This inspection visit took place on 13 February 2018 and was announced. The Croft is registered to provide care and accommodation for up to six persons who have a learning disability or autistic spectrum disorder, older people and younger adults. The home is situated in a residential area of Morecambe close to shops and travel links. All accommodation at the home is provided on a single room basis. At the time of our inspection visit there were two people who lived at the home.

At the last inspection on 26 January 2017 the service was rated Requires Improvement. During the inspection we found improvements had been made and all breaches had been met from our inspection on 19 April 2016. However further work was required to embed the changes made to the care records. We made recommendations about this.

At this inspection carried out on 13 February 2018 we have rated the service Good.

The Croft is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care home can accommodate six people in one adapted building. The home has six single bedrooms. Communal space comprised of a lounge and open plan dining room located on the ground floor.

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.

The registered provider was an individual who also managed the home on a day to day basis. Registered providers 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.

We spoke with the two people who lived at the home. They both said they were happy, felt safe in the care of staff and were treated with kindness. Comments received included, “I have lived here for 20 years and I am very happy and enjoy living here.” And, “I am happy and feel safe. I like the staff who are kind to me.”

The registered provider and staff worked between The Croft and its sister home, Malvern House. People told us they were happy with staffing levels and staff were available when they needed them. We saw the staff member on duty was attentive, showed concern for people’s wellbeing and was available to spend time socially with people in their care.

The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during their daily routines and delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs.

People told us they received their medicines as prescribed and when needed. We found appropriate arrangements were in place for the safe storage of medicines.

We saw there was an emphasis on promoting dignity, respect and independence for people who lived at the home. People told us staff treated them as individuals and delivered person centred care. Care plans seen confirmed the service promoted people’s independence and involved them in decision making about their care.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

The ser

This inspection took place on 26 January 2017 and was unannounced.

At the last comprehensive inspection on 19 April 2016 the service was not meeting the requirements of regulation 12 – safe care and treatment and regulation17 - Good Governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. It was rated overall as requires improvement with well led as inadequate, safe and caring as requires improvement and effective and responsive as good. On this inspection we found improvements had been made and all breaches were met. However further work was required to embed the changes made to the care records and we have made recommendations about this.

The Croft is a small home registered to provide personal care for up to six older people or people with learning disability. All bedroom accommodation is for single occupancy. Communal space consists of a lounge dining room. The home is in a residential area of Morecambe, close to shops and travel links.

At the time of the inspection visit two people lived at the home.

The registered provider was an individual who also managed the service on a day to day basis. Registered providers 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.

Care records had improved since the last inspection. Risk assessments were in place to reduce any potential risks of harm to people who lived at The Croft and their visitors and staff. They were informative in the main but information was not easy to find in each person’s file.

People told us they felt safe living at The Croft and liked living there. There were procedures to protect people from unsafe care or abuse. Staff were aware of these and had received training in safeguarding adults.

People said staff were caring and helpful. They said their health needs were met and staff responded to any requests for assistance promptly. Staff knew the care people needed, which showed us they were familiar with people’s care needs, and preferences.

People we spoke with said staff were caring and respectful, listened to them and assisted them promptly. They said staff supported them to remain as independent as they could be. People looked relaxed and comfortable with the staff who supported them.

Staff recognised the importance of social contact, companionship and activities. They supported people to engage in activities and interests in the home and local community.

The registered provider and staff worked between The Croft and its sister home, Malvern House. People said they were satisfied with staffing levels and staff were available when they needed them. They said staff supported them without rushing.

There had been no new staff appointed to work at the home since we last completed a comprehensive inspection of the service in April 2016. We did not identify any concerns about the services recruitment procedures during that inspection.

Staff had received the training, skills and knowledge to provide support to people.

Staff managed medicines competently. People told us they felt staff gave them their medicines correctly and when they needed them. We saw they were given as prescribed and stored and disposed of correctly.

People told us they were offered a choice of meals which they enjoyed. Drinks were available throughout the day and people’s dietary and fluid intake was sufficient for good nutrition.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). This enabled staff to work within the law to support people who may lack capacity to make their own decisions.

