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Inspection carried out on 30 June 2017

During a routine inspection

Netteswell Rectory is a residential care home that provides support for up to nine adults with learning disabilities. On the day of our inspection there were seven people resident in the home. At the last inspection, the service was rated Good overall, but did not have a registered manager in place. At this inspection we found the service had met all relevant fundamental standards and remained rated as Good.

Since the last inspection the service had a new registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Risk assessments had been completed to enable people to retain their independence and be supported with minimum risk to themselves or others. Staff were aware of their responsibilities to ensure people were safe and what to do if they had any concerns.

Recruitment processes ensured staff were suitable to work with people who needed support. There were enough staff to provide care and support to people and meet their needs.

Medicines were administered by staff who were trained and assessed as competent to do this. People were supported to maintain good health and had access to external health care professionals when required.

The staff were very caring and people had built strong relationships with people that used the service. People's privacy was respected. People where possible, or their representatives, were involved in decisions about the care and support people received. The service was meeting the requirements of The Mental Capacity Act 2005 (MCA).

The service continued to have a friendly and homely atmosphere. Care plans provided information about what was important to people and how to support them and people were involved in activities of their choice.

There was a system of quality assurance in place overseen by the registered manager, the regional manager and provider.

Inspection carried out on 23 March 2016

During a routine inspection

The inspection took place on 23rd March 2016 and was unannounced. Netteswell Rectory is a care home that provides accommodation and personal care for up to nine people who have a learning disability. On the day of our inspection seven people were using the service.

The service did not have a registered manager 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. An acting manager was in post to provider management at the service until a registered manager could be appointed.

People were safe because staff understood their responsibilities in managing risk and identifying abuse. People received safe care that met their assessed needs. There were sufficient staff to provide people with the support they needed to live as full life as possible. Staff had been recruited safely and had the skills and knowledge to provide care and support in ways that people preferred.

Medicines were stored and administered safely, and people received their medicines as prescribed. People and their relatives thought staff were kind and responsive to people’s needs, and people’s privacy and dignity was respected.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People were able to tell us about their care and said how happy they were with the staff. People told us they felt safe living at Netteswell Rectory. We saw people were well cared for and relaxed in the home. They were confident to ask staff for help and staff responded with kindness, humour and warmth. Everyone spoke positively about the staff and living at the home.

Staff knew people well and were trained, skilled and competent in meeting people’s needs. Staff were supported and supervised in their roles. People, were involved in the planning and reviewing of their care and support.

People were supported to attend health care appointments when they needed to and received healthcare that supported them to maintain their wellbeing.

People were supported to maintain relationships with friends and family so that they were not socially isolated. There was an open culture and staff were supported to provide care that was centred on the individual. The acting manager was open, approachable and available for people who used the service.

The provider had systems in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service.

Inspection carried out on 12 June 2014

During a routine inspection

We spoke with four people who used the service and four members of staff. The detailed evidence that supports our findings can be read in the full report.

Is the service safe?

People are treated with respect and dignity by the staff. People told us they felt safe.

Safeguarding procedures were robust and staff understood how to safeguard the people they supported. Systems were in place to make sure managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations.

People who used the service were all assessed as having the mental capacity to make their own decisions. The service understood the need to formally identify when a person's mental capacity required reassessment before decisions were made on their behalf. The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one.

Is the service effective?

People we spoke with were satisfied with the care and support they received. No one raised any concerns with us. This was consistent with the positive feedback received from people as reported in the provider's own quality assurance survey. All of the staff we spoke with were knowledgeable about individual people's care needs, and this knowledge was consistent with the care plans in place.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People commented, “I never feel rushed by the staff that help me, they don’t do everything for me and help me to do things for myself".

Is the service responsive?

We saw that care plans and risk assessments were informative, up to date and regularly reviewed. The registered manager responded in an open, thorough and timely manner to complaints. Therefore people could be assured that complaints were investigated and action was taken as necessary. Staff told us the manager was approachable and they would have no difficulty speaking to them if they had any concerns about the home.

Is the service well led?

Staff said that they felt well supported by the manager, there was a good team ethic and they were able do their jobs safely. The provider had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff.

Inspection carried out on 4 November 2013

During a routine inspection

We spoke with six people who used the service, two relatives and four members of staff including the assistant manager.

Care records were not always presented in a format which reflected the needs of the person for whom it was written. Some language used in care plans did not uphold people’s dignity.

People who used the service were all assessed as having the mental capacity to make their own decisions. Their consent had been recorded in relation to various aspects of their care. The service understood the need to formally identify when a person’s mental capacity required reassessment before decisions were made on their behalf.

People told us that they were happy with the care they received and that their needs were met. One person told us “I have lived here for twenty seven years and I love it. I would not want to live anywhere else.”

Staff could describe people’s needs and demonstrated a good knowledge of their preferences.

People had access to food and drink at all times and were supported to choose and prepare meals. People who required specialised diets were supported by staff who were knowledgeable and competent to meet their needs safely.

Staff received appropriate support and training to meet people’s needs.

The service had a complaints policy which was available in an easy read format. A summary of the policy was on display in the service. Complaints were recorded, investigated and followed up appropriately.

Inspection carried out on 10 July 2012

During a routine inspection

We spoke with three people who used the service. On the day of our inspection there were nine people living at the service.

We asked a person whether they felt safe and happy living at the service. They replied, "Yes I do. It's making me happy as I like living here. It's a good home." They went on to say, "Staff are great. No problems at all."

Another person said, "I go out all the time up town" and "I have to sweep up outside and do litter picking. I get paid for it, of course. I like doing it."

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