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Inspection carried out on 17 February 2018

During a routine inspection

New Witheven provides care and accommodation and respite services for up to ten people with a learning disability. At the time of the inspection eight people were living permanently at the service. Two people were receiving a respite service. The service is located in a rural setting in North Cornwall surrounded by farm land. The service also runs a day centre. Within the large gardens are various outbuildings which are used to accommodate craft sessions and workshops. There is also a vegetable garden with raised beds and poly tunnels. This announced comprehensive inspection took place on 17 February 2018.

At our last inspection in January 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 on-going 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.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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.

We spent some time talking with people and staff. Staff were respectful and caring in their approach. They knew people well and had an understanding of their needs and preferences. Staff supported people to take part in a range of meaningful activities.

The management team had a clear set of values and these were known and shared by the wider staff team. The registered manager and provider both took an active role within the home. Staff told us they were approachable and available for advice and support. There were clear lines of accountability and responsibility within the staff team.

Care plans identified how people preferred to be supported and how much support they required. Risks to people’s safety and well-being were identified and staff had access to guidance on how to minimise risks. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Staff were supported through a system of induction, training, supervision and staff meetings. This meant they developed the necessary skills to carry out their roles. There were opportunities for staff to raise any concerns or ideas about how the service could be developed.

There were effective quality assurance systems in place to monitor the standards of the care provided. Audits were carried out regularly.

Further information is in the detailed findings below.

Inspection carried out on 23 January 2016

During a routine inspection

We inspected New Witheven on 23 January 2016, the inspection was announced. The service was last inspected in January 2014, we had no concerns at that time.

New Witheven provides care and accommodation for up to ten people with a learning disability. At the time of the inspection nine people were living at the service. 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.

New Witheven is located in a rural setting in North Cornwall surrounded by farm land. The service also runs a day centre and offers respite care. Within the large gardens are various outbuildings which are used to accommodate craft sessions and workshops. There is a large vegetable garden incorporating raised beds and two poly tunnels. People were involved in growing produce which one person sold from a stall at a local farmers market.

The atmosphere at New Witheven was relaxed and welcoming. Throughout the day we chatted with people and observed interactions between staff and people which were friendly and supportive. People were happy to show us around the premises and clearly demonstrated a sense of ownership and belonging towards the service.

Relatives told us their family members were supported well by staff who had a good understanding and knowledge of their needs. People were allowed to make day to day choices about how, where and with whom they spent their time. The lay out and organisation of the premises meant people were able to spend time alone or with others as they wished.

Recruitment practices helped ensure staff working in the home were fit and appropriate to work in the care sector. Staff had received training in how to recognise and report abuse, and were confident any concerns would be taken seriously by the registered manager and organisation. Any concerns had been dealt with expediently and appropriately.

People’s care documentation included clear and detailed information about their health and social care needs. Care plan reviews were held regularly and information within the plans was up to date.

Care plans contained risk assessments which had been developed to enable people to take informed, planned risks while staying safe. The deputy manager was up-dating the risk assessments to make them easier to follow and more accessible for staff and people. They were also developing one page profiles to incorporate into the care plans using pictures and simple text.

Where people lacked the mental capacity to make specific decisions the service had consistently acted in the person’s best interest. Staff had received specific training in this area and understood their roles and responsibilities.

Staff had access to regular training, supervision and appraisals. It was a small staff team and they communicated well sharing knowledge and information effectively. Staff meetings were an opportunity to contribute to the development of the service and individuals. Roles and responsibilities were well-defined. The registered manager was supported by a deputy manager who had a clear set of duties.

There were effective quality assurance systems in place to monitor the standards of the care provided. The registered manager and provider had a hands on approach and spent several days a week at the service. Relatives told us they were approachable and kept them informed of any changes in people’s health or support needs.

Inspection carried out on 1 February 2014

During a routine inspection

During our visit to New Witheven we spoke with six people and five staff. We reviewed four care files and observed the interactions between staff and people.

All of the people we met had capacity to make decisions about their care and treatment and the staff assisted people to make decisions by providing them with information and explaining the options available to them. Relatives, social workers and health professionals were involved in care and treatment decisions which ensured discussions were held by staff who knew people well.

We found people had their needs assessed and care plans reflected people's individual choices and preferences.

New Witheven offered people a healthy, balanced diet to encourage a good nutritional intake. A variety of homemade meals were offered and people's preferences and allergies noted. Education and advice to inform people and healthy eating was evident.

There was a complaints policy in place at New Witheven. There had not been any recent complaints for us to review.

We found improvements had been made to people's care records. People's records were kept securely and reflected their individual needs.

Inspection carried out on 10 December 2012

During a routine inspection

When we visited New Witheven we met five people in the lounge, dining room and out in the work shop. Some people showed us their own room. We met with the providers of the service and three staff on duty. The providers were a partnership, one of whom was the Registered Manager.

We found people were happy with their lives at New Witheven and with the choices available to them. People were treated with respect and their rights were upheld.

People told us, “This is a good place.” Staff said, “It’s a happy family atmosphere. People all get on with each other.”

Systems were in place to keep people safe and to ensure that the support available to them was right for their well being, physical and emotional needs. We found although the house was in a rural position the service was not isolated.

A range of training had been provided and staff told us they felt well supported in their work.

We found care records were not all up to date and accurate, but informal communication had maintained good levels of understanding of people’s care needs.