What life is like for people using this service:

¿ The home has shown continuous improvement following our previous inspection in March 2016 and has met the characteristics of a good service in safe and effective and an outstanding service in all other areas and overall. For a home which supports people with multiple and complex needs and with behaviours that challenge, there have been remarkably positive and consistent outcomes for people. The registered manager told us, “I have always run a home around whether I would be happy with my brother or sister living there, I would here.”

¿ People have shown less behaviour that challenges as a result of the consistent positive support approach taken and therefore have needed less ‘as required’ medication and no use of restrictive interventions. Not only is this for people which have lived at The Goodwins for several years but people who have only lived there for a few months.

¿ The provider promoted a good quality of life for people. People were happy living at the home, were able to express themselves and engage with staff, participate in activities they enjoyed within the home and in their community and develop their skills and independence.

¿ People were supported to regain and maintain relationships with those important to them and to develop new relationships. The home used ‘intensive interaction’ to engage with people in a way which was meaningful to the individual.

¿ The registered manager had inspired and supported the staff team to improve people’s lives, had achieved good outcomes for people, ensured people were kept safe and received high quality, person centred care and support in line with all their individual needs.

More information is in Detailed Findings below.

Rating at last inspection:

Good overall and in all domains except caring, which was rated as outstanding (report published 20 April 2016).

About the service:

The Goodwins is a residential care home that was providing personal care for eight people living with severe learning disabilities, autism spectrum disorder and behaviour that challenges. The home 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. These values were seen in practice at the home. For example, the building was like any other on the road with no signs to show it was a care home. Staff did not wear uniforms and people lived their lives in the ways they wanted.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. We found improvements had been made since our last inspection and the service has met the characteristics of Good in safe and effective and Outstanding in all other areas. The overall rating is Outstanding.

Follow up:

Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated Outstanding.

This inspection took place on 24 March 2016, was unannounced and was carried out by one inspector.

The Goodwins is a privately owned service providing care and support for up to 12 people with different levels of learning disabilities. There were five people living at the service at the time of the inspection. The house is a detached property set in its own grounds. Each person had their own bedroom which contained their own personal belongings and possessions that were important to them. The service had its own vehicle to access facilities in the local area and to access a variety of activities.

The care and support needs of the people varied greatly. There was a wide age range of people living at the service with diverse needs and abilities. The youngest person was in their 40’s and the oldest in their 70’s. Some people had behaviours that challenge and communication needs.

A registered manager was leading the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager supported throughout the inspection.

Staff assumed people had capacity and respected the simple decisions they made on a day to day basis. When people needed help or could not make a particular decision on their own, staff supported them. Decisions were made in people's best interests. The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The people at the service had been assessed as lacking mental capacity to make complex decisions about their care and welfare. We received information from the service informing us that people had applications granted to deprive them of their liberty to make sure they were kept as safe as possible.

People received care that was personal to them. Staff understood their specific needs well and had good relationships with them. People were settled, happy and contented. People chose to spend time with staff. They sat close to staff for comfort and reassurance. Staff treated people as individuals with dignity and respect. Staff were familiar with people’s life stories and were very knowledgeable about people’s likes, dislikes, preferences and care needs. They approached people using a calm, friendly manner which people responded to positively. This continuity of support had resulted in the building of people’s confidence to enable them to make more choices and decisions themselves and become more independent.

Staff were caring, kind and respected people’s privacy and dignity. There were positive and caring interactions between the staff and people and people were comfortable and at ease with the staff. When people could not communicate verbally, staff anticipated or interpreted what they wanted and responded quickly. Staff respected decisions that people made when they did not want to do something and supported them to do the things they wanted to. People had choices about how they wanted to live their lives. Throughout the inspection people were treated with kindness and respect.

Before people decided to move into the service their support needs were assessed by the registered manager and another senior member of the organisation to make sure the service would be able to offer them the care that they needed. People were satisfied and happy with the care and support they received. People's care and support was planned and reviewed to keep people safe and support them to be as independent as possible.

People were sup

The people at the service were unable to communicate with us verbally so we observed the interactions between the people and the staff. We found that staff were able to communicate with people non-verbally to gain their consent and people were involved in the decisions about the care and support they received. People wishes were respected.

People indicated that they received the care and support they needed to remain well and healthy. We observed that they were happy at the service. People were relaxed and responsive in the company of staff. They were able to let staff know what they wanted and we saw staff respond in a caring and positive way. There were enough activities and that they enjoyed going out in the local area and doing different things.

People's health needs were supported and the service worked closely with health and social care professionals to maintain and improve people's health and wellbeing.

People told us and records confirmed that medicines were given to people when they needed them in a safe way.

There was enough staff on duty to meet support and meet people's needs. The staff we spoke with had knowledge and understanding of people's needs and knew people's routines and how they liked to be supported.

The views of the people who use the service were listened to and acted on. There was complaints procedure in place and any complaints received by the service were addressed and dealt with appropriately.

The people living in the home were unable to verbalise to tell us about their experiences. We spent time with the people and observed interactions between the people and the staff.

We saw that staff listened to people and took their views seriously and always answered their questions in a way that they could understand. We saw that the staff were friendly with the people and they seemed relaxed in the home.

People who use the service indicated that they were happy at the home. Some people were participating in activities which they indicated that they enjoyed.

We saw that people were responsive in the company of staff. They were able to let staff what they wanted and we saw staff respond in a caring and positive way.

The staff we spoke to had knowledge and understanding of people's needs and knew people's routines and how they liked to be supported.

People who use the service were unable to communicate and tell us in any detail what they thought of the quality of the care due to their communication difficulties. Through observation however during the site visit we were able to observe staff supporting people who use the service in a respectful way and that staff took time to explain where possible the options available and involved them in activities.

Most of the people who lived at The Goodwins had limited verbal communication and used

facial expressions, behaviours and gestures to communicate. Because of this we observed people and generally people appeared relaxed and calm.

We saw that people were eating and enjoying their evening meal and were sitting interacting with staff.

People who use the service indicated that they were happy at the home. On the whole they were relaxed. They were participating in a range of activities which they indicated that they enjoyed. When one person expressed that they were distressed and upset the staff dealt with the situation in away that best suited the person.

We saw that people were relaxed in the company of staff. They were happy to approach staff to express what they wanted and we saw staff respond in a caring and positive way.

The staff we spoke to had knowledge and understanding of people’s needs and knew people’s routines and how they liked to be supported.

Staff told us they sometimes felt there was not always enough of them on duty to care for the people in the way that suited them best.