Station House is a residential care home for four people with a learning disability, associated physical disability and/or autistic spectrum disorder. Station House is a large detached property with local amenities and transport links close by and the home is staffed 24 hours a day.

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.

People were safeguarded from the risk of abuse as staff were trained to recognise and respond to any signs of abuse. There were sufficient numbers staff to meet people’s needs in a safe way. The provider followed safe recruitment procedures to ensure that appropriate staff were employed. Risks to people were assessed and well managed. People’s medicines were safely managed and administered. There were effective systems in place to reduce the risk of the spread of infection.

The provider followed the principles of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were supported to eat well in line with their needs and preferences. People’s health and well-being was monitored and supported. People were cared for by staff who were supported and had the skills and training to meet their needs.

Staff interacted with people in a kind and respectful manner and they knew people well. People’s privacy was respected and staff supported people to maintain their dignity. People were offered choice and had access to an advocate if they needed one.

People were provided with opportunities for social activities and they were supported to maintain contact with their family and friends. People saw healthcare professionals when they needed. People could be confident that they received a service which met their needs and preferences. There were effective procedures in place to respond to any concerns or complaints. People's end of life wishes were being assessed.

There were effective management systems in place and there were systems to monitor the quality and safety of the service provided. People were supported by a team of staff who felt supported and valued.

Further information is in the detailed findings below

The inspection took place on 26 November 2015 and was unannounced. At the last inspection in April 2014 the provider was meeting all of the requirements that we looked at.

Station House provides accommodation and personal care for up to four people with a learning disability. On the day of the inspection visit three people were living at the home. There was a registered manager in post who was present at the inspection. They also managed one other care home. 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.

People were supported by sufficient numbers of staff to meet their individual needs and to keep them safe. Staff knew how to protect people against the risk of abuse or harm and how to report any concerns. People received their medicines when they needed them and as prescribed.

People were supported by staff that were trained and confident in providing them with effective care. People were asked for their consent for care and were provided with care and support that protected their freedom and promoted their rights. Staff gave people choices and ensured they had the food and drink they needed in accordance with their preferences. People’s health care needs were monitored and they were supported to see health care professionals when they needed to.

People were seen as individuals and received care and support that was individual to them when they needed it. Staff had developed good caring relationships with people and knew their preferences well. People were supported by staff that were kind and caring in their approach. They were treated with dignity and respect and staff offered choices to people in a way they could understand. People’s care was regularly reviewed and care plans were personalised and reflected their needs. Staff knew how to make a complaint on behalf of the people they supported.

There was good management and leadership in place. The service had an open culture that encouraged people to be involved in the service provided. Systems were in place to monitor and review the quality of the service to ensure it met the standards required and people’s expectations.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We met two of the three people who lived at Station House. One person was out on a planned activity with staff support. People who received a service were unable to share their views about the service verbally. We spent time observing staff interactions with people. We saw that people were relaxed and happy.

We found that staff were knowledgeable about the individual needs of the people they supported. They told us that people could express their needs and preferences and that staff recognised people's changing moods. They told us that they were able to offer effective support at all times. Health professionals told us that they were very satisfied with the service provided at the home. They told us that staff listened to suggestions for improvements and acted upon them.

We spoke with the advocate who supported the people who received a service. They told us that people's needs and wishes were considered in relation to all aspects of the way that people lived their lives. They told us that the manager and staff understood the role of an advocate and were supportive of their input.

Staff told us that they were well trained and supported. They said that they had the skills to meet people’s individual needs safely.

We saw that risks were being continually assessed and records showed how risks could be reduced and eliminated.

Is the service effective?

We saw individual plans that reflected how people led full and active lives with the appropriate staff support. Staff told us that everyone had allocated one to one time to do activities of their choice. They also said that sometimes the three people who received a service enjoyed trips out together. We saw pictures that showed numerous activities and outings. We saw that activities were arranged in consultation with people and by knowing individual’s likes and interests. Information seen in care plans supported this.

