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Inspection carried out on 24 May 2019

During a routine inspection

About the service

The Court is a care home which provides accommodation and support for up to three people living with a learning disability or autistic spectrum disorder. There were three people living at the service when we visited.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

The service had made improvements and introduced new documentation to support its governance arrangements. Effective systems were in place to monitor people’s Deprivation of Liberty Safeguards (DoLS). The registered manager was responsive to people’s needs and promoted an open, inclusive culture at the service.

Systems were in place to ensure the environment was safe. People were protected from abuse. Robust recruitment checks were completed for potential new members of staff. Health and safety checks were regularly conducted and contingency plans were in place to support people in the event of an emergency.

People were supported by a well-trained, experienced and motivated staff team. Staff treated people with dignity and respected their privacy. People were at the centre of the service. The service promoted positive risk taking, independence and empowered and supported people to achieve set goals with positive outcomes.

People were supported to engage in meaningful activities of their choice. Staff supported people and encouraged them to be as independent as possible.

Care plans were person-centred and clearly outlined people's support and care needs. Effective systems were in place to monitor the quality of the service. The service focused on people’s continuous development. People were regularly consulted and involved in all aspects of the service.

A complaints procedure was in place. People and relatives were supported to raise any issues or concerns. Staff told us they were supported by the management team and the provider.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published date 24 May 2018).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

Inspection carried out on 26 March 2018

During a routine inspection

This inspection took place on 26, 28 and 29 March 2018 and was announced. The provider was given 48 hours notice because the location was a small service for people who are often out during the day; we needed to be sure that someone would be in.

The Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Court is registered to provide residential care and support for up to three adults with a learning disability or autistic spectrum disorder. At the time of our inspection three people were living at the home.

A registered manager was in place. 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.

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. 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.

At the last inspection, the service was rated good. At this inspection we found the service had deteriorated to requires improvement.

During this inspection we found the service did not have robust systems and processes in place for the monitoring of DoLS applications and to safeguard people from abuse. Some people did not receive their medicines as prescribed. We also found the service did not have effective quality assurance processes to monitor the quality and safety of the service provided.

Staff had completed safeguarding training and spoke confidently about the actions they would take if they thought a person was at risk of harm. Sufficient appropriately trained staff were available to support people’s needs.

An effective recruitment and selection process was in place. The provider carried out monthly health and safety checks to ensure people lived in a safe environment. A business continuity plan was in place to ensure people would continue to receive care following an emergency.

Where risks were identified they were assessed and managed to minimise the risk to people who used the service and others.

Care plans were comprehensive and included clear information for staff to follow to make sure people's needs were met.

People were supported to maintain good health and had access to healthcare professionals.

The service was responsive to people’s individual needs and preferences, enabling people to live as full a life as possible. People were supported to maintain relationships, access the local community and go on holidays.

People were 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.

Accessible information was used throughout the service including an easy to read complaints and compliments procedure and within people’s care records.

Staff told us they felt supported by the registered manager and enjoyed working at the service.

The registered manager ensured statutory notifications had been completed and sent to the CQC in accordance with legal requirements.

Relatives felt the organisation was well run and that the registered manager was approachable.

You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 28 January 2016

During a routine inspection

This inspection took place on 28 January 2016. The last inspection of this home was carried out on 18 March 2014. The service met the regulations we inspected against at that time.

The Court is registered to provide care and support for three people who have autism spectrum condition. There were three people living there at the time of this inspection. The care home is a semi-detached family house in a residential area near the city centre. The service is situated next to two similar small care homes and all three services are managed by the same 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.

The people who lived at The Court had complex needs associated with their autism spectrum condition. For some people this affected their communication and comprehension of the world around them. Two people were unable to give their opinions of the service they received but one person was able to tell us they felt “safe” at the home and “enjoyed” living there. Relatives and social care professionals also felt the service was managed in a safe way.

All members of staff were trained in safeguarding adults so were aware of their responsibility to report any concerns. The members of staff we spoke with all said they knew how and when to report any concerns and would have no hesitation in doing so. One staff member told us, “We get lots of safeguarding training and are always prompted to read the policy. I would be able to report anything but certainly haven’t had to.”

There were enough staff to assist people in the house or to go out to activities in the community. The recruitment of staff included the right checks and clearances so only suitable staff were employed. Potential risks to people’s safety were assessed and managed. People’s medicines were managed in a safe way.

Relatives and care professionals said the service provided specialist support for people with autism spectrum condition. Staff were well trained in autism to help them understand the individual challenges faced by the people who lived there. They said they felt “very supported” by the registered manager and other senior staff.

Staff had training in the Mental Capacity Act 2005 for people who lacked capacity to make a decision and deprivation of liberty safeguards to make sure they were not restricted unnecessarily. People’s capacity to consent to care was clearly outlined in their care records. People were supported to maintain a balanced and healthy diet, and to attend any health services when required.

One person told us they were “happy” living at the home and they said they had a good relationship with the staff including the registered manager. People chose to spend time with staff members and were comfortable in their presence. Staff were encouraging and patient with people and made sure people had time to respond to any questions or choices.

A relative commented, “This home is a home, and I feel very lucky that [my family member] is in such a lovely place.” A social care professional told us, “My client’s parents are happy with the placement, their [family member] has been supported by this service for many years now and they see it as their [family member’s] home in every sense of the word.”

The service provided personalised care. Staff understood each person and supported them in a way that met their specific needs. Relatives told us they felt people were well cared for in the home. Each person had a range of social and vocational activities they could take part in.

Staff were familiar with how people might show if they were unhappy with a situation. Relatives had up to date information about how to make a complaint or comment. There had been n

Inspection carried out on 18 March 2014

During an inspection looking at part of the service

During our previous visit we identified that staff were not properly supported to provide care and treatment to people using the service because they did not receive regular supervisions or appraisals. During this visit we saw that regular supervisions had been carried out and all staff had now received an annual appraisal.

Inspection carried out on 15 October 2013

During a routine inspection

Some of the people using the service had complex needs which meant they were unable to tell us their views. Because of this we used a number of different methods to help us understand their experiences.

The service planned and delivered care and support so that people�s needs were met. One relative told us �I can tell my daughter likes it there, she never gets upset when we take her back.�

The home was suitably designed and adequately maintained and systems were in place to manage risks to the health, safety and welfare of people using the service. One relative told us �We are really happy with The Court.�

Staff were trained to carry out their role however staff had not been fully supported in meeting people's needs because they did not receive regular supervision sessions or appraisals.

Inspection carried out on 13 September 2012

During a routine inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We observed that staff interacted appropriately with people within the service and promoted their independence.

We found that each person had their own bedroom and that they had chosen how to decorate it. The people living within the service had also been involved in deciding how to decorate the communal areas of the house.

Inspection carried out on 2 February 2012

During a routine inspection

One person using the service told us that �there�s a lot of choice for food�, and �I like the staff here�. Other people using the service were unable to communicate with us during our visit.

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