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Inspection carried out on 23 May 2017

During a routine inspection

The Old Rectory is a 15 bedded care home for people with learning disabilities. It specialises in caring for people with autism spectrum disorder and health, emotional and behavioural needs. The provider is Oakprice Care Limited, a family run business. People who live there range from young adults to older people, and live within four separate units. At the time of our inspection there were 15 people living at The Old Rectory.

At the last inspection on 8 December 2015, the service was rated Good overall. However, we rated the ‘effective’ domain as requires improvement because there were two breaches of regulations found at that inspection. This was because consent arrangements for people who lacked capacity were not fully in accordance with the Mental Capacity Act 2005, as best interest decisions made were not always recorded. Also, because new staff did not receive a comprehensive induction when they started working for the service to enable them to carry out their duties. This inspection found improvements had been made in both those areas and the service was now meeting all the requirements of the regulations.

At this inspection we found the service remained Good.

Why the service is rated good:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People’s rights were protected because improvements had been made in the policies and recording systems the service used for people who lacked capacity. They had improved their documentation to demonstrate involvement of professionals and relatives in best interest decision making.

Improvements had been made in induction arrangements for new staff. They received a more comprehensive induction, and worked alongside more experienced staff. This meant they got to know people well and how to meet their needs before working with them unsupervised. Staff received regular training and supervision which enabled them to feel confident in meeting people’s needs and recognising changes in their health.

The service continued to provide safe care to people. People were supported to have maximum choice and control of their lives. Measures to manage risk were as least restrictive as possible to protect people’s freedom. There were enough staff to meet people's needs and support them with activities and trips out. Medicines were safely managed on people’s behalf. There were effective staff recruitment and selection processes in place.

People received effective care and support from staff who received regular training and updating.

Health and social care professionals were involved in people’s care to ensure they received the care and treatment which was right for them. People were supported to maintain a balanced diet, and to keep active.

People had built strong relationships with each other and with staff who were caring and compassionate. There was a happy atmosphere in the home and people told us they liked staff who were always kind. People's privacy and dignity was respected. A visiting professional said, “I love going to The Old Rectory, it’s got a nice homely feel, and there is a good mix of older and younger people.”

People enjoyed a wide variety of hobbies and interests and were part of their local community. They received personalised care and support that met their individual needs. Care plans were personalised to reflect people’s preferences and provided detailed information about the support they needed.

The service was well led by a registered manager who was open and approachable. People had lots of opportunities to have their say and their views and suggestions were taken into account to improve the service. Staff spoke positively about good communication and teamwork and had opportunities for professional development. A number of methods were used to assess the quality and safety of the service and staff made continuous improvements in response to their findings.

Further information is in the detailed findings below.

Inspection carried out on 8, 11 and 15 December 2015

During a routine inspection

The Old Rectory is a 15 bedded care home for people with learning disabilities. It specialises in caring for people with autism spectrum disorder and health, emotional and behavioural needs. The provider is Oakprice Care Limited, a family run business. People who live there range from young adults to older people, and live within four separate units. At the time of our inspection there were 15 people living at The Old Rectory.

At the last inspection on 8 December 2015, the service was rated Good overall. However, we rated the ‘effective’ domain as requires improvement because there were two breaches of regulations found at that inspection. This was because consent arrangements for people who lacked capacity were not fully in accordance with the Mental Capacity Act 2005, as best interest decisions made were not always recorded. Also, because new staff did not receive a comprehensive induction when they started working for the service to enable them to carry out their duties. This inspection found improvements had been made in both those areas and the service was now meeting all the requirements of the regulations.

At this inspection we found the service remained Good.

Why the service is rated good:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People’s rights were protected because improvements had been made in the policies and recording systems the service used for people who lacked capacity. They had improved their documentation to demonstrate involvement of professionals and relatives in best interest decision making.

Improvements had been made in induction arrangements for new staff. They received a more comprehensive induction, and worked alongside more experienced staff. This meant they got to know people well and how to meet their needs before working with them unsupervised. Staff received regular training and supervision which enabled them to feel confident in meeting people’s needs and recognising changes in their health.

The service continued to provide safe care to people. People were supported to have maximum choice and control of their lives. Measures to manage risk were as least restrictive as possible to protect people’s freedom. There were enough staff to meet people's needs and support them with activities and trips out. Medicines were safely managed on people’s behalf. There were effective staff recruitment and selection processes in place.

People received effective care and support from staff who received regular training and updating.

Health and social care professionals were involved in people’s care to ensure they received the care and treatment which was right for them. People were supported to maintain a balanced diet, and to keep active.