People’s health and care needs were assessed and actions were taken to ensure that those needs were met. Staff worked with outside health and social care professionals as required. We saw how this joint working was documented in care plans for consistency. Staff told us how they had recently supported one person who received a service to attend for medical checks. This demonstrated how staff had worked hard to ensure that the person they supported got the best possible treatment.

Is the service caring?

We saw that staff on duty were kind and patient. They spoke positively about the people they supported. An official visitor to the home had reflected, “Staff really do seem to go the extra mile for the residents”. We saw that staff had worked hard to support people to achieve their goals. We saw that staff had developed close working relationships with the people they supported.

We looked at care plans and saw that people’s preferences, interests, aspirations and needs had been recorded.

Is the service responsive?

We saw how staff listened to people and acted in accordance with their wishes. We saw how the registered manager had worked closely with staff and health care professionals to ensure people remained in good health. The registered manager was in the process of developing questionnaires for people (living at the home and visiting) to complete about the quality of the service provided. We spoke with the independent advocate of the people who received a service. They told us that the service was responsive.

Is the service well-led?

We saw how the registered manager had started to implement weekly and monthly audits of the service provided. They told us that they had input from an external agency who carried out monthly monitoring visits. They told us that they received actions following these visits which they implemented.

The service was well led and the registered manager and senior staff were approachable and understanding of their roles and responsibilities. The service was able to respond to people’s changing needs and they worked with outside agencies to ensure people received the best care. Health professionals spoke positively about the leadership and commitment of the registered manager.

The registered manager told us about changes they had planned to improve the quality of the service further. For example they were re writing care plans to make them more user friendly.

We used a number of methods to help us understand people’s experiences as they were not able to tell us their views about living at Station House. People appeared happy in the home and were comfortable with the staff and their surroundings. We observed positive staff interaction with people. They were caring and attentive to people and demonstrated a clear understanding of people’s individual needs and preferences.

Staff shared examples of how they offered people choices in their daily lives and how they promoted their independence. We observed this during our inspection. We saw people were supported to attend health appointments to maintain their health and welfare. The manager agreed to review how people received their medication to ensure it was personalised.

We found there were enough staff on duty to meet people’s individual needs. We saw staffing was planned in advance and that staffing levels were flexible dependent on people’s needs and activities.

Information about how to complain was not readily accessible. However staff told us they would know if a person was unhappy and were confident in raising concerns on behalf of the people they supported.

We visited Station House unannounced on 3 July 2012 to check on the care and welfare of people using this service. We used a number of different methods to help us understand the experiences of people using the service. People had complex needs which meant not all of the four people living at Station House were able to tell us their experiences of the service they received. Therefore we spent time observing routines and how people were supported. We spoke with three staff who were on duty on the day of our visit in addition to the care co-ordinator and acting manager.

There had been no new admissions to the home since we last visited in 2010. Staff told us how they supported people in planning and making decisions about their care. They shared good examples of how they ensured they respected and promoted the privacy and dignity of the people living at the home. We saw people being offered choices throughout our visit and staff were respectful of people's decisions. Staff were starting to explore ways in which to involve people more in making choices and decisions, for example through the use of visual aids and symbols.

We reviewed the care and support plans for two people. These were detailed and told us about the needs of the individual and how they liked to be supported. We saw the health needs of individual’s were monitored and reviewed. People were supported to lead active lifestyles and be part of their local community.

People looked relaxed and comfortable in the presence of their peers and the staff supporting them. Staff told us they had received training in keeping people safe. They demonstrated an understanding of the different forms of abuse and knew the procedure to follow if they suspected abuse. The provider had implemented a number of changes in response to an adult protection investigation held. Staff and new managers spoke positively about the changes made in the best interests of the people using the service.

People were supported by a knowledgeable and trained staff team who knew their care and support needs. Staff told they received training and supervision to carry out their work safely and effectively. They said they felt well supported by the new management team.

The provider had recently commissioned the services of an external organisation to assess and monitor the quality of the service. Managers and staff considered improvements had been made in relation to the running of the service in the best interests of people living at Station House.