The inspection took place on 29 December 2016 and was unannounced, which meant no one working at the home knew we would be inspecting the service. The care home was inspected in September 2015 and was in breach of three regulations and was rated overall requires improvement. We also carried out a focused inspection in December 2015, at this inspection we only looked at safe and well led and we saw improvements but the rating was not changed.

Whitwood Grange is a purpose built home which provides care and accommodation for up to 17 people with a learning disability. The service is divided into three houses Hugh and Walton House both can accommodate up to six people. These houses have communal lounges, dining rooms and kitchens. Bedrooms have en-suite facilities. Then the third is The Fold, which are five self-contained flats.

The service had a registered manager in post at the time of our inspection. 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.

Relative's of people who used the service, who we spoke with, told us they were very happy with how care and support was provided at the home. They spoke extremely positively about the staff and the way the home was managed. People we observed who used the service were engaging with staff talking and laughing together.

There was a strong person centred and caring culture in the home. (Person centred means that care is tailored to meet the needs and aspirations of each person, as an individual.) The vision of the service was shared by the management team and staff.

We saw there were systems in place to protect people from the risk of harm. Staff we spoke with were knowledgeable about safeguarding people and were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified risks to people and management plans to reduce the risks were in place to ensure people’s safety.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding and knowledge of this topic. People who used the service had been assessed to determine if a DoLS application was required and some people had authorised DoLS in place and staff were aware of any conditions attached to these.

Systems were in place to ensure people received their medications in a safe and timely way from staff who were appropriately trained. Robust monitoring of medication had been introduced since our last inspection.

There was enough skilled and experienced staff on duty to meet people’s needs. Recruitment systems were robust, so helped the employer make safer recruitment decisions when employing new staff. New staff had received a comprehensive induction into how the home operated and their job role. This was followed by regular training updates and specialist training to meet the needs of the people using the service.

People were supported to eat and drink sufficient to maintain a balanced diet and adequate hydration.

People’s needs had been assessed before they moved to the home and we found they, and if required their relatives had been involved in planning care. Training was also provided to staff before people moved into Whitwood Grange to ensure staff understood how to meet their needs. Care files checked reflected people’s care and support needs, choices and preferences.

People had access to a varied programme of activities which provided in-house stimulation, as well as regular trips out into the community.

There were extensive systems in place to monitor and improve the quality of the service provided. These had been improved and implemented since our last inspection and we s

Observation showed staff supporting people to make their own choices about what activities they took part in. Staff knew exactly how each person communicated which meant people's wishes were understood and respected.

We reviewed three sets of treatment records in detail. We noted that service users had individual care records including assessments of individual need and clear guidelines for staff to follow, in order to ensure the person's health and personal care needs were met. We observed staff supporting people in a positive way. Some people living at the home have Autistic Spectrum Disorders (ASD). We saw staff interacting with people with ASD with a structured and therapeutic approach.

We inspected the planned menus for each month. We were told that the menus were professionally prepared to ensure a balanced and varied diet. Our observation of the menus concluded that the service was ensuring people received appropriate nourishment.

We looked at medication charts and reviewed records for the receipt, administration and disposal of medicines and conducted a sample audit of medicines to account for them. We found that records were complete and that people had received the medication they had been prescribed.

We observed that people who lived at the home received support and assistance in an unhurried manner. Care staff were able to spend quality time with people to assist them with physical care and to provide social stimulation.

This inspection of Whitwood Grange took place on 7 and 11 December 2015.

We carried out an unannounced comprehensive inspection of this service on 22 and 25 September 2015. After that inspection we received concerns in relation to the management of behaviour that challenges causing injury to staff and people who use the service due to a lack of suitably experienced, trained staff and concerns that staff were not supported appropriately. As a result we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Whitwood Grange on our website at www.cqc.org.uk

Whitwood Grange is registered to provide accommodation and personal care for up to 17 people with a learning disability. They provide a service to people with complex needs and behaviours that challenge. The service is divided into three units.

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.

People who lived at Whitwood grange, who were able to do so, told us they felt safe.

Risk assessments minimised risk whilst promoting people’s independence

There were enough suitably trained staff to meet the assessed needs of people who used the service.

Staff had a good understanding of safeguarding adults from abuse and who to contact if they suspected any abuse.

The provider had not done all that was reasonably practicable to assess, monitor and mitigate risks to staff. This was a breach of Regulation 17 (2) (b)of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The culture of the service was positive, person centred, open and inclusive and staff spoke positively about the registered manager

You can see what action we told the provider to take at the back of the full version of the report.