Robinson House is registered to provide accommodation for up to ten people who have a learning and / or physical disability. The service is not registered to provide nursing care. Ten people were living at the service on the day of our inspection.

This inspection was undertaken by one inspector and an expert by experience of people living with a learning disability. At the last inspection on 08 July 2014 the service was rated as ‘Good’. At this inspection we found the service remained ‘Good’.

A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Systems were in place to manage risks to people using the service and to keep them safe. This included safeguarding matters, behaviours that were challenging to others and medicines.

There was sufficient staff on duty to keep people safe. A thorough recruitment and selection process was in place, which ensured staff recruited were suitable to work with people who used the service.

The registered manager and staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s needs were assessed, so that their care was planned and delivered in a consistent way. The registered manager and staff talked passionately about the people they supported and knew their care needs well. Different communication methods had been used to support people to understand information about their care. Staff offered people choices, for example, how they spent their day and what they wanted to eat. These choices were respected.

People experienced a good quality of life because staff received training that gave them the right skills and knowledge to meet their needs. People were supported to carry on with their usual routines, shopping and accessing places of interest in the community.

People were provided with sufficient to eat and drink to stay healthy and maintain a balanced diet. People had access to health care professionals, when they needed them.

There was a strong emphasis on promoting good practice in the service. Staff were clear about the vision and values of the service in relation to providing compassionate care, with dignity and respect. Staff knew what was expected of them and we observed staff putting these values into practice during our inspection.

The provider had a range of systems in place to assess, monitor and improve the service. Significant improvements had been made to the interior décor since our last inspection. People had been consulted on the improvements made to the premises and their choices had been respected. People, their relatives and staff were regularly asked for their feedback about the quality of the service provided. Feedback was used to recognise good practice and to drive improvements where shortfalls were identified.

Further information is in the detailed findings below.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was unannounced, which meant the provider did not know that we were coming. Our last inspection took place in October 2013, at that inspection there were no breaches in the regulations.

Robinson House provides a service for up to 10 people who have a learning and or physical disability. There were 10 people living at the home when we visited. There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We saw that there were proper policies and procedures in relation to the MCA and DoLS to ensure that people who could make decisions for themselves were protected. We saw from the records we looked at, where people lacked the capacity to make decisions, that best interest meetings were held. This was for finances, medicines and other things which affected a person’s safety.

We found that people’s health care needs were assessed, so that care was planned and delivered in a consistent way. From the three people’s plans of care we looked at, we found that the information and guidance provided to staff was detailed and clear, and in an appropriate format. During our observations throughout the day we saw that staff clearly knew how to support people in a way that the person wanted to be supported. We also saw that people at risk of malnutrition or dehydration were effectively supported to have sufficient quantities to eat and drink.

We saw that staff respected people’s privacy and dignity. This was by always knocking on the person’s door or asking for permission before providing any personal care to people. We saw staff using curtains or blinds and offering space for people to talk in private.

Records we looked through and people we spoke with demonstrated to us that the social and daily activities that were provided had been decided upon by each person. People could change their minds if they did not want to do their routine activities. Staff we spoke with confirmed these alternative arrangements to ensure that people who remained at the home were supported to improve their daily living and social skills. One person we spoke with said, “I have been home for the weekend and I am now tired. Tomorrow I am going out for a pizza.”

Other records we looked at such as, easy read documents showed us that people were supported to complain or raise any concerns if they needed to. There had not been any complaints since our previous inspection in 2013. We were provided with positive comments about the service from healthcare professionals. The complaints procedure was available to people in an appropriate format and if required, people could be supported by a social worker or an advocate. Our observations confirmed to us that staff responded appropriately if people were not happy, or communicated that they were anxious about something.

The provider had a robust recruitment process in place. Records we looked at confirmed that staff were only employed within the home after all essential safety checks had been satisfactorily completed. Staff we spoke with told us that they had not been offered employment until these checks had been carried out. Records viewed confirmed this to be the case.

The provider used a variety of ways to assess the quality of service that it provided. This was by involving families, advocates, social workers, health care professionals and others on a regular basis. Records were kept wherever this occurred to evidence the reasoning behind any changes to people’s care.

During this inspection we spoke with four people who used the service and two members of staff. People who used the service told us that were very happy with the care they received and that they felt safe. One person stated that: “I love it here there is always lots to do and we can make our own decisions about whether to go or not”.

Medication storage and records were well maintained.

We found that consent had been recorded within people’s care plans and that people's care and support needs were well documented.

We found that people were given appropriate choices in food and drink. They were given support to prepare and serve the meals.

We found that appropriate numbers of trained staff were available to support people in meeting their care and support needs.

We found there were systems in place to ensure continued improvement in the service provided.

During our inspection of the home on 12 November 2012, we spoke with the acting manager, three staff and people who used the service. We observed and talked to staff who were very knowledgeable about the people who lived at Robinson House and were able to understand their needs. We saw that the care plans were individualised and provided staff with the information on how people like their care and support to be carried out. People’s choices were promoted and actioned by support from staff. The local authority conducted a monitoring visit and commented that people continue to receive a high standard of support to achieve their outcomes. The team appear to be continually striving to improve the service. People we spoke with told us they enjoyed living at Robinson House and the staff are great.

People felt safe living at Robinson House. They were well cared for and liked the staff who looked after them.

One person said that they liked having a wheelchair as this helped them to get around and about inside and out of the home.

People living in the home were able to direct and influence how they received their care and were able to self determine routines such as when they wanted to have their medication and where they wanted to have their meals.

The people living in the home have opportunities to influence how the home is run, to include changes within the menus.