This was an unannounced inspection that took place on 12 May 2017. It was conducted by one adult social care inspector.

At our previous inspection on 10 November 2014 the service was rated as good, with the outcome 'Well -led' rated as outstanding.

Holly Dyke is a purpose built house that can accommodate up to six people who are living with autism or a learning disability. It is situated in a residential area of Workington and is near to local amenities. Accommodation is in single bedrooms. There is a lounge and a dining room, kitchen and a utility room. The house has a pleasant garden and a small car park.

Holly Dyke is operated by Walsingham who run similar services in England. The home has 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.

People in the home were protected from harm and abuse because staff were suitably trained and aware of their responsibilities. People told us that they felt safe in their house and trusted the staff team. Staff told us they felt confident about speaking of any concerns they had to any member of staff but that they would normally go to the registered manager or her deputy.

Staff understood the theories and the practical application of equality and diversity measures and paid attention to the human rights of people in the home.

Risk assessments and risk management plans were in place. There was an emergency plan and the building was safe and secure. Suitable measures were in place to ensure that infection control was in place. Accidents and incidents were reported and managed appropriately.

Staff were suitably recruited and inducted. There were good numbers of staff deployed by day and night. The organisation had appropriate disciplinary procedures in place.

Medicines were appropriately managed and staff received training and checks on their competence.

Staff received good levels of training and support. Supervision and appraisal were in place. Good practice issues were discussed in the team. Good levels of communication were evident in the service.

Staff understood their responsibilities under the Mental Capacity Act 2005 and no one was deprived of their liberty without the relevant authorisations being in place. Restraint was not used but staff had suitable training to support people who found managing their behaviour and emotions to be problematic. People told us that consent was sought for any interactions.

People were happy with the food and drink provided. People were encouraged to eat healthily. The staff had a good knowledge of nutritional needs.

We learned that the mental and physical health of people in the service was closely monitored and advice and treatment sought where necessary.

The house was suitably adapted and was a comfortable home for the people who lived there. Maintenance and improvement to the building were given high priority.

We observed sensitive and caring interactions between staff and the people in the home and between the people who lived in Holly Dyke. People were very involved with everything that went on in the house and their opinions sought. Staff took time to explain things to people and gave them choices. There was good access to advocacy services if necessary. Dignity and independence were promoted.

The staff team were aware that some people in the home were growing older and they were aware of the changes brought about by the ageing process. Staff were to be trained in end of life care.

Assessment and care planning were of a high standard. These documents were current, based on good practice and gave details of how people wished to be cared for in all aspects of their lives. We had evidence to show that good person

This was an unannounced inspection that took place on 10th November 2014 and was carried out by one adult social care inspector.

This service is operated by Walsingham who have similar services around England. Prior to this visit the provider had made us aware that the registered manager was not at work. Her absence was due to a planned health procedure. The deputy manager was acting as the manager of the service. We had an estimated date for the registered manager’s return from this planned absence. 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.

This service was good at keeping people safe from harm. Staff understood their responsibilities in relation to safeguarding and had received suitable training and development support. We judged that the staff team were good at managing risks. We saw evidence of this in the way they managed risks and emergencies. We saw that there were always enough well trained staff on duty to support people. We checked on medicines management and found this to be in order.

Staff were expected to attend mandatory training and we saw that service specific training was delivered. Staff understood legislation around capacity and mental health issues. We saw that staff were trained in how to manage emotions and behaviours in people that might challenge.

People in the home were given suitable nutrition. Health care was good in the service and there was a focus on healthy living. Most of the people in the service took part in some form of sport or exercise.

The staff team knew people really well and they understood their background, life history and place in their family and friendship groups. There were good assessments of need and risk. Care plans had been prepared with the individuals and were detailed and up to date.

There were wide ranging and varied activities and entertainments on offer. People were encouraged to do as much as possible for themselves. No one we spoke with had any complaints but everyone felt confident that any complaints would be responded to appropriately.

The registered manager and her deputy were suitably skilled and experienced. The systems in place for monitoring quality allowed people to have the lifestyle they needed and wanted. The organisation had a variety of ways to consult with external stakeholders as well as people who used the service, their families and friends. We judged that both the internal and external systems for measuring quality and delivering improvements were of a very high standard.

People in the home told us they were happy living in "our house". We also saw, by their relaxed behaviour, that they were comfortable in the environment and with the staff team. We saw and heard that people were involved in the way the home operated, were given options and choices and had meaningful activities in their lives. One person told us:

"This year I have been camping and it was great...the food is good and I like making cakes...these staff are all my friends ...they are great too."

We saw that the people in the home were given good nutrition.There was a wide range of food available and people ate well and looked well. We saw that any health issues (including any weight loss) would be reported to the GP straight away. The staff team took advice from psychiatrists, psychologists and other health care specialists.

Care planning was detailed and up to date. The plans and the daily notes showed how people wanted to be supported and cared for.

The house was clean, tidy and homely. Everyone's bedroom was personalised to their needs and tastes. There was suitable equipment, furniture and fittings in place.

New staff were only taken on when the organisation was sure that they were the sort of people to be supporting vulnerable adults. Good systems were in place to deal with any disciplinary or competence issues with any member of staff.

The home had good records in place that confirmed the way the service was operating.

People in the service told us that they were supported in all aspects of their lives and that they were asked permission before staff did anything. We could see that people received good levels of personal and health care support. Medicines were managed appropriately.

We asked people if they felt safe and protected in the service. We were told:

"I am fine here...no one is horrible to me...they are all nice to me and they come places with me so that I am well looked after."

The home had suitable staffing levels to make sure people could have support in the house and that they could go out and have fulfilling lives. The company made sure that they monitored the care, services and support within the home.

People were very able to talk about their experiences living in the home and those we met were very positive:

"It is a good place ".

"Good staff...they are nice."

"I go to golf and swimming and speedway."

"The staff are good at cooking and we get nice dinners."

"I like my room and it is nice and clean and I keep it tidy."

"We get good coffee here and we like to have a talk around the table when we have our coffee break".