Penhayes

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.

There was a registered manager in post. They were also responsible for a four bed service in the same grounds as Penhayes called Penhayes House. 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 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.

The values that underpin Registering the Right Support and other best practice guidance were seen in practice at this service. There was evidence that the core values of choice, promotion of independence and community inclusion; were at the centre of people's day to day support. Staff were person centred in their approach in supporting people.

At our last inspection in 2016 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.

Why the service is rated Good.

People remained safe at the service. Staff understood safeguarding procedures and said they

would not hesitate to report any concerns. Risk's to people safety and well-being were managed without imposing unnecessary restrictions on people. Medicines were managed safely ensuring people received their medicines as prescribed.

Staff were safely recruited and employed in sufficient numbers to meet people's needs. The staff team were well trained and supported. There was an action plan to ensure all staff received regular supervision. All staff said they felt they were supported in their role.

Staff protected people's rights by following the principles of the Mental Capacity Act 2005 (MCA). People were supported to have choice and control of their lives.

People were provided with nutritious food and drink, which met their dietary preferences and requirements. People were supported to eat a healthy diet of their choice.

People's care plans had been developed to identify what support they required and how they would like this to be provided. People had opportunities to take part in activities and had a core group of staff supporting them. These had been kept under review to ensure they were still relevant based on each person’s wishes.

All complaints had been acknowledged, recorded and investigated in accordance with the provider's policy, to the satisfaction of the complainant. People’s views were sought through regular care reviews. People were supported to keep in contact with their family. Relatives were able to visit Penhayes and participate in regular care reviews.

The service was well managed. There were effective quality assurance arrangements in place to monitor care and plan ongoing improvements. People's views about the running of the service were sought regularly and changes and improvements took account of people's suggestions.

Penhayes is registered to provide care for up to five people who may have an Autistic Spectrum Disorder (ASD) and/or learning disability and complex needs. Some of the complex needs may include mental health issues.

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 safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. People were supported to maintain a balanced diet, which they enjoyed. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate. For example, when a person was feeling anxious.

There were effective staff recruitment and selection processes in place. Staffing arrangements were flexible in order to meet people’s individual needs. Staff received a range of training and regular support to keep their skills up to date in order to support people appropriately.

Staff spoke positively about communication and how the registered manager worked well with them and encouraged their professional development. The registered manager recognised the importance of investing in staff through additional training opportunities in order for them to feel empowered.

A number of effective methods were used to assess the quality and safety of the service people received and make continuous improvements.

Four of the five people who lived at the service were detained under the Mental Health Act 1984. This meant that they may have more restrictions placed on their choices and ability to consent to care and treatment.

We saw that staff acted in accordance with people's wishes and provided care that was delivered with their consent. For example, we saw some evidence that people had been involved in completing their care plans.

One person who lived at the service told us they were "very happy" living there. One professional told us that they "were really pleased with the way things were going" for the person they represented.

We observed some very good interaction between staff and people who lived at the service.

We saw the medication systems in use meant people had their medicines at the time they needed them and in a safe way.

We looked at three staff files which showed us there were effective recruitment procedures in place.

We saw the provider had moved to a computer based system that collated a series of audits that highlighted any concerns.

Since our last visit the hospital had been subject to safeguarding procedures which related to the care of one person who no longer lived at the hospital. The process had been closed and the hospital was working through an action plan with health and social care professionals.

We saw evidence in some people's care plans that they had been involved when their care plans had been reviewed. When we looked in people's care records, we saw that incidents were well recorded and incident forms had been completed.

Staff that we spoke with were able to describe people's needs and how they liked their needs to be met. During our visit we heard staff speaking with people in a respectful and caring way. People looked at ease with the staff members and initiated conversation with them. There was no sign from people's body language of any fear or anxiety in their interactions with staff.