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Inspection carried out on 25 April 2018

During a routine inspection

Yearsley Villa 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 registered providers live at Yearsley Villa and provide all care and support themselves to the three long-term residents. At the time of our inspection there were three people living at the home.

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.

People told us they felt safe. The registered providers had completed safeguarding adults training. People were protected from avoidable harm and risk management plans were in place which provided clear guidance about the support people required to stay safe and well. Medicines were safely managed.

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. The registered providers had the skills and knowledge required to meet people’s needs. People’s health needs were well met.

Care was provided with warmth and compassion. People had lived at the home for between 16 and 22 years and were happy, well cared for and content. The registered providers supported people to be as independent as possible.

Care records were person-centred and contained all relevant information to enable the registered providers to give personalised care and support. Care plans and risk assessments were updated as people's needs changed. People were supported to spend their time how they wanted to. People knew how to raise concerns if they were unhappy.

The registered providers showed a commitment to running a well- led service for the benefit of the people who used the service. Feedback was obtained from people who used the service and their relatives. People described the service as being ‘homely and a family environment’.

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.

Further information is in the detailed findings below.

Inspection carried out on 19 December 2016

During an inspection looking at part of the service

We carried out a comprehensive inspection of this service on 1 December 2015. A breach of legal requirements was found. This was because the registered provider had not fully assessed the risks associated with fire safety, the safety of the home environment or how they would deal with an emergency. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook this focused inspection to check that they had followed their plan and to check that they now met legal requirements. This report covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Yearsley Villa on our website at www.cqc.org.uk.

Yearsley Villa is a small residential home in York which provides support for three adults with a learning disability. The registered providers live at Yearsley Villa and provide all care and support themselves to the three people who have lived at the home on a long term basis.

We inspected this service on 19 December 2016. The inspection was announced. The registered provider was given 24 hours’ notice, because we needed to be sure that someone would be in when we visited.

At this inspection we found the registered provider had made improvements with regard to the management of environmental risk and fire safety and was now meeting legal requirements. An up to date fire risk assessment was in place, along with assessments of risk in relation to the internal and external environment. Other checks such as water temperature checks and fire alarm tests took place regularly. The home was clean and well maintained.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC). 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 found that people’s individual needs were assessed and the registered provider put risk assessments in place to manage and reduce the risk of avoidable harm. The registered providers were aware of their obligations in relation to managing and reporting any safeguarding concerns.

There were systems in place to ensure people received their medication safely.

People using the service told us they felt safe living at Yearsley Villa. We observed warm and positive interactions between people and the registered providers, and people were relaxed and at ease in their home surroundings.

Inspection carried out on 1 December 2015

During a routine inspection

Yearsley Villa is a small residential home in York which provides support for three adults with a learning disability. The registered providers live at Yearsley Villa and provide all care and support themselves to the three long-term residents.

We inspected this service on 1 December 2015. The inspection was announced. The registered provider was given 24 hours’ notice, because we needed to be sure that someone would be in when we visited.

The service was last inspected on the 15 May 2014 at which time it was compliant with all the regulations we assessed at that time.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC). 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 found that people’s needs were assessed and risk assessments put in place to manage and reduce the risk of avoidable harm. People’s medication was managed safely.

The registered manager had not fully assessed the risks associated with fire safety, the safety of the home environment or how they would deal with an emergency. This could have placed people at risk of harm. This was a breach of Regulation 12 (2) (a) (b) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

The registered providers had up-to-date training and were skilled and experienced in their role. People were supported to make decisions, eat and drink enough and access healthcare services where necessary.

People using the service told us the registered providers were kind and caring. We observed positive interactions and people were relaxed and at home in their surroundings. People using the service were supported to make decisions and express their wishes and views. The registered providers maintained people’s privacy and dignity when providing care and support.

We saw there were systems in place to assess people’s needs to provide person centred care. Care plans were reviewed and updated regularly. The registered provider had a system for gathering formal and informal feedback and listening to people’s views and experiences.