People told us they knew how to raise a concern or to make a complaint if they were unhappy with something. They said staff were easy to talk to and were willing to listen which encouraged them to express any ideas or concerns. However whe

We carried out an unannounced comprehensive inspection of this service in March 2015. At this inspection no breaches of legal requirements were found. We undertook this focussed inspection on 19 April following safeguarding alerts received by the local authority that people were at risk of unsafe care. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Malvern House on our website at www.cqc.org.uk

The inspection visit took place on 19 April 2016 and was unannounced.

The Croft is a small home registered for up to six people of either sex. The people currently accommodated have a diagnosis of mental illness/learning disability. Detailed information about the services provided by the home was contained within a Statement of Purpose and Service User Guide which is available from the home. The home is in a residential area of Morecambe, close to shops and travel links. At The time of the visit there were five people who lived at The Croft.

There was an individual registered provider in place. . The registered provider manages the day to day running of the home. Registered providers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During this inspection carried out in April 2016 we found risk assessments were not always in place to ensure people received care and support which met their needs. In addition we found risks were not always assessed or in place. This was a breach of Regulation 12 (Safe Care and Treatment). We also identified a breach of Regulation 17 (Good Governance) as an accurate record in respect of the care and support for people who lived at the home was not always in place.

We found records of care for people who lived at the home did not contain all the information to ensure people received the right care and support. This meant staff would not have all the information available to ensure the right care was provided. We found there were no contracts in place for people who lived at the home. In addition there were no records kept that highlighted costs to the individual such as toiletries and cleaning products. This meant people were unaware of financial implications to the cost of living at The Croft.

This was a breach of Regulation 17 (Good Governance) as an accurate record in respect of the care and support provided was not in place. This placed people at risk of care and support that did not meet their needs.

We found recruitment checks were carried out to ensure suitable people were employed to work at the home. There was sufficient staff to meet people’s needs. This was confirmed by talking with staff members and looking at records of staff recruitment.

Medicines were dispensed in a safe manner and people received their medicines on time. However we made a recommendation the registered provider seek advice and guidance to ensure staff received formal training to ensure medicines were administered correctly and safely.

The registered provider told us they understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). They had the knowledge of the procedure to follow if applications were required to be made.

People who lived at the home were happy with the variety and choice of meals available to them. Regular snacks and drinks were available between meals to ensure people received adequate nutrition and hydration. We asked people who lived at the home about the quality and quantity of meals at The Croft. One person said, “You saw the breakfast it was lovely.”

We observed staff treated people with respect, patience and dignity. People we spoke with told us staff were caring and respectful.

During the inspection we observed people had choices how they spent their time. Activities and social events in the community had been arranged and people were encouraged to be as independent as they

The Croft is a smaller family type establishment situated in a residential area of similar properties. At the time of our visit four people were living at the home. These people had lived together for a considerable period of time and were comfortable with each other.

During our inspection we looked at the way these four people were being cared for, the safe management medicines, the way staff were supported; the effectiveness of quality monitoring systems and the way complaints were managed. We spoke with the homeowner who was also the registered manager and individually with three of the four people living at the home. At the time of our visit no other staff were on duty.

This helped to answer our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Is the service safe?

We saw that people living at the home were treated with respect and dignity by the homeowner. When speaking with each person living there we were told that they felt safe and secure.

Policies and procedures were in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DOLS). This meant that the staff team had clear guidance should consideration need to be given in respect of a DOLS application.

Medication practices were robust. A regular, routine medication audit was in place. This helped to ensure that medication practices remained safe, by enabling any shortfall to be quickly identified and addressed.

Care plans had been developed based upon people`s individual needs. A range of risk assessments were in place and reviewed periodically. It was clear from talking with people that they had a good understanding of their care plan and were happy with the content. The home worked in partnership with the local health care team to support people with their health conditions. People we spoke with told us they were very happy living in the home. One person told us, “They look after us well, Flora (registered manager) is jolly.

It the service effective?

People living at the home told us that they were pleased with the level of care and support that was being delivered to them and that their needs were being well met. From our observations and through speaking with the registered manager it was clear that there was a good understanding of each person’s assessed needs and that accommodating personal preferences had been given high priority. We were told, “This is a happy home”. Another person said, “Things have changed for the better I have no complaints”.

At the time of our inspection there was only one other member of staff employed at the home. We saw from training records and training certificates that a wide range of training had been provided to meet the need of people living at the home.

There was an advocacy service available if people needed it, this meant that when required people could access additional support.

Is the service caring?

