About the service:

• Wavelly House is a care home for people with mental health needs who may also be living with a learning disability or acquired brain injury.

• At the time of our inspection there were six people living at Wavelly House.

People’s experience of using this service:

• People received a service that was safe, effective, caring, responsive and well led.

• The service had the characteristics of a good service in all areas.

• People’s care and support took into account their individual needs, preferences and goals.

• There was a friendly, welcoming atmosphere in a comfortable and well-maintained environment.

• Staff involved people in decisions about their support and the service they received.

• Staff had developed lasting, caring relationships with people they supported.

Rating at last inspection:

• At the last inspection (published 2 September 2016) we rated the service good.

Why we inspected:

• This was a planned inspection to check the service remained good.

Follow up:

• We did not identify any concerns at this inspection. We will therefore re-inspect this service within our published timeframe for services rated good. We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.

This unannounced inspection of Wavelly House took place on 26, 27 and 28 April 2016. Wavelly House is a residential care home without nursing. Wavelly House provides accommodation and support for up to six adults, who live with mental health illness, with associated physical and psychological support needs. The service provides 24 hour recovery support to enable people to regain and maintain their well-being and independence before moving to more independent living accommodation. At the time of the inspection the service was providing support to three people. A fourth person moved into the service during our inspection.

Wavelly House is a large detached house situated in a residential area close to Basingstoke town centre. The staff office and spacious communal areas are situated on the ground floor, together with a staff sleep in room. This is a bedroom used by the night staff who sleep at the house to provide 24 hour support. The communal areas and bathrooms have been redecorated and refurbished since our last inspection. There is a quiet lounge if people wish peace and quiet and an enclosed garden to the rear of the house.

The service had a registered manager in place. 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 and associated Regulations about how the service is run.

Without exception people told us they felt safe living at Wavelly House and were supported by staff to understand what keeping safe meant for them as individuals. Staff had completed the provider’s required safeguarding training and were able to recognise the different types and signs of abuse. Staff understood their role and responsibility and knew how to report abuse and protect people from harm.

People were protected from harm because staff had identified risks and managed these to keep people safe. People had support plans which assessed specific areas of risk associated to their mental and physical health diagnoses and provided guidance to prevent or mitigate these risks. Staff worked alongside local mental health and social care services to build and promote people’s independence, whilst protecting them from harm.

There were arrangements in place to address foreseeable emergencies, such as a fire or flooding, for example; people had individual evacuation plans, which were tested regularly to ensure people and staff knew what to do in the event of an emergency.

The registered manager completed a daily staffing needs analysis to ensure there were always sufficient numbers of staff with the necessary experience and skills to support people safely. Staff had undergone robust pre- employment checks as part of their recruitment. People were safe as they were cared for by staff whose suitability for their role had been assessed by the provider and people using the service.

People received their medicines safely, administered by staff who had completed safe management of medicines training and had their competency assessed annually by the registered manager. We observed staff administer people’s medicines safely in accordance with their medicine management plans.

Staff completed an induction course based on nationally recognised standards and spent time working with experienced staff. This ensured new staff had the appropriate knowledge and skills to support people effectively.

Records showed that the provider’s required staff training was up to date. Staff also underwent further training specific to the needs of the people they supported, for example; in relation to supporting people’s well-being and mental health needs.

People were supported effectively by staff who were enabled to do so by the provider’s supervision processes. There were documented processes in place to supervise and appraise staff to ensure they w

Wavelly House Care Home offers care to up to six people. The home offers 24 hour recovery support for adults with mental health needs with a view to them moving on to independent supported accommodation. On the day of our inspection visit there were five people living at the home and receiving care and support. There was a registered manager present.

People told us that they were happy living at the home and they felt that the staff understood their care and support needs. They described the support staff as, “friendly” and “nice”.

People were actively involved in decisions about their care and support, staff made appropriate referrals to other professionals and community services. We saw that all staff understood people’s care and support needs, were interactive, kind and thoughtful towards them and treated people with dignity and respect.

We found that a range of in-house and community activities were offered to people either in a group setting or on an individual basis. People were given the opportunity to provide feedback on the activities and most people were happy with the range of actives provided. Some people requested that additional outdoor activities were offered and we saw that these requests had been acted on.

We observed that staff communicated well with the people who used the service and this was supported by what people who use the service told us.

We found that staffing levels were safe. We saw that the registered manager had an effective roistering system in place and was able to utilise staff in a creative way to provide additional support when requested.

On three occasions we heard people request additional support to access the community and we saw that by working together and communicating effectively, staff were able to accommodate these requests.

We found that all staff had the necessary skills and training to support people who used the service and this was supported by the records kept in their Continued Professional Development (CPD) folders and observations of their interactions with the people with challenging behaviour.

We found that the home was clean, hygienic and some areas were well maintained. However we saw that the bathrooms and kitchens were in need of re modernising and this was acknowledged by the registered manager who told us, “The bathrooms and kitchen have not been updated since 1996.” We saw that the registered manager had received confirmation that work to modernise the kitchen and bathrooms will begin in May 2014.

We found risk assessments in place to safely support people to be independent in the home and access the community. We observed staff discussing risks with people prior to them leaving the building and accessing the community. We saw people freely walked around the home and accessed the community

We saw that the service had effective financial safeguarding processes in place when people who used the service requested their money. We found consistencies in staff’s understanding of this process and observed three different members of staff carrying out this process.

We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards. People’s human rights were therefore properly recognised, respected and promoted.

We inspected Wavelly House in November 2012 and found that they were not meeting the essential standards of quality and safety in relation to the management of medicines. During our most recent inspection we found that the provider had taken effective action and people were now protected against the risks associated with medicine.

Staff we spoke with showed they had a clear understanding of people's needs and rights. We looked at records and found that each person had been involved in all aspects of their care plan. We saw that their views and consent had been sought and recorded.

Observation of practices showed that people were receiving effective, safe and appropriate care, which was designed to meet their specific needs. We saw that people were treated with respect and care was carried out with sensitivity and patience. Positive comments were made by people about the support they received. One person said, “They treat me like a real person and listen to what I want.” Another person told us, “They help me live my life how I want to live.”

The provider had an effective recruitment process. This ensured that staff were qualified and competent to carry out their role and meet the needs of people who used the service.

People were protected against the risk of or unsafe care by effective assessment and monitoring of the quality of the service provided. They told us how they were able to report concerns and talk to the staff about any issues that worried them.

We spoke with two people living in Wavelly House. One told us "it's great here, we just get on with living; we can do what we like”. The other said the staff treated them with dignity and respect.

The staff we spoke with told us that finding activities people wanted to participate in was a challenge. One person who lived at Wavelly house told us that they were actively encouraged to take part in activities and can ask to try new things. They told us they had just booked tickets to go to the theatre with their support worker.

Each person was involved in their care and treatment and this was recorded in their support plans. The information on the best way to support each person was recorded but was not always easy to find. The staff we spoke with, however, knew each person well and knew how to support them.

Medicines were ordered and safely stored however, the risk of inappropriate administration of some medicines had not been minimised.

The people living in Wavelly House felt safe and well cared for. Staff were well trained and felt supported. The manager had an effective method for reviewing and improving the service that people received, although this was not always well documented.