Rivendell and Lorien (Marsh Lane)

People’s experience of using this service: Risks of abuse to people were minimised because staff demonstrated a good awareness of each person's safety needs and how to minimise risks of abuse for them. The environment was safe, and regular health and safety checks were carried out.

Since the previous inspection the service had reviewed the way referrals were made to local authority safeguarding teams to ensure they were timely and appropriate to ensure people were protected. Where restrictions had been put in place to keep people safe this had been done in line with the requirements of the legislation as laid out in the Mental Capacity Act (2005) and associated Deprivation of Liberty Safeguards. Any restrictive practices were clearly recorded and regularly reviewed to check they were still necessary and proportionate.

People were supported to develop and maintain their independence and have choice and control over their daily lives. Staff supported people according to their individual preferences and needs. There was a drive to deliver person centred care which focused on getting the best outcomes possible for people.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; independence, choice and control over day to day routines and inclusion and involvement in the local community. People's support focused on them having as many opportunities as possible for them to gain new skills and develop and maintain their independence.

People were supported by staff who had the skills and knowledge to meet their needs. Staff understood and felt confident in their role. People’s health had improved because staff promoted healthy active lifestyles. They worked in partnership with a range of healthcare professionals and followed their advice.

People were supported in the least restrictive way possible; the policies, systems and culture in the service supported this practice.

People's concerns and complaints were listened and responded to. Accidents, incidents and complaints were used as opportunities to learn and improve the service.

People gave us positive feedback about the quality of people's care. They said the provider and member of staff were approachable, listened and acted on feedback. The registered manager and staff members were enthusiastic and keen to share their experiences with us. They had high expectations for people and this was evident throughout the inspection.

Rating at last inspection: At the previous inspection the rating was Good. (Report published 11 October 2016).

Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned based on the rating. If we receive any concerns we may bring our inspection forward.

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

At the time of our last inspection in August 2013, Rivendell and Lorien was found to be meeting all of the essential standards relating to the quality and safety of care.

Rivendell and Lorien provides accommodation and personal care for up to 10 people who require specialist support relating to their learning and physical disabilities. The location comprises of two separate bungalows which sit side by side. Each bungalow has the capacity to accommodate five people. At the time of our inspection, both bungalows were fully occupied meaning there were 10 people living at the home.

There was a registered manager 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 service was not always safe because staff had not always recognised the need to raise a safeguarding alert with the local authority, to ensure that people were protected from the risk of abuse and avoidable harm.

People were supported by enough members of staff who had been safely recruited and received adequate training to ensure they had the knowledge and skills they required to do their job effectively.

People received care and support with their consent, where possible and people’s rights were protected because key processes had been fully followed to ensure people were not unlawfully restricted. They were also supported by staff who protected their privacy and dignity.

People’s nutritional needs were assessed and monitored to identify any risks associated with nutrition and hydration and they had food they enjoyed.

People were supported to maintain good health because staff worked closely with other health and social care professionals when necessary. People received their prescribed medicines as required.

People were supported by staff that were very kind and caring and that were dedicated and committed to getting to know people well, to ensure they received the care they wanted based on their personal preferences, likes and dislikes.

People were encouraged to be as independent as possible and were supported to express their views in all aspects of their lives including the care and support that was provided to them, as far as reasonably possible.

The service was very responsive because people and their relatives felt involved in the planning and review of their care because staff communicated with them in ways they could understand.

People were encouraged to engage in activities that they enjoyed and were supported to maintain positive relationships with their friends and relatives.

The service was very well led because the provider had clear visions and values that promoted a positive, person-centred culture within the home. Staff felt supported and appreciated in their work and reported the provider to have an open and honest leadership culture.

Relatives and staff reported the registered manager to be dedicated and committed to providing a high quality service.

The management team endeavoured to improve and develop the service and therefore had systems in place to assess and constantly monitor the quality of the service. People were encouraged to offer feedback on the quality of the service and knew how to complain.

We saw good interactions between people who lived there and staff. We observed that people were at ease in the company of staff. A relative told us, 'My relative is very happy here and we are lucky to have found this home.'

We saw that people's needs had been assessed by a range of health professionals and people's health care needs had been monitored and met.

People had a varied and nutritious diet to prevent malnutrition and dehydration and ensure their health and wellbeing.

Equipment was provided that was well maintained and safe for people to use to help promote their independence.

We saw that checks were made on staff before they started working there to ensure people's safety. Staff had the skills and knowledge to know how to support people to meet their needs. One relative told us, 'I have total confidence in the staff here.'

People were asked for their views about the home and these were listened to. Audits were completed and action was taken to make improvements where needed.

People made choices about what they did and what they ate and were supported to develop their independence skills.

Staff supported people to meet their health needs to ensure their well being. We observed that staff interacted well with people.

Staff knew how to safeguard the people living there from harm. We observed that people were comfortable in the company of staff.

People had their medicines when they needed to ensure their health needs were met and these were stored safely.

People lived in a safe, clean and comfortable home that was adapted to meet their needs. People told us they had chosen what things they had in their bedroom and how it was decorated.

There were enough staff to be able to support people to do the things they wanted to do.

Staff received the training they needed to be able to safely support the people living there. Staff told us they were well supported and enjoyed working there.

Risks to people's health, safety and welfare were identified and assessed, so risks were minimised, ensuring people's safety and well being. Improvements were made as a result of listening to the views of people and their relatives.