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Inspection carried out on 17 July 2017

During a routine inspection

College House is a large bungalow that provides care and support for people with learning disabilities. It is registered to provide accommodation and personal care for up to 12 people who have a learning disability. There were 10 people living at the service at the time of our inspection.

The service had 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.

The inspection took place on 17 July 2017 and was unannounced. One social care inspector undertook the inspection. The home was previously inspected on 2 June 2015 and was rated Good. At this inspection we found the service remained Good.

Why the service is rated good:

People told us they felt safe at the home and with the staff who supported them. One person said "Yes, I am" when asked if they felt safe living at College House, another said, “Yes, they [the staff] are nice.” There were enough staff on duty to meet people's care needs and support them with activities both in and out of the home. Records showed, and people told us they were supported to take part in a variety of activities and trips out. Risks to people’s health, safety and welfare were identified and managed well. People received their medicines safely.

People received effective care and support from staff who were well trained and competent. Staff monitored people's health and made sure they were seen by appropriate healthcare professionals to meet their specific needs. People were happy with the food served in the home and we saw people helping to prepare the lunchtime meal.

Staff were very caring and had many worked at the home for many years. Staff and people knew each other well and we saw kind and friendly interactions between them. People were supported to make choices about how they wished to be cared for and staff supported their independence. People's privacy was respected.

Staff provided care and support which was responsive to people's individual needs. Each person had a care plan that described their needs, however we found one person’s plan did not reflect all of the information provided to us by staff. Following the inspection, the registered manager confirmed this had been updated.

The service was well-led by the registered manager and management team who were open and approachable. People told us they were comfortable talking to the staff or registered manager if they had a concern or wished to make a complaint.

Equipment used to support people with their care had been serviced regularly to ensure it remained in safe working order. Electric and gas installations and fire safety systems were also regularly checked and serviced.

Inspection carried out on 02 June 2015

During a routine inspection

College House is a care home for people with learning disabilities located in Newton Abbot. It is registered to provide accommodation and personal care for up to 12 people. There were 10 people living at the service at the time of our inspection.

The service did have 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.

The inspection took place on 2 June 2015 and was unannounced.

People told us they felt safe and enjoyed living at College House. Comments included, “Yes, I’m safe” and “yes, it’s nice here.” We saw people and staff relaxing together and enjoying a variety of activities throughout our inspection. Some staff had supported the people at the home for many years and it was obvious they had close friendships.

People’s care needs were clearly documented and risks monitored and were managed well. People were encouraged to live full and active lives and were supported to participate in community life. Activities were varied and reflected people’s interests and individual hobbies. On the day of our inspection people went to Newton Abbot, either by themselves, or in a small group with staff. We observed staff actively engaging with and encouraging people to be involved in activities around the home.

People had their medicines managed safely. People received their medicines as prescribed and on time. People were supported to maintain good health through regular access to healthcare professionals, such as GPs, social workers, occupational therapist as well as to attend hospital appointments.

Care plans contained information about people’s health and social care needs. People’s likes and dislikes, daily routine and preferences were recorded. “You can help me by” information provided staff with guidance about specific care and support issues. The home used a keyworker system, with staff having the responsibility to oversee the care and support of one or two people. They were responsible for ensuring care plans were reflective of people’s needs and wishes and that personal goals for the future were identified and supported. People were encouraged and supported to maintain links with the community to help ensure they were not socially isolated or restricted due to their disabilities.

The care plans included risk assessments specific to each person, including how to support people safely. Staff had a good knowledge and understanding of each person. People were supported by suitable staff and safe recruitment practices were in place.

The registered manager was aware of the recent changes to the interpretation of the law regarding Deprivation of Liberty Safeguards and had a good knowledge of their responsibilities under the legislation. All staff had undertaken training on safeguarding adults from abuse. Staff displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm.

People and staff told us the home was well run. The registered manager had a good rapport with people and staff. They said they had an ‘open door’ policy and encouraged people and staff to come in and talk, and we saw this throughout our inspection. Regular resident and staff meetings allowed people and staff to contribute to the running of the home, and share ideas for future improvements.

The registered manager used a variety of methods to review the quality of care provided at the home, both formal and informal. Feedback from people, friends, relatives and staff was encouraged and positive. Incidents were appropriately recorded, investigated and action taken to reduce the likelihood of reoccurrence.

We found the home to be clean and tidy with no offensive odours.

Inspection carried out on 1 September 2014

During a routine inspection

Our inspection team was made up of a single inspector. We considered all the evidence we had gathered under the outcomes we had inspected. We used the information to answer the five questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Safe.

People were treated with dignity and respect by the staff. People told us they felt safe. Safeguarding procedures were in place and staff understood how to safeguard the people they supported.

People who used the service told us "I am extremely happy here it’s much better than my old place. I love the staff they always make me laugh and giggle ". Another person said "I love it here. I come and go as I please but it’s lovely to know I have the care and support when I need it”.

Systems were in place to make sure that the managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve. The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. The Registered Manager had been trained to understand when an application should be made and how to submit one. The staff however had not received formal safeguard training since 2005. This led us to look at other training as a whole. When questioned they demonstrated knowledge of correct procedure for reporting any concerns. This meant that people were safeguarded as required.

