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Inspection carried out on 29 January 2019

During a routine inspection

About the service: This service supported people with learning disabilities and/or autism. It was registered for the support of up to five people. Five people were using the service at the time of the inspection

What life is like for people using this service:

• People had developed strong bonds with staff who knew them well. People were at ease with staff, and enjoyed sharing a joke with them. Relatives were very positive about the caring relationships which had developed between their family members and the staff supporting them. One relative told us, “I can’t fault the staff.”

• Staff spoke warmly about the people they cared for. People were confident to ask for assistance and reassurance from staff when they wanted this.

• People made many of their own day to day choices and decisions. Where people needed support to make some decisions staff assisted them, using people’s preferred ways of communicating.

• Staff promoted people’s rights to privacy and dignity and celebrated people’s independence.

• People were supported to stay as safe as possible by staff who understood risks to people’s safety.

• There were sufficient staff to care for people at times people wanted assistance.

• People were supported to have their medicines safely and checks were undertaken to ensure these were administered as prescribed. People’s medicines were reviewed.

• The risk of infections and accidental harm was reduced, as staff used the knowledge and equipment provided to do this.

• Staff had received training and developed the skills they needed to care for people, through induction and on-going training. One relative told us, “Staff know what they are doing and do a tremendous job.”

• Staff supported people to have enough to eat and drink so they would remain well. Meals were served at the times to suit people.

• People had good access to other health and social care professionals. Where people required an admission to hospital to address their health concerns, Montfort Fields staff continued to support them. This helped to ensure people experienced consistency of care and good levels of well-being and physical health.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this.

• Staff ensured people had opportunities to do things which they enjoyed in the community and people were supported to keep in touch with others who were important to them.

• The views of people, relatives and other health and social care professionals were considered when people’s care was assessed, planned and reviewed, so people’s needs continued to be met, and care provided as people individually preferred.

• Procedures were in place to take any learning from complaints and to further improve people’s care.

• People’s wishes for their care at the end of their lives were known. The registered manager planned to further develop the care available to people at the end of their lives, so their wishes would be responded to.

• Relatives highlighted how good the communication was with the registered manager and staff team. One relative said, “We have regular meetings, and the [registered] manager is doing a really good job.”

• The registered manager and provider checked the quality of the care provided and sought suggestions for improving people’s care further. Suggestions were listened to and acted on.

• The registered manager kept up to date with best practice developments, so they could drive improvements in people’s care.

•We found the service met the characteristics of a “Good” rating in all areas; For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good. The last report for Montfort Fields was published on 21 September 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Foll

Inspection carried out on 7 July 2016

During a routine inspection

The inspection took place on 7 July 2016 and was unannounced.

The home provides accommodation for a maximum of five people requiring personal care. There were five people living there at the time of the inspection. A registered manager was in post when we inspected 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 and associated Regulations about how the service is run.

People were at ease and relaxed with staff supporting them in the home. Relatives were also assured that people were safe living at the home and that they received the support they needed.

People were familiar with the staff supporting them. Staff understood the signs of abuse and understood what needed to be done in order to raise their concerns. The registered manager understood their obligations and who their concerns could be reported to.

Staff understood each person’s individual health conditions and the associated risks to their health. Staff knew the symptoms to look out for and what action need to be taken. The registered manager followed recruitment processes that included background checks to assure the registered provider of their suitability to work at the service. People were supported when required and relatives were happy with staffing levels at the home. People’s support to take their medicines was also monitored regularly both by the registered manager and by an external pharmacy.

People received care and support from staff who were regularly supervised and who accessed guidance in order to better support people they cared for. Relatives were confident that staff supporting their family members had the training to care for their family member.

Staff understood the importance of obtaining a person’s consent and received training to supplement their knowledge. People were supported to make choices about their meals. Staff knew about people’s individual dietary requirements and ensured people received a healthy meal in line with this. If people required support to access further medical help, staff supported people to attend appointments and incorporated any recommendations from medical professionals into people’s care.

People’s care needs were updated regularly and people’s preferences were known and understood by staff. People and their relatives were familiar with care staff, many of whom had worked at the home for a number of years and understood people’s care needs. Staff knew about people’s personal preferences and how they preferred to be cared for. Staff also developed an understanding with people’s families and how to involve them in their family members care.

People care needs were regularly reviewed and updated based on peoples changing needs. People and their families had not made any complaints. Relatives were confident that any concerns they had would be to listened to and acted on.

People knew who the registered manager was and were comfortable around them. Staff felt supported and felt able to raise any issue they needed to with the registered manager. The registered manager assured themselves of the quality of care being delivered by making regular checks. Feedback was then given to staff so that staff understood where improvements were needed or if no change was needed. The registered provider also undertook their own checks to assure themselves of the quality of care and supported the registered manager to further develop their skills as a registered manager.

Inspection carried out on 19 June 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

When we visited we met the five people who lived at the home. They were not able to tell us about their experience of living at the home due to their communication needs. We observed people being supported by the care staff and a visiting relative gave us their views.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

Risks to people had been identified, assessed and kept under review. Staff had the skills and knowledge to know how to meet people�s needs and keep them safe. They had undertaken training including fire safety and how to manage people�s health conditions.

We found that people who lived in the home were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent it from happening.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Relevant staff had been trained to understand when an application should be made and applications had been submitted appropriately.

There were well developed systems to make sure the house was hygienic and the risks of cross infection were reduced as far as possible.

Is the service effective?

We found that people�s on-going needs were regularly assessed and the care and support provided for them was well planned and purposeful. Staff discussed people�s needs during their shift to ensure that there was a continuity of the care provided. We found that people had activities planned ahead that were based on what they enjoyed. Each person had their own activities planned for the day we visited.

The systems in place to inform staff about changes in people�s needs were effective. Staff meetings and supervision sessions were held regularly. Staff were well supported and encouraged to attend training. This meant that staff were well trained and skilled in their work.

Is the service caring?

We observed that the staff worked calmly and were well organised. They smiled and engaged with people in a natural and caring way. The atmosphere was relaxed and homely. We saw that staff did not rush people and they encouraged them to make choices and gave them time to make their decision. Discussions and observation showed that staff knew people's preferred routines, likes and dislikes well.

Feedback from people�s relatives was positive about the care provided. One relative told us that they had confidence in the standard of care provided. They said, �I can tell X (person�s name) is happy, they run in smiling.�

Is the service responsive?

We found that the management team were open to feedback. Ideas were listened to and used to continually try to improve outcomes for people living in the home.

The service worked in close cooperation with other service providers and relatives to help ensure the best outcomes for people.

Is the service well led?

We found that there were good care outcomes for people living at the home. The team were committed to continually improving the service. People�s relatives had confidence in the service and no complaints had been received in the last year.

Staff told us that the felt part of a good team and that they were well supported. They said the registered manager listened to any issues and took action quickly when needed.

The service operated in an open way and welcomed the involvement of people�s relatives and other professionals.

There were well developed quality assurance systems and risks to people�s safety were kept under close review.

Inspection carried out on 18 April 2013

During a routine inspection

When we visited we met all of the people who lived there. People were not able to give us their views on the service because of their special needs. People looked well cared for and seemed relaxed and comfortably within their home. The staff spoke about the people in the home in a caring and respectful way seeking their co-operation and consent for daily living tasks and planned activities.

People were provided with a nutritious and interesting diet. They were also encouraged to take part in food and drink preparation.

Suitable systems were in place to support people with their daily medicines.

People were supported by an established manager and staff team who knew them well. The staff team felt well supported and were suitable trained.

Systems were in place to monitor the quality of the service and to ensure proper health and safety arrangements were in place.

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