People using the service were positive about the management of the home and the registered providers were committed to providing a safe and effective service that benefited and improved people’s quality of life.

Inspection carried out on 15 May 2014

During a routine inspection

The summary is based on our observations during the inspection, speaking with people who used the service, speaking with the owners who supported them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People received an assessment which helped to ensure that the home was able to meet their needs. We saw care plans and risk assessments were in place to help ensure people's safety and welfare. Information was reviewed regularly to ensure that it was up to date and reflected any changes. People told us that they were consulted about their care. Comments included, "I can choose what I want to do and how I spend my time. I am well cared for."

The home had risk assessments in place. This helped to reduce the risks to people.

Is the service effective?

The home had appropriate arrangements in place for gaining people's consent. People's health and care needs were assessed with them, and they were involved in decisions regarding their plans of care. People told us they were very happy living at Yearsley Villa.

Is the service caring?

People were supported by the providers. They lived as part of a family. We observed warm and caring interactions between the providers and those living at the home. The people living at Yearsley Villa had lived there for a number of years so they knew each other well.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support was being provided in accordance with people's wishes.

Is the service responsive?

People told us that they felt able to raise any issues and that they did this informally. People also attended an annual review meeting so that their care needs could be discussed. People were confident that if any issues were raised these would be responded to by the providers.

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Is the service well-led?

The home is run by the providers and people live as part of a family. Some of the policies and procedures in place would benefit from review as were not based on up to date legislation or guidance. The service worked well with other agencies and services to make sure people received their care in a joined up way. All of the people we spoke with said that they felt able to raise any concerns and were confident that these would be addressed.

Inspection carried out on 4 July 2013

During a routine inspection

People told us that they were supported to make decisions and choices regarding their care and treatment. One person said "I am happy living here. I am well cared for and I get the support I need. People were supported to consent to their care and treatment and had access to a range of health professionals.

People said they were well cared for and liked living at the home. One person said "I go to visit my sister and I go to a day service."

The home had systems in place which helped to safeguard people. The owners had attended training in safeguarding adults.

The home is run by the owners and therefore no staff are employed. The owners provided appropriate care and support to people living at the home. They had attended training to ensure that their skills and knowledge remained up to date. One person said "I like the

owners and it is a good home."

The home had systems to monitor the quality of service which people received. Some of these were informal systems as this is what people living at the home preferred. We saw that people's views and wishes were taken into account. One person said "I don't like having meetings but I can chat to the owners. I would tell them if I had any concerns."

Inspection carried out on 2 October 2012

During a routine inspection

People told us that they were supported to make decisions and choices regarding their care and treatment. People told us �I can choose when I get up and I get support if I need to see my GP� and �I attend my review meetings with my social worker, I can discuss my care.� People told us that they had signed their agreement to their care records.

People said they were well cared for and liked living at the home. One person said �I get well looked after and I am able to go out on my own.� Another person said �I go to visit my sister and I can go to the shops.�

The home had systems in place to ensure that people received their medication safely. People were encouraged to manage their own medicines where possible to promote their independence.

The home is run by the owners and therefore no staff are employed. The owners provided appropriate care and support to people living at the home. They had attended training to ensure that their skills and knowledge remained up to date. One person said �I like the owners and I like it here.�

The home had formal complaints systems in place although people living at the home preferred to use more informal systems if they had any concerns. We saw that people's views and wishes were taken into account. One person said �I don�t like having meetings but I enjoy sitting chatting to the owner. I would tell her if I had any concerns.�

Inspection carried out on 1 July 2011

During a routine inspection

We spoke with people living at Yearsley Villa, who told us they were happy living there. Their comments include 'I just like it. It's a nice place. I've been here a long time'. They added 'they're (the owners/providers) are good company. Another person told us 'I like the people, the food and the way I'm looked after. They said they liked the owners, adding 'I can't imagine them being unkind to me'. One person gave the thumbs-up sign when we asked about the service and what it was like to live there.

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