The inspection took place on 6 April 2017 and was unannounced.

Walcott House provides care and accommodation for up to nine people and there were nine people living at the home when we inspected whose ages ranged from 18 to 65 years. People had needs associated with learning disabilities and some of these people had complex needs. The service promoted people to be independent and to access community facilities.

At the last inspection carried out on the 11 and 14 July 2014 the service was rated Good. At this inspection we found the service remained Good.

All bedrooms were single and each had an en suite bathroom with a toilet and shower. Communal toilets were also provided on each floor. There were two communal lounges and a dining room which people used.

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.

Staff were trained in adult safeguarding procedures and had a good awareness of what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said they felt safe at the home.

Care records showed any risks to people were assessed and there was guidance on how those risks should be managed to prevent any risk of harm. People were prevented from accessing a ground floor communal toilet due to risks to people and the area being damaged by one person. However, the rationale for this was not assessed or recorded. The registered manager took action to address this and carried out assessments which were supplied to us after the inspection.

There were sufficient numbers of staff to meet people’s needs. Staff recruitment procedures were adequate and ensured only suitable staff were employed.

Medicines were safely managed.

Staff were trained and supervised so they provided effective care to people.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). People’s capacity to consent to their care and treatment was assessed and applications made to the local authority where people’s liberty needed to be restricted for their own safety.

People were involved in choosing and preparing meals with the support of staff.

People’s health care needs were assessed, monitored and recorded. Referrals for assessment and treatment were made when needed and people received regular checks such as dental and eyesight checks.

People said were treated well by the staff who were patient and treated people with respect. The service promoted people to develop independence and to access community facilities.

Care plans were individualised and showed people received person centred care. Person centred care ensures the person is at the centre of arrangements for their support taking account of their individual wishes, needs, circumstances and health choices. People attended a range of activities based on what they wanted. The service promoted people to access employment.

People had opportunities to express their views or concerns, which were looked into and addressed. There was a complaints procedure if people or their relatives wished to complain.

The culture of the service was person centred. Staff demonstrated values of treating people as individuals and promoting people to have a fulfilled lifestyle. People’s views about the quality of the service were sought. Staff views were also sought and staff were able to contribute to decision making in the home.

A number of audits and checks were used to check on the effectiveness, safety and quality of the service.

We were not able to speak with some of the people who use the service due to their disabilities. Instead we spent time observing the interactions between staff and people. We found this interaction to be positive and friendly. Staff spent time with people engaging them in activities and providing reassurance and support when people requested help.

We spoke with one person who told us that they were very happy living in the service and had no concerns. They spoke positively about their activities and the staff who supported them.

We spoke with three staff members during this inspection. They demonstrated a good knowledge of the needs of the people they supported. The staff we spoke with told us that they had a good level of training including an induction and they were encouraged to develop their skills. They also told us that they felt supported in their work and had regular supervision.

We observed that there were enough staff in the home to support peoples care needs and social activities. Staff also told us that they felt that there were enough staff on duty to support people appropriately.

People were receiving appropriate care and treatment which met with their needs, and encouraged their independence where appropriate.

Due to their disabilities many of the people accommodated were not able to tell us about their experiences. To help us to understand the experiences people have we used our Short Observational Framework for Inspection (SOFI) tool. This tool allows us to spend time watching what was going on in a service and helps us to record how people spent their time, the type of support they get and whether they have positive experiences.

We spent 15 minutes watching care and support provided to three people over lunch. We observed lunch being served and people being helped to eat their meals. We found that people had positive experiences. The care staff on duty knew what support they needed and they respected their wishes if people wanted to be left on their own.

We spoke with three members of staff who were on duty. We were informed how people had been treated with respect and dignity. We were also informed how people have been encouraged to make choices with regard to the activities provided as well as in how people spent their time.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection.

Walcott House provides accommodation and support for up to nine adults with learning disabilities focusing on people living with autism and epilepsy. Some of the people who lived at the home had complex needs and behaviour that could challenge services if those needs were not met. There were nine people living at service at the time of our inspection.

The service did not have 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 and associated Regulations about how the service is run. The deputy manager had been appointed to the role of manager of the home and the provider had taken steps to register them with the CQC within a reasonable period.

People told us they enjoyed living at the home. One person said, “I like it here, it’s fun.” Relatives were positive about the home and that they were pleased that the deputy manager had been appointed to the manager’s role. One relative told us they were confident that, “The home would go from strength to strength under their management.” A relative told us, “If I could bottle what they do and sell it I would be a millionaire.”

We observed people as they engaged in activities or moved around the home. Staff supported them in an unobtrusive, friendly, dignified and reassuring manner. People appeared comfortable and confident within the service and good relationships existed between staff and people.

Staff had received training in how to safeguard adults from abuse. Staff were able to tell us about the signs that might indicate someone was at risk of abuse and action they should take if they had any concerns. Safety risks had been assessed and people were encouraged to be as independent as possible. Some people had complex needs and care plans contained detailed information that showed staff how these needs should be met. People’s care plans were reviewed monthly and this ensured that their most up to date needs were met. People had one member of staff known as a keyworker, who co-ordinated all aspects of their care and who they met with on a monthly basis to review the support provided and ensure their needs were met. Accidents and incidents were recorded and appropriate follow-up action was taken.

Staff followed the requirements of the Mental Capacity Act 2005 for people who lacked capacity to make a decision. The manager had completed mental capacity assessments to ensure the home met the requirements of the Act in relation to Deprivation of Liberty Safeguards (DoLS)

The provider had robust recruitment procedures in place and staff were supported to deliver care and support to meet the needs of people. Staff received essential and additional training. They completed an induction programme and shadowed other staff to learn about their role. The provider had appropriate arrangements for the safe ordering, administration, storage and disposal of medicines. People were supported to get the medicine they needed when they needed it.

People undertook a range of leisure, social, educational and work activities in line with their individual needs. There were enough staff to support people to undertake activities on an individual basis. One person told us about college courses they accessed to learn how to use computers and of their work at a local shop. We saw that another person had been able to choose the staff member they wanted to take them swimming on a weekly basis. People were encouraged to be involved in the running of the service and participate in activities such as shopping. People were supported to maintain contact with their family. One relative told us, “They escort her on the train and she loves it. She enjoys the routine of that and it is never a problem going back. Once she sees staff she is happy.”

The needs and choices of people had been clearly documented in their care records. Where people’s needs changed the provider acted quickly to ensure the person received the care and treatment they required. People had access to healthcare services when required. There were enough, qualified and experienced staff to meet people’s needs. People were supported to have sufficient to eat and drink and maintain a healthy diet in line with their preferences.

There were quality assurance procedures in place such as regular audits and the provider sought feedback through questionnaires from people, relatives and professionals. People were supported to make complaints and action was taken to resolve any concerns. The provider took steps to ensure that care and treatment was provided in an appropriate and safe way and, where necessary, improvements were made.