People had built strong relationships with each other and with staff who were caring and compassionate. There was a happy atmosphere in the home and people told us they liked staff who were always kind. People's privacy and dignity was respected. A visiting professional said, “I love going to The Old Rectory, it’s got a nice homely feel, and there is a good mix of older and younger people.”

People enjoyed a wide variety of hobbies and interests and were part of their local community. They received personalised care and support that met their individual needs. Care plans were personalised to reflect people’s preferences and provided detailed information about the support they needed.

The service was well led by a registered manager who was open and approachable. People had lots of opportunities to have their say and their views and suggestions were taken into account to improve the service. Staff spoke positively about good communication and teamwork and had opportunities for professional development. A number of methods were used to assess the quality and safety of the service and staff made continuous improvements in response to their findings.

Further information is in the detailed findings below.

Inspection carried out on 13 December 2013

During a routine inspection

There were 11 people living at the home when we visited. We spoke with eight people and asked them about their experiences of living at the home and we spoke with five relatives who regularly visited the home. We spoke with seven staff which included the provider, a member of management team and five care staff and asked them about people's needs. We observed people’s care in communal areas of the home and looked in detail at four people's care records. We also spoke with two health professionals who regularly work with the home to ask them about their experiences.

Once person said, “Staff are quite nice”, another person said, “I’m really happy here”. We saw another person use sign language to indicate to staff that they were feeling happy. Relatives we spoke with told us they were very happy with the care provided at the home. They said they were included involved and included in the person’s life and in decision making about their care and felt welcome to visit the home anytime. One relative said, “The home is marvellous, we couldn’t survive without them. The change in him is amazing, he was quite aggressive at home. Now he is so relaxed and happy”. Another relative said, “They have been brilliant, staff are so supportive. X looks happy, relaxed and chatty”. Health professionals told us staff worked well with the family and contacted them appropriately about people’s health care needs. A GP we spoke said, “I have no concerns at all about the home, it is very well run”.

We found people's care needs and risks were assessed and care plans were developed to meet individual needs. Staff we spoke with knew about people's needs and how to meet them, which was in accordance with their care plans. People were protected from abuse because staff were trained to recognise signs of abuse and report any concerns. We found the provider had taken steps to provide care in an environment that was suitably designed and adequately maintained.

Inspection carried out on 3 January 2013

During a routine inspection

We met all of the people who lived at the home and looked in detail at the care given to three people. Some people we met were unable to communicate with us and we observed their care to help to understand their experience of living in the home. We spoke with six staff about how they were supported to meet people's needs.

People told us they were happy at The Old Rectory and that they have the opportunity to go out and do different things. They told us that staff listened to what they wanted and helped people to do things they found difficult. People told us that they felt safe, were well looked after and are involved in making decisions about their life.

We observed staff sensitively and positively responding to the needs of people that had no verbal communication. We also observed staff listening and responding to what people said to them.

Staff told us that they have opportunity to undertake training (in addition to mandatory training) and had regular supervision and appraisals. They felt well supported.

Staff at The Old Rectory work closely with other service providers to ensure good quality care was maintained.

Inspection carried out on 9 February 2012

During a routine inspection

We (the Care Quality Commission) carried out an unannounced inspection on 09 February 2012. We spent a day at the service talking to people who lived there, observing care and reading records. We met 11 of the 12 people who lived at the home and looked in detail at the care given to three people. Some people we met were unable to communicate with us so we used a specific way of observing their care to help to understand their experience of living in the home. We spoke to five staff about how they were supported to meet people’s needs. We asked two health professionals who visited the home regularly about their experiences of working with the home.

People who lived there and the visiting health professionals we spoke to were very positive about the caring attitudes of staff. They reported that care workers treated people with dignity and respect and involved them in making choices about their care.

We heard about the wide variety of activities that were available to people who lived at the home. These included horse riding, shopping trips, meals out, and trips to various amusement parks. People told us they enjoyed exploring the local countryside, walking and picnics and some people attended the local church. Some of the younger people attended local colleges.

People we spoke to confirmed that staff knew how to provide the care they needed. Everyone we spoke to said they felt safe and were able to raise concerns and were confident they would be dealt with. We observed staff interactions with people and saw that people’s views were listened to and respected.

The Old Rectory showed us a variety of methods through which they monitored the quality of care provided. Detailed risks assessments and care plans were in place to minimise the risks to people and keep them safe. The home undertook regular checks of health and safety systems, medicines management and fire checks. The home sought feedback from people through monthly meetings. The service demonstrated how they improved the service as a result of feedback from people, the staff and in response to incidents. We found that The Old Rectory were compliant with all five outcomes we inspected.