care home for up to four adults with autism and severe learning difficulties, often accompanied by complex needs. The accommodation is on two levels and there is access to a garden area and outside space.

Reiver House 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 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.”

At our last inspection we rated the service good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on going monitoring, that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection on 12 February 2015.

The service does not currently 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. An application has been received from the newly appointed manager and is currently being processed by the Care Quality Commission, Registration Team.

We found systems and processes were in place to keep people safe. Staff understood their responsibilities and were able to explain the measures they took for safeguarding people they cared for. Any foreseeable risks to a persons safety and health were fully assessed and measures put into place that minimised the potential risk. The measures supported people to stay safe, whilst not unnecessarily restricting their freedom. Incidents and accidents were reported and the management team reviewed all incidents and put measures in place to reduce to reduce the risk of similar incidents happening again.

Medicines were managed effectively and safely. The premises and environment was in need of some refurbishment and chipped paint and damaged wall covering was noticeable. The manager informed us that redecoration was planned and quotes for the work to be carried out had already been obtained. Infection prevention and control was effectively managed.

Staff received appropriate training for their role and they were supported to further develop their knowledge and skills.

People's needs were assessed and care was delivered in line with national guidance. Care plans contained detailed information about each person's individual support and their preferences. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. When people were unable to make decisions about their care and support, the requirements of the Deprivation of Liberty and Mental Capacity Act (2005) were followed.

All the people currently living at Reiver House are unable to express themselves verbally, however they clearly felt comfortable with the staff and appeared to be relaxed and happy. From speaking and watching the staff interaction with the people it was evident that caring relationships had developed with people. We saw people were treated with kindness and respect. People felt able to express themselves in a safe and supportive environment.

People living at Reiver House had complex needs and one to one or two to one support was provided to ensure the safety of the people and the staff. Staff had a detailed knowledge of

Reiver House is located in a residential area of Leyland, close to the town centre. It provides accommodation for up to four people with learning disabilities, who require help with their personal care needs.

There are a range of amenities within the local community, such as shops, pubs, a post office, church and leisure centre. Reiver House is owned by Autism Care (North West) Limited.

We last inspected this location on 17th October 2013, when we found the service to be compliant with the regulations we assessed at that time. This unannounced inspection was conducted on 12th February 2015, when the registered manager was on duty. 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.

Records showed new employees were guided through a detailed induction programme and were supported to gain confidence and the ability to deliver the care people needed.

We found the planning of people’s care and support to be very detailed and person centred. This provided good guidance for the staff team about each person’s assessed needs and how these needs were to be best met, in accordance with the preferences and wishes of those who lived at the home.

Medications were well managed and our findings demonstrated that proper steps had been taken to ensure people who used the service were protected against the risks of receiving inappropriate or unsafe care or treatment. This helped to ensure people’s health, safety and welfare were consistently promoted.

The staff team were confident in reporting any concerns about a person’s safety and were competent to deliver the care and support needed by those who lived at Reiver House. Recruitment procedures adopted by the home were robust. This helped to ensure that only suitable people were appointed to work with this vulnerable client group.

The premises were clean and well-maintained throughout. There were no unpleasant smells noted. Systems and equipment within the home had been serviced in accordance with the manufacturers’ recommendations, to ensure they were safe for use.

The management of risks was consistently robust. This helped to protect people from harm. The staff team were provided with a wide range of learning modules and were regularly supervised. This helped to ensure those who worked at Reiver House were trained to meet people’s health and social care needs.

Staff were kind and caring towards those they supported and people were helped to maintain their independence with their privacy and dignity being respected at all times.

We visited the home on 17th October 2013 and looked at outcomes 2, 4, 9, 10, 11, 12 and 16. We found the service was compliant with these outcomes. We spoke to one person at the home and observed their care. We also spoke with staff on duty. At the time of our visit there was only one person accommodated at the home.

The person living at the home did not just use words to communicate their needs and used some signing as well as their own methods of communicating their needs.

We observed staff responding respectfully and sensitively to their nonverbal communication and actions. Staff were supported in their approach to care through access to detailed, person centred care and support plans and regular meetings. Throughout the visit the staff demonstrated a person centred approach in the way they provided care.

Assessment of the person’s need was thorough and person centred, with focus on their individual circumstances and immediate to longer-term needs. Care and support plans placed an emphasis on the person’s right to determine how they lived their lives with the emphasis on managing risks safely.

The person’s capacity to make their wishes known when they did not use words was recorded and appropriate communication methods used.

The right of the person to take risks had been acknowledged and risk assessments ensured a balance of safety and effectiveness. The person was cared for by staff that were recruited properly and trained well.

We spoke with a number of the people who live at the home during our visit and a selection of staff members. We received positive feedback and comments included;

From service users:

“The staff are really great.”

“I like the staff here.”

“I can get up and go to bed when I like.”

“We all help with choosing the meals and can go and help with the shopping.”

“I choose my own clothes when I go shopping with my key worker.”

“I chose my room colours and bedding, its my favourite colour.”

From staff:

“I will tell the manager if I am not happy with anything.”

“We have a great team with a variety of ages.”

“I love working here with these residents.”

“There is plenty of training available.”