About the service: Wigginton Cottage is a residential care home providing personal and nursing care to seven people with Prader-Willi syndrome (PWS) at the time of our inspection. This is a genetic condition with specific characteristics which include excessive appetite, poor muscle tone and some hormonal imbalance. People may also have a learning difficulty.

Registering the Right Support has values which include choice, promotion of independence and inclusion. This is to ensure people with learning disabilities and autism using the service can live as ordinary a life as any citizen. The home was meeting the principles of this policy.

People’s experience of using this service:

• People were protected from the risk of abuse and risks to safety were assessed and managed.

• People received effective care and support.

• Staff were trained and showed they had the skills to support people with meeting their needs.

• People were supported by staff that knew them well and had positive relationships with them.

• Staff were kind and caring.

• People’s needs and preferences were understood and their privacy and dignity was respected.

• People were encouraged to make choices for themselves and maintain their independence.

• People could go to places which interested them and do activities of their choice.

• People were involved in the service and any concerns were listened to.

• The systems in place to monitor the quality of care people received were effective and these identified improvements.

• The registered manager and staff created a positive atmosphere where people were central to the service they received.

• The registered manager understood their responsibilities.

• Learning and partnership were promoted to improve people’s quality of life.

• Everyone we spoke with about the service was positive about the changes they had seen and their experience.

The service met the characteristics of Good in all areas; more information is available in the full report below.

Rating at last inspection: At the last inspection the service was rated Requires Improvement (report published 19 June 2017).

Why we inspected: This was a scheduled inspection based on previous rating.

Follow up: We will continue to monitor the service through information we receive.

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

We inspected Wigginton Cottage on 20 April 2017 and it was an unannounced inspection. The home provides accommodation and support for eight people who have Prader-Willi syndrome (PWS). This is a genetic condition with specific characteristics which include excessive appetite, poor muscle tone and some hormonal imbalance. People may also have a learning difficulty. At the time of our inspection six people were living at the home. This was the home’s first inspection.

The home had 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.

Medicines were not consistently managed to protect people from the risks associated with them and to ensure that people received them as prescribed. The quality assurance systems did not always successfully improve the service. People and their relatives were not always communicated with so that their feedback could contribute to the development of the service. Staff did not always receive the necessary support to equip them to do their job well.

People were kept safe by staff who understood their responsibilities to protect them. Pictorial posters helped to explain to people how to raise a concern or make a complaint. They were also supported to make choices about their care and what they wanted to achieve. They planned their week to make sure they developed their independence and did the activities that they liked. People had busy, active lives which included education and leisure opportunities. They had care plans in place to support this and they were involved in reviewing these regularly.

Communication systems were adapted for each individual to ensure that they understood their plans and could make their own decisions. When they were unable to make a decision then these were made in their best interest in accordance with legal guidance.

There were enough staff available to be able to support people. The staff were knowledgeable about people’s condition and understood the risks to people’s health and wellbeing. They supported people to manage these risks and this included managing their food and drink. They also supported them to see healthcare professionals regularly to maintain good health.

Staff had been recruited following procedures to check that they were safe to work with people. They had positive relationships with people and respected their privacy and dignity. People were supported to develop relationships in the home and outside to ensure that they had a social network to support them.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.