This inspection took place on 29 June 2018. 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 ongoing 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.

Woodhouse Cottage is a care home which provides accommodation and personal care for up to six people with a learning disability. There were six people who were living at the home on the day of our visit.

Woodhouse Cottage 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.

People continued to receive safe care as they were supported by staff who knew how to protect them from harm. Staff were aware of people’s individual risks and plans were in place to minimise these while maintaining the person’s independence. Staffing was arranged based on people’s individual needs and what activities were happening in the home. Staffing remained flexible to suit the people living at the home.

The registered manager supported staff by arranging training so staff developed the skills to provide care and support to people, which was in-line with best practice. People receive care and support that was agreed with their consent, the policies and systems in the service support this practice.

People were supported by staff who knew their individual dietary requirements and how to support them in the right way. People had access to healthcare professionals when they required them.

People were treated well which had a positive impact on their well-being. People we spoke with told us that all staff spoke kindly to them and they felt happy and comfortable in their home. Staff helped people to make choices about their care and the views and decisions they had made about their care were listened and acted upon.

People were involved in the planning and review of their care and support. People were supported to continue with their hobbies and interests which promoted their independence and confidence. Information was provided to people should they wish to raise a complaint.

Systems were in place to monitor and assess the quality and safety of the care provided. There were opportunities for people and relatives to feedback their views about their care and this was used to improve the service. Staff were supported to carry out their roles and responsibilities effectively, so that people received care and support in-line with their needs and wishes. The checks completed focused on people’s experience of care. Where areas for improvement were identified, systems were in place to ensure lessons were learnt and used to improve the service delivery.

Further information is in the detailed findings below.

This inspection took place on 24 February 2016 and was announced.

Our last inspection took place on 7 January 2015, at that time we found the service was not meeting the regulations relating to consent. The registered person did not have suitable arrangements in place to show they were acting in accordance with the Mental Capacity Act (MCA) 2005. At the last inspection on 7 January 2015, we asked the provider to take action to make improvements for ensure consent, and this action has been completed.

Woodhouse Cottage is registered to provide accommodation for up to six people who have a learning disability. The home has a kitchen, dining area and two lounge areas on the ground floor. There are six single en-suite rooms with showers on the first floor. There is one bathroom on the ground floor. The home has a well maintained garden area and is within easy walking distance to local amenities. At the time of inspection there were five people living at Woodhouse Cottage.

At the time of this inspection the home 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.

At this inspection we found people were happy with the care they received. People felt staff were caring. We saw people received good support during the inspection and enjoyed the company of staff.

People told us they felt safe and did not have any concerns about the care they received.

We found the provider was meeting the legal requirements relating to Deprivation of Liberty Safeguards (DoLS).

The provider was meeting the requirements of the Mental Capacity Act 2005 (MCA). Staff understood how to help people make day-to-day decisions and were aware of their responsibilities under the MCA and Deprivation of Liberty Safeguards (DoLS).

We found that staff had training throughout their induction and also received refresher training in areas such as dementia care, MCA, DoLS, safeguarding, health and safety, fire safety, first aid and infection control. This meant people living at the home could be assured that staff caring for them had up to date skills they required for their role.

Medicines were administered to people by trained staff and people received their prescribed medication when they needed it. Appropriate arrangements were in place for the ordering, storage and disposal of medicines. At the time of inspection a visiting pharmacist was at the home completing their six monthly checks of the homes medication.

People enjoyed a range of social activities and had good experiences at mealtimes. People’s health needs were met.

People told us the food was good and that they had enough to eat and drink. People chose to eat in the home or out in the community.

Robust recruitment and selection procedures were in place to make sure suitable staff worked with people who used the service. Staff felt supported and had regular supervisions and appraisals

We saw the provider had a system in place for the purpose of assessing and monitoring the quality of the service. This showed through audits that this was an effective system.

People told us they would feel comfortable raising concerns or complaints. People provided positive feedback about the registered manager.

This was an announced inspection carried out on the 7 January 2015. At the last inspection in October 2013 we found the provider met the regulations we looked at.

