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Inspection carried out on 31 May 2018

During a routine inspection

Wilton Villas provides residential care for men who may have mental health issues , a substance misuse issue or a learning disability. The service can accommodate up to 23 people with mental health problems and/or substance misuse issues, each person having their own bedroom. The service recognised that some people may have an additional learning disability so a specific five bed flat within the building was created for people with a mental health, substance misuse history and who also have a learning disability. There were 18 people using the service at the time of this inspection.

This inspection took place on 31 May 2018 and was unannounced. At the last inspection on 25 April 2016 the provider met all the legal requirements we looked at and was rated good.

At this inspection we found the service remained Good.

At the time of our inspection a registered manager was employed at the service. 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.

We saw that risk assessments concerning people’s day to day mental health and other support needs were detailed and were regularly reviewed. There were clear descriptions of potential risks and information for staff about action to be taken to reduce risks and how to respond if new risks emerged. A psychologist employed by the provider took part in assessing potential risks for people. The service liaised with other community based health and social care professionals in order to minimise and respond to potential risks and to keep people safe from harm.

There were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected. The service was applying MCA appropriately. Physical restrictions under DoLS were not applied for at the service as almost everyone using the service was subject to a community treatment order. This would mean that if they did not comply with their treatment in the community they could be recalled to undergo treatment in a secure hospital ward if necessary.

People’s health care needs were assessed and the service had introduced health action plans to ensure that the range of potential health care needs were met, Care was planned and delivered in a consistent way in co-operation with community mental health services and other health and social care professionals. Information and guidance was provided to staff about what was expected of them and the procedures used at the service.

The service complied with the provider’s procedures to carry out regular audits of all aspects of the service. The provider carried out regular reviews of the service and sought people’s feedback on how the service operated.

The provider worked well to ensure that people were included in decisions about their care. People’s views about how the service was run were respected and taken seriously.

Further information is in the detailed findings below.

Inspection carried out on 25 April 2016

During a routine inspection

Wilton Villas provides residential care for men with mental health problems, substance misuse and learning disabilities. There are 23 rooms for people with mental health problems and/or substance misuse. The service recognised that some people may have an additional learning disability so created a specific five bed flat within the building was created for people with a mental health, substance misuse history that also have a learning disability. There were 24 people using the service at the time of this inspection.

This inspection took place on 25 April 2016 and was unannounced. Following our previous inspection in January 2014 we undertook a focused inspection to look into concerns about the service. That inspection took place on 12 March 2015 and looked into concerns about people’s safety as the result of incidents that had required the police to be called to the service or people having been involved with the police in the local area. We found at that time the service had taken action to address those concerns and the situation had improved. Positive relationships with the local community had been established, a recent garden party event hosted by the service had occurred and the feedback received had been very positive.

At the time of our inspection a registered manager was employed at the service. 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.

We saw that risks assessments concerning people’s day to day support needs, mental healthcare support, other healthcare conditions and risks associated with daily living and activities were detailed and were regularly reviewed. Instructions for staff on how to mitigate risks were clear and informed staff about action to be taken to reduce risks and how to respond if new risks emerged. A psychologist that was also employed by the provider took part in assessing potential risks for people.

There were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected. The service was applying MCA appropriately. Physical restrictions under DoLS were not applied for at the service as almost everyone using the service was subject to a community treatment order. This would mean that if they did not comply with their treatment in the community they could be recalled to undergo treatment in a secure hospital ward.

We found that people’s health care needs were assessed and the service was introducing specific health action plans to ensure that these assessments improved the range of potential health care needs assessed, whether previously known about or not. Care was planned and delivered in a consistent way and the service had regular contact with community mental health services and other health and social care professionals. Information and guidance provided to staff about what was expected of them and the procedures used at the service were clear.

The service complied with the provider’s procedures to carry out regular audits of all aspects of the service. The provider carried out regular reviews of the service and sought people’s feedback on how the service operated.

At this inspection we found that the service met all of the regulations we looked at.

Inspection carried out on 12 March 2015

During an inspection to make sure that the improvements required had been made

Wilton Villas is registered to provide residential accommodation and support to a maximum of 30 men with severe and enduring mental health issues.

At the time of our inspection a registered manager was employed at the service. 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.

Following our inspection of 16 January 2014 we undertook a focused inspection to look into concerns about the service. The inspection took place on 12 March 2015 and looked into concerns about people’s safety as the result of recent incidents that had required the police to be called to the service or people having been involved with the police in the local area. During the visit, we spoke with one person using the service, were introduced to four others who did not wish to speak with us at this time, spoke with a project worker, the deputy manager and the registered manager.

From our observations of interactions between staff and people using the service and from our conversation with one person using the service we found that they were satisfied with their support.

People were able to complain or raise concerns if they needed to. We saw from looking at the record of complaints that where people had raised issues these were taken seriously and had been resolved appropriately. We found that any concerns people had were listened to.

Inspection carried out on 16 January 2014

During a routine inspection

We spoke with five people who used the service and, for the most part, they were content with the service they received. One person told us, 'Everything's satisfactory.' There was evidence that people had regular one-to-one meetings with their keyworkers and people told us they valued these. People who used the service had plenty of opportunities to provide the service with feedback about their experience and many of them did so.

The five members of staff we spoke with were skilled and knowledgeable, they were able to give in-depth answers to all our questions. Staff benefited from access to a wide range of training and we saw evidence that learning had been effectively applied from training on the Mental Capacity Act 2005. A need for training on 'legal highs' had been identified and a trainer sourced. The use of legal highs was becoming a problem for the service, reflecting increasing use amongst the wider community.

The communal areas of the building were attended to by a cleaner and people who used the service were supported to keep their bedrooms clean and to carry out other household tasks. People had access to small group activities on site and some attended college or day services.

The provider carried out regular audits to ensure that the service was functioning as required and we saw that they responded to any problems identified. There were close cooperative relationships with a range of placing authorities and other agencies.

Inspection carried out on 14, 24 March and 2 April 2013

During a routine inspection

We spoke with people who use the service, they told us:

"(this is the) best place I have lived since coming out of hospital"

"Its okay living here"

"Everything here is fine"

We found that people's views and experiences were taken into account in the way the service was provided and that care, treatment and support met their needs and protected their rights.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

There were enough qualified, skilled and experienced staff to meet people's needs. Staff were supported to deliver care and treatment safely and to an appropriate standard. The provider had appropriate arrangements in place to manage medicines and had an effective system to regularly assess and monitor the quality of service that people receive.

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