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Inspection carried out on 20 June 2017

During a routine inspection

Care service description

5 George V Avenue is a residential care home for five people with learning disabilities.

Rating at last inspection

At the last inspection, the service was rated Good.

Rating at this inspection

At this inspection we found the service remained Good.

Why the service is rated Good

People told us they were happy living at the service and that it was well managed. The service was small and family run and there was inclusive culture. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. There were always enough staff to keep people safe. Risks relating to people’s care and support were assessed and mitigated and people were supported to be as independent as possible.

People told us that staff were kind and caring. Staff treated people with respect and dignity. People were working towards goals such as saving money for their holiday and doing more things for themselves. Relatives told us they were proud of the things their loved ones had achieved since living at the service. People led active lives and we were shown pictures of the things they enjoyed doing, such as driving a horse and carriage, dancing and going on trips to London and to local farms.

People were encouraged to access the kitchen whenever they wanted and were able to prepare their own drinks whenever they wished. They were supported to shop for and prepare meals of their choosing. Staff had made prompt referrals to healthcare professionals when they needed additional support and advice. People and their relatives told us they saw a doctor when they were unwell and received their medicines when they needed them.

Staff knew how to recognise and respond to abuse and the registered manager had reported any safeguarding concerns to the local authority. Action had been taken to ensure they did not occur again. Small concerns raised by relatives were documented as complaints and responded to appropriately. People and their relatives told us they were happy with the support provided. Regular feedback was sought from people and their relatives. All the feedback we saw was positive, and included comments such as, “More than satisfied with present care and [my relative’s] lovely lifestyle has much improved, therefore, cannot think of any improvements.”

Staff received appropriate training and were supported by the registered manager to carry out their roles effectively. The registered manager completed a range of checks on the service, including care plan reviews, environmental checks and weekly audits of medicines to ensure people were safe. Regular fire drills were held so people knew how to evacuate the service in an emergency. Staff were recruited safely. The Care Quality Commission had been notified of important events within the service, as required by law.

Further information is in the detailed findings below.

Inspection carried out on 13 April 2015

During a routine inspection

5 George V Avenue was inspected on 13 April 2015. The inspection was unannounced. The service provides accommodation for persons who require nursing or personal care for up to five people with learning disabilities. There are communal spaces which include two lounges, a dining room and kitchen. People have access to the garden. The providers live in the home and at the time of the inspection there were four people with a learning disability using the service.

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.

People were protected from bullying and avoidable harm. Staff were up to date with safeguarding training and knew how to report abuse. People told us that they were safe.

People's care and support needs were assessed and reviewed with them. Any personal risks were identified when people moved into the service and these assessments were ongoing. People had the opportunity to be as involved as they wanted to be in their assessments and in the planning of their care. Care needs were regularly reviewed, so that staff were able to manage risks and support people in ways that suited them best.

People’s medicines were managed safely.

People had lived at the family run service for a number of years. When there had been a change at the service, the provider had employed staff who had the necessary skills, knowledge and experience to make sure people received their care safely. Staff were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Staff had access to specialist training in order to meet individual people’s needs.

People were asked for their consent in ways they could understand before care was delivered and staff understood the requirements of the Mental Capacity Act 2005 (MCA).

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager was in the process of making a DoLS application for one person at the service. They were aware of a recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The service was meeting the requirements of the DoLS. The manager understood when an application should be made and how to submit one. After the inspection the provider informed us that they had submitted the DoLS application.

People were encouraged to follow a healthy diet. People were asked about their dietary requirements and were regularly consulted about their food preferences. One person told us, “I love my meals. The food’s very good”.

People had regular access to the doctor, dentist and optician and had an annual health check. Healthcare professionals, including GPs, nurses, speech and language therapists and dieticians, had been consulted as required. All appointments with, or visits by, health care professionals were recorded in individual care plans and advice and recommendations were followed.

Staff felt valued and supported by the manager. Communication between staff took place through regular meetings and handovers between each shift. At staff meetings any changes in people’s needs were discussed.

People were treated with respect and dignity. Staff spoke with and supported people in a caring, respectful and professional manner. People’s diversity was recognised and encouraged in that individuals were supported to follow their beliefs and to live the life they chose.

Staff supported people to be as independent as they could be, and their privacy was respected. There were no restrictions on people having visitors.

People told us that they and their relatives were fully involved in the planning of their care. People knew where their care plans were and were able to look at them when they wanted to. Care plans included details about the person’s favourite activities, people who were important to them and their likes and dislikes. People’s care was regularly reviewed.

There had been no complaints at the service since the last inspection. People showed us that there was an easily readable complaints procedure displayed in the hall and said that they held regular meetings to make sure their views about the service were heard.

People, visitors, staff and outside professionals were asked for their opinions about the service. This information was used to develop and improve the service.

The manager and staff were aware of their accountability and responsibility in meeting the requirements of legislation. Systems were in place to monitor the quality of service and action had been taken to address any shortfalls, discrepancies or issues that were highlighted.

Inspection carried out on 11 February 2014

During a routine inspection

We found that people who use the service were respected and involved. We were told by relatives that they had felt listened to and included by the service.

We found that the service had assessed, planned and reviewed the support and care provided. Relatives that we spoke with told us that the standard of care had been very good. One relative described the service as, “outstanding”; another remarked that they, “…thanked God they (person using the service) was being so well looked after”.

We were told by relatives of people using the service that they were confident their relative was kept safe whilst having excellent opportunities to enjoy an active outgoing life. One relative remarked that they had “slept at night knowing that they (person using the service) were safe”. We found that the provider who was also the registered manager had taken appropriate action to help safeguard people who used the service.

We found that the service was carried on from safe and suitable premises. We found that the provider had taken action to eliminate, reduce and manage hazards and risk. Relatives told us that they were pleased with the standard of accommodation and facilities provided.

We found that the provider had considered information gathered from observations, monitoring and feedback and had sought to develop practice. The provider had through their continuous and close involvement in the provision of services maintained a suitable overview of standards.

Inspection carried out on 20 February 2013

During a routine inspection

People who use services said that the staff treated them with respect, listened to them and supported them to raise any concerns they had about their care. People told us that the service responded to their health needs and that staff talked to them regularly about their care and any changes that may be needed. People told us they received care from a small team of staff and were happy with the care received.

All the people who use the service spoken with expressed a great deal of satisfaction from living within the service and did not raise any concerns about the quality of care. They told us that if they were not happy they would speak to the manager. We had the opportunity to speak with many of the people who lived within the service and they all expressed satisfaction with regard to the quality of care. One person said he enjoyed helping out and doing the shopping and cooking. He spoke of how staff supported him to do the activities he enjoyed. Another person spoke of how the service was supporting him with his medical needs with regard to hospital appointments etc.

Reports under our old system of regulation (including those from before CQC was created)