The Legard is registered to provide care and accommodation for eight adults who may have learning disabilities and physical disabilities. Accommodation is provided over two floors with lift access. There are eight single bedrooms, four assisted bathrooms, two kitchens, a sensory room and lounges. The building has been designed to cater for the specific needs of people with physical disabilities. This includes spacious living areas with access to people using wheelchairs and overhead tracking for hoists in bathrooms and bedrooms. There is a large accessible enclosed garden area to the rear of the building and car parking at the front of the property.

Local amenities for example, shops, local public house are within walking distance of the service. Two adapted vehicles are available for people’s use.

At the last inspection in January 2016, the service was rated Good. At this inspection, we found the service remained Good.

People who used the service were supported by sufficient numbers of staff who understood the importance of protecting them from harm. Staff had received training in how to identify and report abuse. A robust recruitment and selection process was in place that ensured prospective new members of staff had the right skills and were suitable to work with people who used the service.

Staff had a good understanding of people’s needs and were kind and caring. We saw people were comfortable in the presence of staff and had developed good relationships with them. People were treated with dignity and respect and were involved in decisions about the way their support was provided. Friends and relatives were welcomed by the service.

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.

Assessments were carried out to ensure people were protected from potential harm and staff took steps to minimise risks without taking away people’s right to make decisions.

Staff had a good understanding of systems in place to manage medicines and to ensure people received them safely.

The service had an open and inclusive ethos and people’s relatives and staff were positive about the way it was managed. Feedback was sought from people who used the service through regular ‘residents meetings’ and feedback forms. This information was analysed and action plans produced when needed. Advocates were accessible for people.

Relatives and healthcare professionals confirmed that staff were caring and looked after people’s health and nutritional needs well. People were provided with the care, support and equipment they needed to stay independent.

Further information is in the detailed findings below.

The Legard is registered with the Care Quality Commission [CQC] to provide care and accommodation for eight adults who have a learning disability and may also have physical disabilities. There are eight single bedrooms, four assisted bathrooms and communal areas. The service has a large enclosed rear garden area and there is a car park to the front of the property.

The home is located to the east of Hull city centre and is near to local amenities and public transport.

This inspection took place on 22 December 2015 and was unannounced. The service was last inspected in September 2013 and was found to be compliant with the regulations inspected at that time.

At the time of the inspection seven people were living at the service.

There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood they had a responsibility to protect people who used the service from harm and knew how to report any abuse they may witness or become aware of. They had received training in this subject and this was updated regularly. Staff were provided in enough numbers to ensure the needs of the people who used the service were met and they had been recruited safely. This ensured, as far as practicable, people who used the service were well cared for, their needs were met and they were not exposed to staff who had been barred from working with vulnerable people. The service was clean and there were no malodours. People’s medicines were administered as prescribed by their GP and staff had received training in this subject.

People were provided with a wholesome and varied diet which was of their choosing. Staff monitored people’s dietary needs and involved health care professionals when required. Staff received training which was relevant to their role and equipped them to meet the needs of the people who used the service. Staff received support from the registered manager to gain further qualifications and experience. People were supported to make informed decisions and legislation was used to protect people’s rights and choices where needed. People who used the service were supported to lead a healthy lifestyle and to access health care professionals when required, for example GPs and district nurses.

People had good relationships with staff who were kind and caring. Staff understood people’s needs and how these should be met. People who used the service or their representatives were involved with the formulation of care plans. These described people’s preferences for the care they required and how this should be delivered by the staff.

People who used the service could choose from a range of daily activities to participate in. Trips out into the community were also available. Staff had access to documentation which described the person and their preferences. People who used the service and their relatives knew they could raise concerns or complaints if they wished. These were investigated and the outcome shared with the complainant.

People lived in a well led and inclusive service and the registered manager sought their views about how it was run. The registered manager undertook audits which ensured people lived in safe environment and their health and welfare was monitored and upheld. Staff were supported and encouraged to achieve excellence and systems were in place which identified short falls in the service and how these should be improved.

We used a number of different methods to help us understand the experiences of people who used the service, because the majority of people had complex needs which meant they were not able to tell us their experiences.

Prior to our visit we spoke with the local authority safeguarding team who told us a recent investigation had been undertaken and the outcome of this had been substantiated. This resulted in two care staff been dismissed from their posts.

We were not able to speak with any of the people who used the service, however we did speak with two relatives and they confirmed that regular activities took place and choice was promoted. They commented, "The activities have improved vastly since the current manager came on board" and "We know they are very happy and well looked after."

We also observed people who used the service take part in a movement to music group and this appeared to be an enjoyable experience. We saw that positive relationships had been developed with staff.

We saw only one choice of food was offered at the lunchtime meal and staff did not offer fruit or salad as directed by the menu policy.

We found systems were in place to manage potential abuse and the environment was clean, homely and maintained safely.

There was a system in place to ensure the quality of care and services provided were monitored and continuously improved.

We used a number of different methods to help us understand the experiences of people who used the service, because the majority of people who used the service had complex needs which meant they were not able to tell us their experiences.

We saw that choice was offered to people who used picture menus, individualised activity planning sheets and person centred planning. Staff spoke to and engaged positively with people who used the service.

Prior to our visit we spoke with the local authority contracting and commissioning department, who told us they had not carried out a monitoring visit to the home but had no current concerns.

We were able to speak with one person who used the service who told us that regular activities took place and choice was promoted. They commented, “I like living here”, “I am going out this afternoon to the shops”, “I like going to McDonalds and the Humber Bridge” and “I’ve just booked my holiday.”

We spoke with one person who used the service and they told us they liked living in the home and said, “I feel safe and I like all the staff.”

We were able to speak with one person about the environment and they confirmed that the home was warm and comfortable. They commented, “I like living here”, “I’m happy and I like my room.”