Voyage 1 Ltd is a large registered provider, having 291 registered locations across the country. The Acorns is registered to accommodate up to four people in an all female service. The service provides support to people living with learning disabilities or other complex needs who need support with personal care. At the time of our inspection there were four people living at the service, which is set in a modern detached house in a residential area of Crawley.

This inspection took place on 27 September 2017. The service was given short notice of our visit. This was to ensure people would be available to support us with the inspection.

We had previously inspected the service on 3 July 2015, when the service was rated as good in all areas. We found this good practice had been sustained.

The service has 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. The registered manager was on leave at the time of our inspection so a regional manager attended the service to assist us with the inspection.

People benefitted because the service had a well understood, positive and open culture, with a clear set of values, ethos and clear lines of management. Regular audits and assessments of the service showed they were performing well and any areas needing attention or improvement were swiftly acted upon. Staff spoke highly of the manager and organisation. There were regular staff meetings and staff received regular supervision and appraisal.

People were protected from the risk of abuse as staff understood the signs of abuse and how to report concerns. People were encouraged to speak out if they were worried about anything and staff had access to people at all levels within the organisation to refer any concerns to. The service had a clear focus on the people they were supporting, their rights and the opportunities to help them reach their potential maximise independence and choices.

Risks to people were identified and plans were put in place to minimise these risks. For example, where people had health conditions that could present risks there were clear and well understood protocols in place to assist staff. Systems were in place to ensure any complaints or concerns were responded to and managed, including easy read documentation to support people’s understanding; however for some people staff understood the need to interpret people’s behaviour or facial expression in order to understand they were unhappy about something.

People received their medicines safely as prescribed. Medicines were stored safely in each person’s room, and records completed when people received their medicines.

People were supported by sufficient numbers of well trained and supported staff to meet their needs. Staff were very positive about the service and the people they supported. They told us “It’s a really nice place to work. It’s not like work really. It’s like spending time with friends” and another staff member told us a person living at the home “is more like a friend than a person I support. I just love working here.” Staff recruitment systems were robust, and helped to ensure that people were not supported by staff who may be unsuitable to work with people.

The Acorns provided a comfortable and homely environment in a residential area on the outskirts of Crawley. People had their own bedroom with en-suite facilities to match their needs. People had access to a pleasant garden with a decked seating area, and comfortable communal spaces.

People’s rights were respected. Staff had a clear understanding of the Mental Capacity Act 2005 and had received training in its implementation. Where people lacked capacity to make an informed decision, staff

The inspection took place on 3 July 2015 and was unannounced.

The Acorns is registered to accommodate up to five people. It is an all-female service that provides support to women with a learning disability and or other complex needs who need support with personal care. There were three women living at the service at the time of our inspection. The property is a modern, detached house situated on the outskirts of Crawley town centre. It has a rear garden, sitting room and kitchen. All bedrooms have en-suite facilities. All areas are easily accessible to people living at the service. There is a local bus service into town and people can also receive lifts in the home’s vehicle.

The service 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.

People were supported to be as independent as possible and live the lifestyle of their choice. Those that were able to took an active role in the running of the home by completing their own domestic tasks and choosing and preparing their meals. They decided for themselves or were supported to choose what to wear, when to get up and when to eat their meals and have a drink. One person told us “I don’t need staff help, I get my own breakfast and lunch. Sometimes I do the cooking. I can cook meals if I want to.” A relative told us “The staff are good on the food. X (relative’s name) doesn’t always want to eat, so what they’ve done is made individual meals for her so they can be microwaved quickly when she wants to eat”. The registered manager stated “We all strive to make it their home we are here to support them to make their own choices.”

People led active lives and were supported to participate in a range of activities that they enjoyed such as trampolining, swimming and cookery. A relative told us “X (person’s name) is really active she goes to a club a couple of times a week and a day centre. She goes swimming and has an annual holiday with staff. This is what Y (the registered manager) has been good at, sourcing activities that would be beneficial for X (person’s name)”. People were supported and encouraged to maintain relationships with people that mattered to them and there were no restrictions on visiting.

Staff knew the people well and were aware of their personal preferences, likes and dislikes. Person centred support plans were in place detailing how people wished to be supported, and people and or their representatives were involved in making decisions about their care. Where people lacked the capacity to make specific decisions they were being supported to make decisions in their best interests. They were supported with their healthcare needs and staff liaised with their GP and other health care professionals as required.

Feedback about the registered manager and staff was positive. A relative said “Since X (registered manager) has been on board things have been fantastic” and “The staff are really good”. Staff referred to the registered manager as being “Really good, I can go to her about anything.” and “Lovely, she really is really supportive of everybody”. They described an ‘open door’ management approach, where the registered manager was available to discuss suggestions and address problems or concerns. A member of staff said “Making sure they are all happy is the most important thing and they are well looked after”.

Staff were aware of their responsibility to protect people from harm or abuse. They knew the action to take if they were concerned about the safety or welfare of an individual. They told us they would be confident reporting any concerns to the registered manager or the person on call. A relative felt their loved one was safe and was confident their family member would let it be known if something was wrong. The registered manager had responded appropriately when concerns had been raised and the relevant people had been informed. Systems for recruiting new staff made sure they were suitable to work at the home. They included security and identity checks and references from previous employers.

Staff felt supported and received regular training. They had obtained or were working towards obtaining a nationally recognised qualification in care. They were knowledgeable about their roles and responsibilities and had the skills, knowledge and experience required to support people with their care and support needs.

Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed and emergency procedures were in place in the event of fire. Staff had completed training in safeguarding adults and knew what action to take if they suspected abuse was taking place.

The provider had robust quality assurance systems in place to measure and monitor the standard of the service and drive improvement. People, their visitors, health care professionals and staff were all encouraged to express their views and complete satisfaction surveys. Feedback received showed a high level of satisfaction overall. Areas identified as in need of improvement had been detailed in an action plan with planned dates for completion.