We saw that the registered manager was sensitive and caring toward the people being supported. Individual needs, preferences, wants and wishes had been given high priority and patience and encouragement was shown when supporting people. We observed that people were encouraged to do things at their own pace and at a time of their choice. It was clear that there was an inclusive and supportive culture that helped people to feel comfortable and valued.

Individual preferences, interests and needs had been recorded along with the actions required to ensure these were met. This helped to make sure that people were provided with an individualised service that met their specific requirements.

Is the service responsive?

People had opportunity to undertake a range of activities suited to individual needs and preferences. The home had its own transport that helped people to keep involved in their local community.

People knew how to make a complaint if they were unhappy about anything. However nobody expressed any complaints or concerns to us. People told us that they were happy living at the home and that they could say what they wanted at a time of their choice. One person said, “The complaint procedure is on the wall, I would say if things were not alright, I would tell Flora (Registered Manager)”. We looked at the only complaint that was addressed some time ago and found that the response had been open, thorough and timely. People could therefore be reassured that complaints were investigated and action taken as necessary.

Is the service well led?

The service worked well with other agencies and services to make sure people received their care and support in a joined up way.

We saw from the meeting minutes that the registered manager held weekly and monthly house meetings so that people living at the home could have their say and influence change. This was also strengthened by an annual satisfaction survey that was comprehensive and through. The outcomes we saw were all positive.

The service had quality assurance systems in place. Records seen by us showed that any shortfalls were addressed promptly. As a result the quality of the service was continually improving.

We found that the service provider had good systems in place for assessing people's needs, planning for their care and support, and reviewing that care to ensure people were safe and their needs met. The service provider had internal monitoring systems in place such as audits and checklists that were used to review the quality of the services provided. We found that the service provider and staff were good at keeping people informed of developments, and were interested in their care and support arrangements. People felt happy to approach the service provider and staff with a view to raising their concerns. People told us that they did not have any concerns, but if they did, they would speak to the provider, or their social worker. People knew how to contact the Care Quality Commission, and would ring the national contact number if they were worried about how the home was operated. People said that they could talk to the service provider and staff about their care and support needs, and that if and when changes were needed, these were always made. We found that that in recent months changes to the ways in which the home was run had meant that people had been enabled to get out in the local community and do a lot more. People were helped and supported to express their views about what they do, how they spent their time and the type of care and support they needed.

The inspection visit at The Croft took place on 31 March and the 01 April 2015 and was unannounced.

The Croft is a small home registered for up to six people. The people currently accommodated have a diagnoses of mental illness/learning disability. Detailed information about the services provided by the home are contained within a Statement of Purpose and Service User Guide which is available from the home. The home is in a residential area of Morecambe, close to shops and travel links. At the time of the inspection there were four people living at the home.

There was a registered manager in place. 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 owner was also the registered manager and the service is run mainly by the registered manager with part time staff.

At the last inspection on the 19 May 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Procedures and systems were in place to safeguard people against abuse. People who lived at the home and relatives we spoke with told us they felt safe and secure at the home. Policies and procedures were in place so relatives and staff were aware of who to contact and what process to follow should they have any concerns. A staff member said, “If I felt abuse was taking place I would report it.”

This is a small home and we observed people were comfortable, relaxed and had freedom of movement around the premises. Staffing levels were sufficient with the owner/registered manager and one part time staff available to enable people to go to their own rooms or the lounge and bedrooms areas. This meant staff would be able to monitor movements of people regularly, because of the nature of the small building and number of staff and management around.

We had received concerns about the heating and lighting at the service. The building was not kept warm, also the lighting was poor so people were at risk of falling and not kept safe. When we visited on the night of 31 March unannounced we found no issues with the lighting and the building was adequately heated.

This is a small home and mainly only one staff on duty for the four people. However the owner lived on the premises and was available most of the time and cared and supported the people with part time staff. The owner/registered manager and staff we spoke with had a good knowledge of the process to follow should they suspect people were not safe and at risk of abuse.

Care records contained an assessment of people’s needs, which lead into a review of any associated risks. These related to potential risks of harm or injury and appropriate actions to manage risk. The people who lived at the home were independent and risk management plans were in place for people when they were out in the community.

The owner/registered manager demonstrated an understanding of the legislation as laid down by the Mental Capacity Act (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). The service had policies in place in relation to the MCA and DoLS. We spoke with the owner/registered manager to check their understanding of MCA and DoLS. No applications had been made at the time of the inspection. During the inspection we saw no restrictive practices.

