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Inspection carried out on 6 February 2018

During a routine inspection

Harboro is a residential care home for five people with learning disabilities and complex health needs. Harboro is a two story building with a communal lounge, sensory area, adapted bathroom and kitchen on the ground floor. Bedrooms are accessed by a lift to the first floor. There is a second adapted bathroom on the first floor.

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.

At this inspection we found the service remained Good.

Why the service is rated good.

Staff knew the people living at Harboro and provided individualised support for each person. Clear person centred care plans were in place detailing people’s interests, likes, dislikes and the support routines for the day. Risks had been identified and guidance provided for staff to mitigate the known risks. Clear behavioural support plans were in place where people had complex behaviours.

People and their relatives told us they felt safe living at Harboro. Staff were described as being kind and caring. Staff were able to explain how they supported people to maintain their privacy and dignity. Observations showed staff supported people in a respectful way.

People were supported by a team of trained staff. Staff completed a thorough induction and annual competency checks so they were able to meet people’s complex health needs. The provider had achieved the investors in people’s award. These awards are given to services that demonstrate a commitment to the on-going training and development of their staff.

Robust recruitment procedures were in place to recruit staff who were suitable to support vulnerable people. Staff said they felt well supported by the registered and deputy managers. Supervisions and staff meetings were held where staff were able to discuss the support people required and their own development.

Medicines were safely managed by the service and people received their medicines as prescribed. People’s nutritional and health needs were met by the service.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Residents meetings were held and people’s relatives had been involved in agreeing the care and support provided.

A comprehensive quality assurance process was in place. Monthly audits were completed and quality assurance reports written for the Chief Executive Officer (CEO) and the provider’s trustees. Evidence was seen that the assistant CEO and CEO carried out their own audit checks at the service.

Surveys were completed to gain feedback from people living at Harboro, their relatives, staff and other professionals involved with the home. These were used to inform the quality assurance process and to drive improvements at the service.

A range of activities was available for people to engage in. The provider had employed drivers so that people were able to attend activities even if the staff supporting them were unable to drive.

The home had been adapted to meet the needs of the people living there. Track hoists were available in communal rooms and there was an adapted accessible bathroom on each floor.

Further information is in the detailed findings below.

Inspection carried out on 16 & 17 November 2015

During a routine inspection

The inspection took place on 16 and 17 November 2015. The first day of inspection was unannounced. At the previous inspection in November 2013 the service was meeting the legal requirements.

Harboro provides care and accommodation for up to six people with learning and physical disabilities.

The service has 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.ale, Altrincham & District Ltd

Harboro is one of the services run by Stockdales of Sale, Altrincham and District Limited, a registered charity providing person centred care and support to people with complex care needs.

Due to the unique methods people used to communicate, which did not always include language, we were only able to speak with one person who used the service and had limited discussions with them. However we used a Short Observational Framework for Inspection (SOFI) to help us understand the experiences of the people who used the service.

There was a very positive atmosphere within the home and people were very much at the heart of the service. People and their relatives were enabled to be involved in their care and staff implemented the service’s core values to ensure people had a meaningful and enjoyable life.

The registered manager and provider regularly assessed and monitored the quality of care to ensure national and local standards were met and maintained.

Continual improvements to care provision were made which showed the registered manager and provider were committed to delivering high quality care.

All of the staff received regular training that provided them with the knowledge and skills to meet people’s needs in an effective and individualised manner.

People’s health and wellbeing needs were closely monitored and the staff worked well with other professionals to ensure these needs were met.

Staff sought people’s consent before they provided care and support. However, some people who used the service were unable to make certain decisions about their care. In these circumstances the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were being followed.

People and their relatives were involved in the assessment and review of their care. Staff supported and encouraged people to access the community and participate in activities that were important to them. Innovative ideas had been implemented which ensured people received care that was meaningful and personal to them.

Feedback was sought and used to improve the care. People knew how to make a complaint and complaints were managed in accordance with the provider’s complaints policy.

People’s safety risks were identified, managed and reviewed and the staff understood how to keep people safe.

There were sufficient numbers of suitable staff to meet people’s needs and promote their safety. Systems were in place to protect people from the risks associated from medicines.

People were treated with kindness, compassion and respect and staff promoted people’s independence and right to privacy. The staff were highly committed and provided people with positive care experiences. They ensured people’s care preferences were met and gave people opportunities to try new experiences.

Inspection carried out on 20 November 2013

During a routine inspection

We were made aware that the home had recently gone through a transition from a children's service to an adult's service and we saw that meetings had taken place and pathway planning had been done with young people to help them, their families and other stakeholders through the transition. There was a manager in post who was registered with the Care Quality Commission (CQC).

People's care plans were being reviewed on a routine basis by staff and the risk assessments enabled and promoted the independence of the individual as much as possible. We asked staff about their understanding of safeguarding, whistleblowing and key working. Staff were knowledgeable in all these areas and felt confident with their knowledge around care planning, best interests, mental capacity and safeguarding.

We spoke with visiting family members who told us they had received lots of information about the service which they found helpful. They told us they felt satisfied with the information and they felt confident they could ask questions at any time about things they were not sure about.