The deputy manager set the staff rotas which took people’s care needs into account when making decisions about numbers, qualifications, skills and experience required. However this had proved more difficult to achieve in the weeks preceding the inspection due to people's care need increasing. We saw evidence that the deputy manager was doing their best to ensure people’s care needs were always met.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected

Adaptations and improvements to the home had been performed over the years by the provider to make the home and accommodation safer and more wheel-chair accessible. Therefore it was clear that the provider had taken steps to provide care in an environment that was suitably designed and adequately maintained and had future maintenance jobs planned.

Is the service effective?

People's healthcare needs were assessed with them and they were involved in writing their care plans. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said they had been involved in writing them and they reflected their current needs.

Is the service caring?

People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people. People commented, “The staff here are brilliant they are so helpful and caring”.

People using the service, their relatives, friends and other professionals involved with the service were completing annual satisfaction surveys. We saw the results were very positive.

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

Is the service responsive?

People had regularly completed a wide range of activities inside and outside of the home with help and support of the staff where required.

People knew how to make a complaint if they were unhappy. No one we spoke to felt the need to make a complaint as they were very happy with the service they received. We looked at how complaints had been dealt with and found that the responses had been open, thorough and timely. People could therefore be assured that complaints were investigated and action was taken as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure that people received the care they needed. We saw evidence that staff were receiving extra training to help cater for people's deteriorating care needs.

The service had an external quality assurance system. Records seen by us showed that identified shortfalls had been addressed promptly. As a result the quality of the service was continually improving.

Staff told us they were clear about their roles and responsibilities.

Inspection carried out on 19 August 2013

During a routine inspection

We spoke with seven of the eleven people who lived at College House. We also spoke with three care workers and the deputy manager.

The people who lived at College House were positive about their lives at the home. They had lived there for some time and knew each other and the staff well. One person told us “I like living here, I get along with everybody here.”

We saw that people interacted with care workers in a relaxed and friendly manner. There was warmth and humour in these interactions. One person said "“I love it here because I feel looked after.”

We toured the home with the deputy manager and looked at all areas, including bathrooms, toilets, bedrooms and communal areas. People told us that they had made choices about the personal effects and furniture in their rooms.

Records showed that people ate a balanced diet. We saw that people helped prepare meals and made choices in relation to what they ate. One person told us "The food is very, very good here."

The building looked safe well maintained. Risks in the garden and the home had been assessed. A low gradient ramp at the front of the premises made it easily accessible.

We saw that quality assurance systems were in place to effectively monitor the quality of care and that feedback was acted upon appropriately.

Inspection carried out on 14 January 2013

During a routine inspection

We spoke with seven of the ten people who lived at College House. We saw that people were supported to carry out activities, and to go out either independently or with the support of staff.

The people who lived at College House were positive about their lives at the home. They had lived there for some time and knew each other and the staff well. People had clear assessments of their needs and plans and strategies were in place to meet them. People’s care plans were reviewed regularly.

We saw that staff interacted with people in a relaxed, friendly and respectful manner. Staff worked at the pace of each individual and encouraged their independence. People had made friendships within the home and had access to social activities such as an organised walking group, a pottery group and attendance at a local activity group.

During our visit we toured the communal areas of the home and looked at some of the bedrooms. We saw that people’s rooms were clean and warm, tastefully decorated and individualised with personal effects.

Staff were skilled and experienced and had worked at the home for many years. Staff had received training in safeguarding vulnerable adults and recognising abuse and knew how to report any concerns.

There were sufficient staff on duty to meet people’s needs. Appropriate background checks had been completed on staff. Most records were up to date, accurate and securely stored.

Inspection carried out on 28 February and 28 March 2011

During a routine inspection

The people that we spoke with at College House were very positive about their lives at the home. Everyone we spoke with told us that they were happy living at College House. All the people who live at the home have lived there for some time and know each other and the staff very well.

We saw care plans for two people living at the home. Each of them showed that the person had been consulted about the goals set in the plan. People we spoke with said they felt safe and supported at the home, they told us they had a 'key worker' and talked positively about this. A key worker is a member of staff who takes particular responsibility for the needs of that individual.

Records and discussion with staff confirmed that when necessary the home seeks the views and support of other professionals such as GPs.

People were keen to show us around their home and during our visit we looked at the communal areas and were invited to look at 2 bedrooms. The home was clean and well maintained throughout and there were no unpleasant odours. There was a warm and friendly atmosphere and many personal items on display around the home.

People were seen to be enjoying their meals and they told us they always liked what they had to eat.

During our visit we saw staff interacting with the people they support and providing opportunities for discussions. The staff listened to people's views and provided advice and guidance when appropriate. We saw staff that were competent, attentive and caring. We did not see any practice that gave us any cause for concern.

All the staff we spoke with were able to tell us about the needs of the people they support and also how these needs are met. We heard staff speaking with people in a kind and respectful manner and responded promptly, discretely and sensitively to people when they asked questions or needed help.

Medication is prepared by a local pharmacist and managed by staff in the home. Staff told us they had received training in managing medication and they felt confident to administer any needed.

There is a stable staff group at the home and it was clear that staff and people living at the home knew each other very well and showed each other mutual respect. All staff spoken with said they enjoyed working at the home and felt well supported. Staff spoke of the supportive staff team and good communication between shifts.

We were told by staff and management that people are encouraged and supported to be fully involved in the running of their home.

The home has a complaints procedure and all complaints and outcomes of investigations are logged and the outcomes are communicated to the complainant. We saw that personal records were being well maintained by the staff team. And any information about an individual had been regularly reviewed to ensure that it was correct and still meeting the individual's needs.

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