Care records of the four people we looked at contained documented evidence of people’s consent to their care and support. This included information about people’s choices with regard to, activities and food and drink preferences and what they wanted to be known as. This meant people were involved in care planning and staff were aware of people’s individual choices and preferences.

We spoke with all four people who lived at the home and they made it clear they liked the staff member who supported them and looked upon them as friends. Comments included, “We are like one happy family.”

Activities were centred on the four people who lived at the home. When we visited on 31 of March 2015 all the people who lived at the home had gone out to Mencap for an activity in the evening. Mencap was a centre in the community which provided support and social interaction for people who had a learning disability. The next day we spoke with the people who lived at the home about activities and going out in the community to the local shops and events that were taking place. They told us they go out on a regular basis to shops, for walks or to organised events.

The owner/registered manager had a range of audits in place to assess the quality of the service provided. These audits included, medication, care plans of people who lived at the home and the building. Also regular ‘resident’ meetings and informal discussions took place to ensure the views of people who lived at the home and relatives gave their views of how the service could develop.

The inspection visit at The Croft took place on 31 March and the 01 April 2015 and was unannounced.

The Croft is a small home registered for up to six people. The people currently accommodated have a diagnoses of mental illness/learning disability. Detailed information about the services provided by the home are contained within a Statement of Purpose and Service User Guide which is available from the home. The home is in a residential area of Morecambe, close to shops and travel links. At the time of the inspection there were four people living at the home.

There was a registered manager in place. 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 owner was also the registered manager and the service is run mainly by the registered manager with part time staff.

At the last inspection on the 19 May 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Procedures and systems were in place to safeguard people against abuse. People who lived at the home and relatives we spoke with told us they felt safe and secure at the home. Policies and procedures were in place so relatives and staff were aware of who to contact and what process to follow should they have any concerns. A staff member said, “If I felt abuse was taking place I would report it.”

This is a small home and we observed people were comfortable, relaxed and had freedom of movement around the premises. Staffing levels were sufficient with the owner/registered manager and one part time staff available to enable people to go to their own rooms or the lounge and bedrooms areas. This meant staff would be able to monitor movements of people regularly, because of the nature of the small building and number of staff and management around.

We had received concerns about the heating and lighting at the service. The building was not kept warm, also the lighting was poor so people were at risk of falling and not kept safe. When we visited on the night of 31 March unannounced we found no issues with the lighting and the building was adequately heated.

This is a small home and mainly only one staff on duty for the four people. However the owner lived on the premises and was available most of the time and cared and supported the people with part time staff. The owner/registered manager and staff we spoke with had a good knowledge of the process to follow should they suspect people were not safe and at risk of abuse.

Care records contained an assessment of people’s needs, which lead into a review of any associated risks. These related to potential risks of harm or injury and appropriate actions to manage risk. The people who lived at the home were independent and risk management plans were in place for people when they were out in the community.

The owner/registered manager demonstrated an understanding of the legislation as laid down by the Mental Capacity Act (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). The service had policies in place in relation to the MCA and DoLS. We spoke with the owner/registered manager to check their understanding of MCA and DoLS. No applications had been made at the time of the inspection. During the inspection we saw no restrictive practices.

Care records of the four people we looked at contained documented evidence of people’s consent to their care and support. This included information about people’s choices with regard to, activities and food and drink preferences and what they wanted to be known as. This meant people were involved in care planning and staff were aware of people’s individual choices and preferences.

We spoke with all four people who lived at the home and they made it clear they liked the staff member who supported them and looked upon them as friends. Comments included, “We are like one happy family.”

Activities were centred on the four people who lived at the home. When we visited on 31 of March 2015 all the people who lived at the home had gone out to Mencap for an activity in the evening. Mencap was a centre in the community which provided support and social interaction for people who had a learning disability. The next day we spoke with the people who lived at the home about activities and going out in the community to the local shops and events that were taking place. They told us they go out on a regular basis to shops, for walks or to organised events.

The owner/registered manager had a range of audits in place to assess the quality of the service provided. These audits included, medication, care plans of people who lived at the home and the building. Also regular ‘resident’ meetings and informal discussions took place to ensure the views of people who lived at the home and relatives gave their views of how the service could develop.