About the service:

• Walnut Close is a small specialist service providing care and support to people living with complex needs. The service is operated by Hexagon Care Services. The property is owned and managed by a Registered Social Landlord and each person living at Walnut Close is considered a tenant and therefore subject to a tenancy agreement. At the time of the inspection three people were living at Walnut Close.

People’s experience of using this service:

• The service continued to provide people with safe care which met their needs and wishes. People had been involved in assessing risks and determining how these would be addressed.

• The provider had systems in place to safeguard people from abuse. Staff were aware of what action to take, should they suspect or witness any abuse. Safeguarding information was clearly displayed within the service and written in a way which made it accessible to everyone.

• Staff had all received initial and ongoing training, to ensure their knowledge and skills were up to date. Completion of external qualifications was encouraged and promoted.

• Staffing levels were determined by people’s plans and activities. Rotas demonstrated sufficient staff had been deployed to support people to do the things they wanted to.

• 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.

• Care files contained personalised information about the people using the service and how they wished to be supported. People had been involved in setting up their care plans and completed regular reviews to ensure information was accurate and reflected current needs.

• People’s social, recreational, educational and employment needs were promoted and supported. People had been assisted to enrol and complete college courses, voluntary work and attend social events of their choosing, with an emphasis placed on integrating safely and successfully within the local community.

• Both people and staff’s views on the service were sought through meetings and questionnaires, with action points generated and shared.

• The service had a range of systems and procedures in place to monitor the quality and effectiveness of the service. Action plans had been completed to promote continuous improvement.

• The service met the characteristics for a rating of ‘good’ in all key questions.

• More information is in the full report.

Rating at last inspection:

• At our last inspection the service was rated as ‘good’. The last report was published on 28 April 2016.

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received. Inspection timescales are based on the rating awarded at the last inspection and any information and intelligence received since we inspected.

Follow up:

• We will continue to monitor information and intelligence we receive about the service to ensure care remains safe and of good quality. We will return to re-inspect in line with our inspection timescales for good services, however if any information of concern is received, we may inspect sooner.

We carried out a comprehensive inspection of this service on 15 March 2016. Walnut Close is a small specialist service providing care and support to people living with complex needs. The service is operated by Hexagon Care Services. The property at Walnut Close is owned and managed by a Registered Social Landlord and each person living at Walnut Close was considered a tenant and therefore subject to a tenancy agreement.

This inspection was the first comprehensive rating inspection since the service first registered.

At the time of our inspection visit there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

A total of three people used the service at Walnut Close at the time of our inspection visit. Staffing levels were safe and sufficient to meet people’s individual needs. People who used the service were well supported by two residential support workers during the day and one residential support worker at night.

The service had appropriate systems and procedures in place which sought to protect people who used the service from abuse. The service maintained a corporate safeguarding policy and associated local procedures. Staff demonstrated a good awareness of safeguarding procedures. People who used the service spoke confidently about how to report abuse.

Support plans contained a wide range of comprehensive individual risk assessments which were completed with the agreement of people who used the service.

Recruitment and selection of staff was robust with safe recruitment practices were in place. This was evidenced through our examination of employment application forms, job descriptions, people’s proof of identity, written references, and Disclosure and Barring Service (DBS) checks. These helped ensure potential employees were suitable to work with vulnerable people.

Accidents and incidents were appropriately recorded and included details of preventive strategies used by the service to reduce the likelihood of such events occurring in the future.

Health and safety records relating to buildings and premises were complete and up to date. Emergency equipment was maintained and records kept. Gas and electrical safety certificates were up to date. The service had a business continuity plan to be implemented in the event of a domestic emergency such as flood, fire or loss of power. This included guidance for staff and emergency contact numbers.

Medicines were ordered, stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

The staff induction programme was robust and included mandatory training, opportunities for shadowing of more experienced staff and direct observations of practice before new employees were able to work unsupervised with people who used the service. Existing staff were well supported with opportunities for on-going training and professional development.

Staff supervision sessions were undertaken on a regular basis with each member of staff expected to agree a supervision contract. Annual appraisals were also completed

We looked at the how service supported people with eating and drinking and found that staff demonstrated a good understanding of people’s likes and dislikes, dietary preferences and personal requirements. Staff we spoke with also clearly understood the importance of encouraging people who used the service to maintain a healthy balanced nutritious diet whilst acknowledging that individuals were able to make their own choices.

People who used the service told us staff were kind and caring. Some people had lived at Walnut Close for a number of