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Inspection carried out on 7 January 2019

During a routine inspection

At our last inspection in June 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.

Pye Green Road is a Residential 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.

Pye Green Road accommodates up to seven people in one adapted building, where people had access to communal areas along with their own individual flats. At the time of the inspection there were seven people using the service.

Registering the Right Support has values which include choice, promotion of independence and inclusion. This is to ensure people with learning disabilities and autism using the service can live as ordinary a life as any citizen. The home was meeting the principles of this policy.

There was a registered manager in post at the time of our inspection. 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 safeguarded from abuse and risks were assessed and planned for. There were sufficient staff to support people. Medicines were administered as prescribed. People were protected from the risk of cross infection. The provider learned when things went wrong.

People had their needs assessed and plans put in place to meet them. Staff received training and had support in their role. People received consistent support in an environment that met their needs. People were supported to eat and drink safely and have their health needs met.

People had choice and control of their lives and staff were aware of how to support them in the least restrictive way possible; the policies and systems in the service were supportive of this practice.

People were supported by staff that were caring. People had control over their lives and were supported to make choices and maintain their independence. People were supported with their communication and had their privacy and dignity protected by staff.

People received person centred care and had their needs and preferences understood by staff. There was a policy in place to respond to complaints about the service. Nobody was receiving end of life care so this was not considered.

The registered manager submitted notifications as required and understood their responsibilities. The rating from the last inspection was on display as required. Quality audits were in place which were used to drive improvement.

Inspection carried out on 21 June 2016

During a routine inspection

This inspection visit took place on 21 June 2016 and was unannounced. At the last inspection on 26 August 2014, we found the provider was not meeting the regulations and asked them to make improvements to ensure appropriate arrangements were in place for recording, handling and administering people’s medicines. We received a provider action plan which said that the legal requirements would be met by October 2014. At this inspection, we found that the required improvements had been made.

Pye Green Road is registered to provide accommodation and or personal care for up to eight people. There were seven people living at the service at the time of our visit.

The service had a registered manager. 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.

There were effective systems in place to ensure people’s medicines were administered and managed safely. Risks to people were assessed and managed to keep people safe whilst promoting their independence. The manager and staff understood their role in protecting people from abuse and took appropriate action if they had any concerns.

There were sufficient staff to meet people’s needs and the provided carried out checks to confirm staff were suitable to work in a caring environment. Staff received an induction and training to gain the skills and knowledge to support people.

Staff had positive, caring relationships with people and provided care and support in the way people wanted. People were able to follow their hobbies and interests and had opportunities to engage in activities both inside and outside of the home. People’s privacy and dignity was respected and staff encouraged people to be as independent as possible. People were supported to have food and drink which met their individual needs and preferences. Staff supported people to access other health professionals to maintain good health.

There was a positive, inclusive atmosphere at the home. People and their relatives were asked for their opinions on the service and felt confident that any concerns or complaints would be acted on. Staff felt supported and valued by the provider and were involved in the development of the service. There were arrangements in place to check people received a good service and improvements were made where needed.

Inspection carried out on 26 August 2014

During a routine inspection

This inspection was carried out by a CQC inspector. We spoke with five people who used the service, two relatives, two members of staff and the acting manager. We also reviewed records relating to the management of the service, which included three care records, medication records, staffing records and quality monitoring records. We used the information to answer the five questions we always ask:

Is the service safe?

All care records had been reviewed and updated since our last inspection, including risk assessments. This ensured that there was a current profile of risk for each person and staff had the necessary information to keep people safe.

We found that three monthly reviews had been completed for each person and also a monthly review of records including risk assessments, for each person. This ensured that people's needs and risks had been reviewed regularly .

We found that some improvements were needed in the way that medicines were recorded and administered. This would ensure that people were protected against the risks associated with the unsafe use and management of medicines. We have asked the provider to tell us how they will make improvements.

We spoke to a relative about safety. The relative told us, "I feel that X is safe there and their basic needs are met."

We monitor the operation of the Deprivation of Liberty Safeguards 2009 (DoLS) that apply to hospitals and care homes. No applications had been made to the local authority under this legislation since our last inspection. Key staff were aware of the process for making applications.

