Rowan Cottage is a residential care home providing care and accommodation for up to nine people with a learning disability or autistic spectrum disorder. It is a single storey building with an annexe and an enclosed garden. At the time of the inspection there were nine people living at the service, eight in the main house and one in the self-contained annexe.

The service is required to have a registered manager. There was a registered manager in post who had been registered to manage the service since July 2016. 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.

This was an unannounced comprehensive inspection which took place on 10 May 2017. We were assisted by the registered manager during the inspection.

People were safe at Rowan Cottage. They were encouraged and supported to learn about how to keep themselves safe and raise any concerns or worries they may have. People were protected from harm and abuse by staff who had been trained and had knowledge of how to safeguard people. Staff understood their responsibilities to report and act on issues if they arose. Risks were assessed, managed and reviewed to keep people safe. There were sufficient staff who had been recruited using effective procedures to ensure their suitability. Medicines were managed and administered safely. Routine health and safety checks were completed in accordance with legislation and guidance. Infection control procedures were followed.

Staff were praised by people for providing effective support. Staff were trained in areas relevant to their job role and their skills assessed and monitored. They were supported by the management team to develop and gain appropriate qualifications. Staff felt supported and received regular supervision and appraisal of their work. The provider was meeting the requirements of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards. Consent to care and support was sought in line with legislation and guidance. When appropriate mental capacity assessments had been completed and where people had been assessed as not having mental capacity to make a decision, a best interests meeting had taken 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 service supported this practice.

Staff knew people and their individual needs very well. Key workers spent time with people discussing their support and any changes they wished to make. People were comfortable and relaxed with staff demonstrating trusting relationships had been established. These relationships had led to exemplary work being undertaken to develop people’s independence. Other excellent work had involved proactively supporting people to overcome difficulties and challenges. People were respected and their dignity was maintained. They were supported to develop and maintain important and significant relationships.

The service was extremely responsive. People’s support plans were comprehensive and provided detailed guidance to staff on preferences and personal routines. Innovative ways had been sought to assist people in achieving their goals and aspirations as well as overcoming personal challenges. People were encouraged to recognise their own talents and self-worth and to celebrate this with others. People’s changing needs were responded to positively and they were supported to make their own decisions whenever possible. Varied activities were sought and identified for each individual to engage them in meaningful occupation alongside social enjoyment. People were consistently offered new experiences and supported when necessary to embrace

The inspection took place on 9 and 10 February 2016 and was unannounced.

Rowan Cottage is a care home without nursing for up to nine people with a learning disability or autistic spectrum disorder. Rowan Cottage is a one storey building with a self-contained annexe in the rear garden. At the time of the inspection eight people lived in the main building at Rowan Cottage and one person lived in the annexe. The people living at the service had a range of support needs.

The service is required to have a registered manager. 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. At the time of the inspection the manager was not registered with CQC. They had recently been appointed and were in the process of applying to become a registered manager.

Staff felt well supported by the manager and said they were listened to if they raised concerns. However, individual staff members had not had annual appraisals or regular one to one meetings with their line manager. This had been identified and addressed by the new manager but we could not be sure at the time of the inspection if the improvement would be sustained.

Some records lacked organisation, making it difficult to locate the most current information and were not always up to date or completed fully. This was being addressed by the manager at the time of the inspection.

Relatives had raised concerns with regard to the management of the service. However, they were more positive since the appointment of the new manager and felt their concerns had been listened to.

Staff received training to meet people’s needs which was refreshed periodically. New staff received an induction, training and support from experienced members of staff.

People using the service were happy living at the service and they felt safe. People were relaxed and a sense of fun and spontaneous banter was evident throughout the two days of the inspection.

Staff treated people with kindness and showed respect to each individual. Support was focussed on individuals and designed to meet the specific needs and preferences of people living at the service.

Robust risk assessments were carried out and detailed guidance provided to staff in order to keep people safe. Staff were aware of their responsibilities to safeguard people and knew how to report concerns promptly through procedures they understood well.

The provider had robust recruitment procedures in place to ensure only staff of suitable character were employed.

People’s medicines were managed safely. Staff had received appropriate training in the safety of medicines and their knowledge and skill had been assessed.

People had their rights protected. Staff understood the relevance of the Mental Capacity Act 2005 (MCA), Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care.

People and their relatives were involved in planning and reviewing the support they required. People were encouraged to be as independent as possible and they worked toward agreed goals.

Each person had a programme of activities planned and designed to meet their personal preferences and goals. Links with the community were maintained and people were encouraged to use community facilities such as public transport, leisure centres, shops and colleges.

The manager and provider assessed and monitored the quality of the service. People, relatives and stakeholders were encouraged to give feedback on the service and this was used to make improvements. Complaints were recorded, investigated and responded to in line with the provider’s policy.

There was a happy atmosphere within the home, where people who used the service and staff were friendly and treated one another with respect. People told us they had lots of activities but were always given a choice. One person said, "I like the way they encourage me to do things, even if I say no to start with, because I always enjoy myself when I get there."

We saw staff treat people in a calm and reassured manner that met their needs and ensured their safety and welfare. People we spoke with praised the staff for supporting them to be independent and achieve their goals. One person said, “I love it here because everyone is friendly and looks after one another.” A relative we spoke with said, “The care is excellent and you can see immediately that the staff know the people they care for by the way they communicate with them.”

The provider had an effective system to ensure that medicines were managed safely. We saw lunchtime medication being administered in a person centred way, which was accurately recorded.

People were protected from the risk of unsafe care because the service had a thorough recruitment and selection process. Staff we spoke with confirmed that references and other security checks had been completed before they had joined the home.

The manager conducted audits and surveys to monitor the quality of the service provided. We saw that complaints and incidents were reviewed and that appropriate action had been quickly taken where required.

People living in the home had individual communication and behavioural needs. We spoke with four people who told us they liked living in the home. They said staff were lovely and they could talk to staff about anything that was troubling them. One person told us that their key worker “was great”. Another told us "I like living here. Some of my best friends live here". One person said the manager is “Ace”. We saw that people were involved with their care and the running of the home as far as they were able.

We were told that independence and individuality were promoted within the home. People living there were supported and enabled to do things for themselves as far as they were able. They were encouraged to express their views using their preferred individual communication styles and to participate in making decisions relating to their care and treatment.

We looked at a range of records, spoke with the manager, three staff and observed a shift handover. We also spoke with a relative of a person living in the home. They told us that they were always welcomed into the home and the manager and staff were approachable. They thought the home did a reasonable job of meeting their relatives very complex needs within the constraints of the rules and regulations they had to adhere to. We saw the communal areas of the home, some people’s bedrooms and spent some time observing interactions between staff and people living in the home.

People told us that they liked living in the home. They told us staff were kind and they could talk to them if they had concerns. People were involved with their care and the running of the home. They told us that there were house meetings where they could put forward ideas and make requests.