Pelham

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, with the exception that the service accommodated more than six people. 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.

People’s experience of using this service: The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were supported to complete major achievements, relevant to their individual wishes. People had developed strong links with local leisure facilities and other amenities as well as securing work placements leading to paid employment.

The provider had systems in place to safeguard people from abuse. Staff could recognise and report any safeguarding concerns if they suspected abuse. Relevant risk assessments had been completed. Medicines were managed safely. Accidents and incidents were monitored to identify and address any patterns or trends to mitigate risks.

Staff had appropriate skills and knowledge to deliver care and support people in a person-centred way. Staff recruitment was safe and staff understood how to keep people safe.

People told us they were happy with the service they received and felt staff had a clear understanding of their needs and preferences. People were supported with good nutrition and could access appropriate healthcare services.

People saw their families and friends when they wanted, as there were no visiting restrictions. People were fully involved in ensuring the home they lived in was safe, taking responsibility for key elements of running the service. Staff supported people to learn about safety issues, such as fire risks and how this could be managed safely if unexpected events occurred.

People were involved in the recruitment of new staff. Staff skills were considered alongside the people living at the service to ensure people were able to access the activities they enjoyed and to try new experiences.

Staff cared about the well-being of people they supported and we received positive feedback about the kindness of staff. People were treated with respect and dignity and their independence was encouraged and supported. Where people required support at the end of their lives, this was carried out with compassion and dignity.

People described a range of activities and events both within the service and the local community, based on their interests and preferences. People and their relatives were supported to receive information in an accessible way either through easy read, large print or pictorial formats to enable them to be involved in their care and support.

Care plans had been developed and were regularly reviewed. These contained relevant information about how to meet people's needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and systems supported this practice.

All areas were clean, tidy and there was effective cleaning taking place to keep people safe from the risk of infection. The rooms we looked at were personalised and decorated in colours of people's choosing. The environment supported people to have time on their own and time with other people if they chose this. Cleanliness and health and safety were well managed.

The registered manager and staff team worked together in a positive way to support people to remain as independent as possible and to be safe. Staff told us they were well supported by the registered manager and management team.

Checks of safety and quality were made to ensure people were protected. Work to continuously improve was noted and the registered manager was keen to make changes that would impact positively on people's lives.

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

Rating at the last inspection: Good (published 11 October 2016).

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

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

It has two downstairs bedrooms one which has en - suite facilities. Three further bedrooms are accessible by stairs. The house has a large communal lounge and dining area. It benefits from its own established front and rear gardens.

This inspection took place on 16 September 2016. The service was last inspected on 4 November 2013 and was compliant with all of the regulations we assessed. At the time of our inspection there were 4 people using the service.

The service aims to promote personal autonomy; independence and achievement, ensuring people have the same rights and opportunities for inclusion, fulfilment and feeling valued in society as everyone else.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 used the service had different levels of identified needs and received support from staff in relation to these, with some people receiving identified one to one support from designated staff.

The service developed and maintained strong links with external organisations and within the local community. There was a strong emphasis on key principles of care such as compassion, inclusion, respect, dignity and enablement.

People participated in a range of vocational, educational and personal development programmes at both the organisation's college facility and a range of community facilities, including work placements. They were encouraged to follow and develop social interests and be active and healthy. All programmes and support were geared to maximising the person's independence and support them into adulthood, staff were very skilled and consistent in their approach.

Staff had developed very positive relationships with the people who used the service and respected their diverse needs. Where people had moved from other college houses within the organisation, staff had moved with them to offer continuity for people. Staff knew people's individual care and support needs very well

Staff knew people's individual care and support needs very well. People told us staff looked after them well and they were kind and caring and would do anything for them. People felt cared for and that they mattered. Staff supported people to maintain their relationships with friends and family. Comments from relatives were very complimentary and consistent stating they were extremely happy with the care, treatment and support the service provided.

People told us they felt included in decisions and discussions about their care and treatment. Staff described working together as a team, how they were dedicated to providing person-centred care and helped people to achieve their potential. Staff told us the manager led by example, had a very ‘hands on’ approach and was visible within the service, making themselves accessible to all.

We found people lived in a safe environment. Risk assessments were completed to help minimise risks in specific circumstances, such as when supporting people in the community or with day to day support within the home. Positive behaviour plans directed staff to effectively support people's behaviour that challenged the service. Systems to monitor and review all incidents were in place. Medicines were administered and stored safely.

There were policies and procedures in place to guide staff and training provided for them in how to keep people safe from the risk of harm and abuse. In discussions, staff were clear about how they protected people from the risk of abuse. We found staff were recruited in a safe way; all checks were in place before they started work and they received an induction. Staff received training and support to equip them with the skills and knowledge required to support the people who used the service.

Training was based on best practice and guidance, so staff were provided with the most current information to support them in their work. People were supported by sufficient numbers of staff.

People's nutritional needs were met and people were supported to shop for food supplies and were assisted to prepare meals. Where people had special dietary requirements, we saw that these were provided for.

We saw staff monitored people's health and responded quickly to any concerns. People who used the service were encouraged to make their own decisions. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns that people lacked capacity or when important decisions needed to be made in their best interests.

There were systems in place to monitor the quality of the service, such as observations of staff practices, audits and surveys. A complaints process was in place which was accessible to people, relatives and others who used or visited the service.

The service had recently re-opened following a period of dormancy when it was unoccupied. Prior to re-opening the service had been completely refurbished.

We found that staff helped to make sure health and social care was well coordinated and provided by a range of professionals.

We found that the numbers of staff provided was based on individual need and regularly reviewed to ensure that there was adequate support available to meet the needs of the people who used the service.

We observed positive interactions between staff and people living in the home. We saw that staff offered people choices in how care was to be delivered and that they took their time to explain care tasks to people.

Discussions with staff showed that staff were knowledgeable about peoples care needs and the care required meeting these. We found that professional advice had been sought by care workers where any health needs were identified.

Comments included 'My keyworker is a great lady, she helps me with the things that I don't like doing like cleaning. She makes it fun' and 'We can go to any of the staff about anything and they will help us to get things sorted.'

People we spoke with made comments such as; 'Its awesome here, I can play my drums or listen to music', 'I've got an XBOX in my room', 'I feel safe here, these are all my friends' and 'The food is good, I like it.'

During the inspection we spoke to two members of staff, three relatives and four people that used the service.

People told us they were happy with the care and support that they received. People's comments included: "I enjoy being here, I have lots of friends and have learnt a lot of new things' and 'The staff are good, they are kind and help us when we don't understand something.

People told us about the weekly meetings in place to decide menus, leisure activities and allocation of tasks which promoted independent living skills: "We all get together and talk about what we want to do, decide what tasks we are doing and anything about the house.' 'If we are upset about something or we want to talk to someone we can speak to our key worker or any of the staff in private."