Inspection site activity started on 20 February 2018 and ended on 16 March 2018. At the time of our inspection, two people were using the service.

Wintofts Residential Home is a residential home for up to six people who have a learning disability. Accommodation is provided in one adapted building over two floors. This service is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service is not required to have a separate registered manager, because the registered provider is an individual who is registered with us. 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 were protected from the risk of harm. Risk assessments were in place where required. Staff were able to describe action they would take if they suspected abuse was taking place. There was enough staff on duty to provide the support needed. However, contingency plans required further information and clarification to ensure appropriate support could be sourced in the event of staff sickness.

Medicines had been administered and stored safely. Staff had completed appropriate training to ensure they were competent within their roles.

People had access to food and drink and were provide with home cooked meals of their choosing. People were able to access to their own GP’s and were supported to receive annual health checks. It was not always clear if relevant professionals had been consulted when people’s mobility needs changed.

Positive caring relationships had been developed and it was clear the provider and staff were familiar with people’s like dislikes and interests. Staff communicated well with people using their preferred communication techniques.

Care plans were person-centred and contained required information. Where possible relatives and advocates had been involved in the development of care plans.

A complaints procedure was in place and was available to people if needed. Relatives told us they were confident any concerns would be addressed appropriately.

The provider was responsible for completing all care documents and ensured this task was completed each day. People were asked their views and wishes with regards to day to day activities. Informal discussions took place to ensure people were satisfied with the service provided.

We found that complete and accurate records had not been always been kept. The provider did not clearly record activities that had taken place and contingency plans were in place but did not contain enough information.

The provider was a member of the Independent Care Group and was able to seek advice and guidance when needed to ensure they followed best practice.

Further information is in the detailed findings below.

This inspection took place on 28 January 2015 and was announced. The last inspection took place in January 2014 when the service was found to be meeting the Regulations.

Wintofts Residential Home is registered to provide residential care and support for up to six people with a learning disability. The service is located in a rural area close to a range of community amenities and facilities in Pickering. At the time of our inspection there were two people living there.

A registered manager was in post. 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. The majority of care and support was provided by the registered manager and her husband who lived on site.

Wintofts Residential Home provided good care and support for the people that lived there. People were encouraged to lead fulfilling lives in line with their own preferences and choices. People were involved in making decisions about their care and how the service was run. Care and support plans contained up to date and personalised information about how people wanted their needs met. There were good opportunities for people to discuss any concerns or ideas that they had.

People were supported to have their day to day health needs met. Health services such as dentists, doctors and opticians were used as required and there were close links with other specialist services where required.

Staff were knowledgeable about the needs of each person and how they preferred to live their lives. Staff received training to support them in their roles, although we identified that some staff would benefit from updated training to make sure they were aware current best practice. There were safe recruitment practices in place for staff and there were a sufficient number of staff on duty to meet people’s needs.

There were systems in place to keep people safe. Staff were confident about their responsibilities in relation to safeguarding and also knew who they could contact regarding any concerns they had about the service. There was a positive approach to risk taking so that people could be as independent as possible. Risks in peoples’ day to day lives had been identified and measures put in place to keep people safe. The focus was on how each person benefited from the activity undertaken.

The staff team were aware of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS are safeguards put in place to protect people where their freedom of movement is restricted. Staff had been trained in the MCA and had a good awareness of issues relating to capacity and consent.

The service was well led. The registered manager had been at the service for a long time and knew the people that lived there very well. Staff told us that the service was well managed and that there was good support. The registered manager promoted a culture of respect, involvement and independence. The registered manager had a good oversight of the service to make sure that the quality of care was maintained.

The people who lived at this service were able to choose and plan what they wanted to do throughout the day with the support of the manager, her husband and one member of staff. It was a very homely environment.In the care files we saw evidence of involvement with other healthcare professionals.

People had a care plan for nutrition which was individual to them. This stated what they liked to eat. People had specific routines at meal times and we observed that the manager tried to ensure that those routines were maintained to suit the wishes of each person. On the whole the people who used this service ate a healthy, nutritious diet which contained all food groups.

People who used the service had their own care files that showed input from other healthcare professionals. Information in the care files suggested that information was shared appropriately between the service and other professionals.

We observed that people were given the correct medication at the right time. We looked at medication records and found that these were up to date.

We looked at the service's policies and procedures and found that there were plans in place for emergency situations.

We saw that people had their views taken into account both when reviews were carried out by the local authority and also when service questionnaires were completed with the help of staff. One person who used the service told us,"I like it here."

When we visited the home both people who lived there were present. One person told us that they enjoyed living at the home and that they were supported to do things they liked. The other person did not communicate verbally, but we could see they were contented by their body langauge and actions.

People indicated that they were happy with the way staff cared for them and that they were supported to live well in the community. One person told us “I go out to Morrisons for something to eat. I like Morrisons at Scarborough best. We go there because I like it."

People’s consent to care was gained and we saw evidence that people received the care they needed. Staff had training in the Mental Capacity Act (2005) and Deprivation of Liberty safeguards (DoLS) to ensure people's rights were protected.

We saw up to date plans of care which considered individual physical, emotional and mental health care needs. We saw risk assessments and that all documentation was kept up to date to ensure people had their changing needs met. We saw that the home consulted with specialists to make sure people had the benefit of expert advice.

People were protected from harm and the risk of harm through staff training and risk assessments.

There were sufficient staff on duty at all times to ensure people had their care needs met.

We saw that the home had an effective system to deal with complaints.

We were unable to communicate with people who use the service. We did observe the interactions between them and the staff. All interactions were seen to be positive and staff sought the opinion of the person using the service as best they could. People were treated with respect and dignity at all times.

Staff spoken with said that their priority were the people who lived at Wintofts .They said they worked with relatives, friends and other professionals to ensure people received the care and support they required. They also said that they received training and support to do their job.

We spoke with the Local Authority Contracts Officer who informed us that they did not have any concerns about this service.