Woodhouse Cottage is registered to provide accommodation for up to six people who have a learning disability. The home has a kitchen, dining area and two lounge areas on the ground floor. There are six single en-suite rooms with showers on the first floor. There is one bathroom on the ground floor. The home has a well maintained garden area and is within easy walking distance of local amenities.

At the time of this inspection the home 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 we spoke with told us they felt safe and did not have any concerns. People attended ‘Your Voice’ meetings which included discussions on bullying. However, we found people were subjected to control that was unlawful and excessive, even though the service had involved other professionals in some of the decision making processes.

We found people were cared for, or supported by, sufficient numbers of suitably qualified and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Staff received the training and support required to meet people’s needs.

People received their prescribed medication when they needed it and appropriate arrangements were in place for the storage and disposal of medicines.

Staff talked about assessing capacity in relation to particular decisions. They said people were supported to make decisions and where people did not have the capacity decisions had to be in their best interests.

Suitable arrangements were in place and people were supported and provided with a choice of suitable healthy food and drink ensuring their nutritional needs were met.

People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made.

We observed interactions between staff and people living in the home and staff were respectful to people when they were supporting them. Staff had good relationships with the people living at the home and the atmosphere was happy and relaxed. Staff knew how to respect people’s privacy and dignity. People were supported to attend meetings where they could express their views about the home.

A range of activities were provided both in-house and in the community. People were able to choose where they spent their time. For example, in the lounge areas, in the garden or in their room.

The management team investigated and responded to people’s complaints, according to the provider’s complaints procedure.

There were effective systems in place to monitor and improve the quality of the service provided.

We found the home was in breach of one of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

The environment in which people lived promoted their privacy and dignity and supported their rights to choose and retain a level of independence. Each person had their own room which was decorated in the way that people wanted. We spoke to one person who showed us his room and we observed that the room was personalised in a way that reflected his tastes and interests.

We spoke to three people who use the service. People who use the service said that they were given choices about how they spent their days.

People we spoke to were aware that they had a care record containing information about them. One person said ‘’ I see my key worker and we talk’’. We looked at three care records which had information on key worker meetings which documented any changes in peoples care needs.

We observed staff being respectful to people by talking to them in a kind and caring way and by knocking on people’s doors and awaiting a response before entering their rooms. We observed that people were comfortable in the presence of staff and the atmosphere in the home was pleasant and calm.

We saw from training records that all of the staff had received training in safeguarding and were able to demonstrate a clear understanding of the learning. An up to date safeguarding and whistleblowing policy was in place.

We looked at two staff records which demonstrated that effective recruitment and selection procedures were in place. We did note however, that one record did not have information on an application form being in place nor any references. The manager said she was aware of this and that they were in the process of getting this information from the HR department.

The home carried out monthly audits which covered areas such as staff communication and interaction with service users, respect, privacy and dignity, promoting service user involvement and managing difficult situations and/or challenging behaviour. Records and documentation were also audited and this covered areas such as risk assessment, incident records, and medication and keyworker meetings.

We were unable to speak with the registered manager as he was on annual leave at the time of our visit. We spoke with the deputy manager who was responsible for the day to day running of the home and for the supervision of staff.

There were two people, who used the services, at the home on the day of our visit. One person was in hospital and the other people had chosen to go on a caravan holiday and had been supported by staff to do this.

The people we spoke with told us they had one to one meetings with their key worker to discuss their goals and how they wished to spend their one to one time. One person told us; “I can choose what to do.” Another person said; “I can do the things I want.” People said they had resident meetings to discuss what activities to do and about how the home was run.

People told us they had chosen how their rooms were decorated and could put their own belongings in their room. Both people we spoke with understood they had a care plan and said that staff treated them well. One person commented; “I like it here.” Another said they had “no problems” with the staff.

We asked what people would do if they were unhappy with something at Woodhouse Cottage. Both people told us that they would speak to a member of staff. People told us they felt “safe” and felt they would be listened to by staff.