This inspection took place on 17 and 18 September 2018. The first day of the inspection was unannounced but we arranged to attend the service for a second day of inspection. A previous inspection in April 2016 rated the service as good overall. At this inspection we found the provider was continuing to meet the requirements in all domains and continued to be rated as good overall.

Woodlands 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. The home is registered to provide support for up to four people in a purpose built bungalow. Residential care is provided for people with a learning disability or physical disability. Nursing care is not provided at the home. On both days of the inspection there were four people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Registering the Right Support CQC.

Risks within the service were recorded, monitored and reviewed. The provider had a safeguarding policy in place and any issues had been dealt with appropriately.

Sufficient staff were employed to support people’s personal care needs. Staff told us they worked as a team and supported one another. Appropriate recruitment systems continued to be operated.

Medicines in the service continued to be managed and monitored appropriately. Staff had received training on the safe handling of medicines. The service was maintained in a clean and tidy manner.

People’s needs were assessed and care delivered in line with these needs. Staff had undertaken a range of training and had sufficient skills and experience to support people with individual care. People were supported with a healthy diet and specialist requirements were supported and catered for.

The service was working within the requirements of the Mental Capacity Act 2005. People were supported to make personal choices, wherever possible. Family members were involved in decisions as much as practical. The environment was homely, warm and welcoming. People’s rooms were personalised.

People appeared exceptionally happy and relaxed in staff company and we noted good relationships between staff and people who used the service. Relatives we spoke with praised the care highly and told us it was planned around the needs of their relatives. Staff were committed to ensuring people they supported received good quality and personal support. They had detailed knowledge about people’s backgrounds, personal likes and dislikes and individual care needs. People were supported to make day to day decisions about their care, if at all possible.

People’s privacy and dignity were respected. Staff spoke knowledgably about how they promoted and encouraged people’s independence.

People’s care records contained information that supported staff to deliver person centred care that met the individual’s needs. Care was reviewed and families were involved in care reviews, where appropriate. People were supported to access a range of events and activities, both within the service and outside, including holidays. There had been no recent formal complaints about the service.

Families and staff spoke highly of the registered manager who they felt had the needs of people who used the service as her driving force. Staff said the registered manager was approachable and offered good support and knowledge. Staff told us there was a strong and stable staff team at the service.

Regular audits and checks were in place to monitor the quality of the service. Records were well maintained and up to date. Daily records contained d

Woodlands Cottage is a residential home for up to four people with learning and physical disabilities. It is located in the village of Choppington in Northumberland.

The inspection took place on 28 January 2016 and was announced. We gave short notice as it is a small service and people often go out to day care services and take part in activities in the community. We wanted to be sure that someone was in.

The service was last inspected on 25 April 2014 and all regulations that we inspected at that time were met apart from those relating to quality assurance and governance arrangements. The service was re-inspected in November 2014 and this regulation had been met.

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.

Staff had received training in the safeguarding of vulnerable adults and robust staff recruitment procedures ensured people were protected from abuse.

Checks on the safety of the building and premises were carried out, and individual risk assessments were carried out to identify risks to individuals living in the service. Care plans were in place to address these risks and staff were skilled and knowledgeable in relation to people’s specific health needs or risks posed by the use of specialist safety equipment.

Systems were in place to ensure that medicines were managed safely. We saw that there were appropriate procedures in place for the receipt, storage and administration of medicines.

There were suitable numbers of staff on duty during the inspection and a number of new staff had been appointed following a period of short staffing last year.

The service was clean and there were appropriate infection control procedures in place. Bedrooms were personalised and homely.

Staff were suitably trained and had undergone safety training including in the use of specialist equipment and moving and handling. A new induction process meant that staff had received training before commencing work and they were given opportunities to shadow experienced staff before working more independently. The manager was diligent in ensuring unfamiliar staff were introduced to people using the service gradually as some people found new staff unsettling.

Appraisal and supervision systems were in place and staff supervision was happening more frequently following a period of short staffing last year.

People had access to health care services. We saw that people had attended community based health appointments and where there were concerns about the health of people using the service, these were addressed promptly. Specialist support was sought where appropriate from speech and language therapy professionals, or occupational therapy teams. Hospital Passports were in place to support people with Learning Disabilities if they were admitted to hospital.

The service was working within the principles of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Applications had been submitted to the local authority for assessment and authorisation where necessary. Capacity assessments had been carried out and decisions taken in the best interests of people were documented.

People were supported with eating and drinking and had individual care plans which responded to their needs, preferences and risks. We saw that staff supported people at mealtimes and followed instructions identified in care plans.

Staff were caring and respectful towards people during the inspection. They demonstrated through their interactions with people that they knew their individual needs and preferences well. Staff showed skill while supporting people and were able to balance a need to set boundaries to maintain the safety of a

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we found-

Is the service safe?

This was a follow up inspection that only focused on certain areas of previous non-compliance and did not relate to this question.

Is the service effective?

This was a follow up inspection that only focused on certain areas of previous non-compliance and did not relate to this question.

Is the service caring?

This was a follow up inspection that only focused on certain areas of previous non-compliance and did not relate to this question.

Is the service responsive?

This was a follow up inspection that only focused on certain areas of previous non-compliance and did not relate to this question.

Is the service well led?

The home had a registered manager. We saw the provider had systems in place for checking the quality of the service and for taking action to make improvements where necessary.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;-

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

This is a summary of what we found-

Is the service safe?

People were cared for in an environment that was safe, clean and hygienic and equipment at the home had been serviced regularly though there were delays in responding to and carrying out repairs. A member of the management team was on call in case of emergencies and clear evacuation procedures were in place.

Staff personnel records contained all the information required by the Health and Social Care Act.

CQC monitors the operation of the Deprivation of Liberty Safeguards which apply to care homes. While no applications had been submitted, policies and procedures were in place.

Is the service effective?

A relative told us they were happy with the care and it was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well. Staff who had been recently recruited had to demonstrate their suitability and competence to carry out the job.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. A relative told us they were happy with the care their relative received at the home. Comments included; "Y seems really happy, they look after him really well. They know him well, better than I do."

Is the service responsive?

People had lived at the home for more than ten years and some staff had worked with them longer than this in other services. We saw that people's keyworkers kept their assessments, care plans and reviews up to date. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People had access to activities that were important to them and had been supported to maintain relationships with their relatives. One relative told us, "Because we live hundreds of miles away we can't visit that often but the manager keeps us informed and reassures us. We are always welcomed and made to feel at home when we are there."

Is the service well led?

Staff demonstrated a commitment to person centred care. However, we saw quality assurance systems were not fully developed and there were delays in responding to some risks to safety. Customer satisfaction surveys were not being used. Staff told us they felt the communication with the provider was not as good as it should be and they had not been fully involved in the changes to the management of the home. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.