Is the service effective?

People's health and care needs had been assessed. We saw that the health care needs of two people had changed. The service had responded to this and had worked closely with health professionals. Records reflected the correct level of support that people needed to maintain good health.

People's goals and aspirations had been recorded with action plans in place to monitor their progress in achieving their aims.

Improvements had been made in the way people gave their consent to care and treatment. The review of all care records and risk assessments meant that people knew what they were agreeing to when giving their consent.

Is the service caring?

Staff engaged in meaningful conversation with people and treated them with dignity and respect. We saw that people were responsive to this.

People's preferences, choices, interests and aspirations had been recorded and were known to staff. Care and support had been provided in accordance with people's wishes,

Relatives told us they were satisfied with the service provided at Pye Green Road. One relative said, "The staff are helpful and kind. When we visit we have never seen anything that gives us cause for concern."

Is the service responsive?

When people's health care needs had changed, external health professionals had been contacted in a timely way. Their advice had been sought, recorded and actioned.

Contacts with relatives had been promoted. Some people were taken for home visits by staff to ensure on-going contacts were maintained. One person told us they spent three nights at home regularly.

We saw that minutes of staff meetings and reviews with key workers had been actioned to improve the quality of the care that people received.

Is the service well-led?

The service did not have a registered manager in post. An acting manager had been managing the service since December 2013 and told us they were in the process of making an application to CQC to become the registered Manager. An additional post of assistant manager was filled three month's prior to our inspection. This has strengthened the level of management cover in the home.

Regular staff meetings had been held. Staff told us they felt able to raise any concerns in meetings, or to make suggestions for improving the service. This was reflected in the minutes of meetings we saw.

Inspection carried out on 17 December 2013

During a routine inspection

We carried out this inspection to check on the care and welfare of people who used this service.

During the inspection, we spoke with the registered manager and the acting manager who had been at the service for two weeks.

We were told that the registered manager for the service had been providing management support at three separate locations for the past six months. We were told that the acting manager had been appointed to work at the service until March 2014.

On the day of the inspection, we spoke with three people who used the service and two members of staff.

We were told that consent was obtained from people who used the service in relation to their care and treatment. We could not always find documentation to confirm this. We could not verify whether the provider consistently acted in accordance with people�s wishes.

We found that people�s care plan documentation was not always up-to-date to confirm that the needs of people who used the service were being met.

One person told us: �I go to college and do the things I want to do�.

We found that there were effective recruitment and selection procedures in place.

We found that records were not consistently accurate and did not always reflect the most up-to-date needs of people who used the service.

Inspection carried out on 29 April 2013

During an inspection to make sure that the improvements required had been made

Our inspection of 26 November 2012 found that Pye Green Road was non - compliant with outcome 16: Assessing and monitoring the quality of service provision.

At the last inspection we found that the service had some systems in place to monitor and evaluate the service. However the quality monitoring systems they had did not provide assurance that people would be protected from risk.

We completed a responsive review to look at how things had improved since the last inspection.

During our visit we spoke with the registered manager about changes and improvements that had been made at the home.

Having spoken with the registered manager and reviewed evidence provided we found that the provider was compliant. The provider had an effective system to regularly assess and monitor the quality of service that people received.

Inspection carried out on 26 November 2012

During a routine inspection

During our visit we spoke with the registered manager, the staff and people living at the service.

One person living at the service told us,�I like the staff here. I go to college and work in a shop�.

Another person told us, �I like living here. I feel safe�.

Staff we spoke with told us they had completed safeguarding training and understood how to identify abuse and what to do if an incident occurred.

We found that there was a system in place to obtain people�s views about the service and we saw evidence that people�s views were acted on.

We looked at five key outcomes to establish whether people were involved and participated in the service they received; whether care was provided appropriately; whether the home could adequately ensure people�s safety; whether carers were adequately supported in their role and whether there was a system for ensuring ongoing quality assurance within the home.

We found that Pye Green Road was compliant in four outcome areas.

We found that Pye Green Road was non compliant with outcome 16. We found that the systems in place to identify, assess and manage risks to the health, safety and welfare to people using the service and others had not always been implemented effectively.

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