18 Wolverton Gardens, Horley (Active Prospects) Also known as Heathercroft

18 Wolverton Gardens is a care home providing accommodation and personal care to up to five people living with profound learning disabilities and complex physical health needs. The home is a purpose-built bungalow. At the time of the inspection five people lived in the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The service applied the principles and values of Registering the Right Support and other best practice guidance. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. These ensure that people who use the service can live as full a life as possible. People using the service received person-centred support that was appropriate and inclusive for them.

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

People’s experience of using this service and what we found

People’s well-being was enhanced as a result of the way staff cared for them. People were encouraged to be as independent as possible and to be involved in decisions about their care. People were treated with consistent respect and dignity and staff valued people’s individual characteristics. They had personalised care plans that guided staff on how to meet their care and communication needs in a person-centred way.

Family members told us their relative was safe. Staff understood their roles in safeguarding people from harm. Risks to people were assessed and identified. There was guidance for staff on how to manage these risks safely. There was a process to identify learning from accidents, incidents and safeguarding concerns. There were enough staff to meet people’s needs and safe recruitment practices were in place. Medicines were safely managed. Staff were supported to ensure they had suitable skills and knowledge to meet people’s needs.

People were asked for their consent before care was provided. People’s nutritional needs were assessed and monitored. There was access to health and social care professionals as required. There was an accessible complaints system and there had been two complaints since the last inspection. These were resolved in a timely manner.

Family members and staff told us the manager promoted an open culture of communication and staff confirmed they felt well supported by him. The provider used effective systems of quality assurance and governance which improved people’s experience of care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was GOOD (published 03 October 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

18 Wolverton Gardens is a residential home that provides support to up to five people with learning disabilities. On the day of the inspection there were 5 people living at the service. The people who live at the service have a range of complex needs and are supported with a full range of daily tasks, including personal care, support with eating and drinking and activities. We were informed during our inspection that the goal of the service is to ensure people maintain their independence as much as possible and live full and active lives at the home and within their community. We saw some examples of this during our inspection.

During our inspection we met the 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.

During our last inspection on 23 June 2016 we found shortfalls that affected the support provided to people. During this inspection we found that the registered manager had made improvements to the service. Improvements had been made with regards to staff knowledge, dignity and respect, activities and the management of the service.

During the last inspection on 23 June 2016 we highlighted that the registered manager had not always notified CQC of events at the service. During this inspection we found the registered manager understood their responsibilities in terms of notifying CQC of significant events at the service. This meant that CQC could now monitor that people were safe at the service.

During the last inspection on 23 June 2016 audits were not robust at the service. We found at this inspection the provider audited the care and support delivered and sought feedback from people and relatives regarding the support received. These audits were robust and highlighted actions had been completed. All feedback from audits and questionnaires was positive.

During the last inspection on 23 June 2016 we highlighted concerns with staff knowledge of how to support people when they became agitated. During this inspection we saw that improvements had been made. Staff had received the training and support they needed to meet people's needs effectively. Due to this, there had been a reduction in incidents where people become agitated. Staff felt supported by the management team.

During the last inspection on 23 June 2016 people were not always supported with dignity and respect. During this inspection people were supported by staff who were kind and respected people’s privacy, dignity and independence. Care staff were thoughtful and recognised and respected people's wishes and preferences.

During the last inspection on 23 June 2016 we recommended that the registered manager review the activities offered to people. During this inspection we observed that improvements had been made. People received person centred care and people were supported with activities which were meaningful to them and were in line with their interests and preferences.

People were safe at 18 Wolverton Gardens. Risks of harm to people were identified at the initial assessment of care and staff understood what actions they needed to take to minimise risks. Staff understood people's needs and abilities.

People were supported by staff who understood the signs of abuse and their responsibilities to keep people safe. People were supported by sufficient staff to meet their needs. Recruitment practices were followed that helped ensure only suitable staff were employed at the service.

People were supported by regular members of staff who supported people in a timely manner. Staff were confident and had the knowledge to administer medicines safely. They knew how to support people to take their medicines safely and to keep accurate records.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had a good understanding of MCA and DoLS. When people lacked capacity the best interest process was followed.

People were supported to eat meals of their choice and staff understood the importance of people having sufficient nutrition and hydration. Staff referred people to healthcare professionals for advice and support when their health needs changed.

People knew how to complain and were confident any complaints would be listened to and action taken to resolve them.

Staff supported people in line with the organisational values as support was centred around increasing people’s independence.

18 Wolverton Gardens is a residential home that provides support to up to five people with learning disabilities. On the day of the inspection there were 5 people living at the service. The people who live at the service have a range of complex needs and are supported with a full range of daily tasks, including personal care, support with food and drink intake and activities. We were informed during our inspection that the goal of the service is to ensure people maintain their independence as much as possible and live full and active lives at the home and within their community. We saw some examples of this during our inspection.

During our inspection the registered manager was not present. 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.

We identified a breach of Regulation 18 Care Quality Commission (Registration) Regulations 2009 as the registered manager had not notified the CQC of incidents in relation to safeguarding and events that affect the running of the service.

People were protected from harm as staff had a good understanding of safeguarding procedures. Relatives told us they felt their family members were are safe living at the home

Risks to people had been appropriately managed and staff knew what action to take to keep people safe from harm. Safeguarding concerns had been reported to the local authority.

Medicines were stored, administered and disposed of safely. Staff received medicines training to ensure they administered them in line with best practice.

There were enough staff on available to meet people’s needs, there had been thorough recruitment checks undertaken to ensure that only suitable staff were employed.

Although staff said they felt they had enough training to carrying out their jobs effectively they had not received training to support people with challenging behaviour. This led to trends with behaviours not being identified or acted upon. Staff had received other training to help them in their roles and were supported by the registered manager.

People did not always have the capacity to make decisions on their own behalf. Staff had a good understanding of the Mental Capacity Act (2005) and decisions were made in line with this. The Deprivation of Liberty Safeguards were followed appropriately.

There was adequate food choice and the people were involved in choosing the weekly menu. Staff knew dietary needs and preferences of the people. We observed staff offering choice.

People’s health needs were being met and people had access to other healthcare professionals to maintain good health.

Relatives and a care professional said the service was caring however people were not always treated with dignity and respect. Staff did not always show concern for people’s wellbeing in a caring and meaningful way and people’s anxieties were not always picked up and acted upon.

A lack of activities for the people living at the service was highlighted at our last inspection. Some improvement had been made in this area however one of the relatives said the lack of meaningful activities was a problem for their family member. Despite this, we saw people being offered opportunities to go out and some in-house activities throughout the day. The provider had identified they needed to make further improvements in this area.

Care plans were person centred and all had recently been reviewed or were in the process of being reviewed. Relatives told us they were involved in the care planning process. The service supports the people to proactively maintain relationships with relatives. The service acted on complaints and concerns seriously and used them as a chance to improve service delivery.

Quality assurance systems were not always effective as shortfalls were not always actioned within timescales specified by the manager. Staff felt supported and believed their views and feedback were respected. The provider had the foresight to fill potential managerial shortfalls that may have affected service delivery.

We spent time observing how people spent their time, the support they received from staff and whether or not they had positive experiences. Our observations of staff practice showed that people were receiving effective, safe and appropriate care, which was designed to meet their specific needs.

We saw people felt comfortable in approaching staff and asking for assistance. People were relaxed and content in their surroundings. Staff engaged positively with people who used the service to encourage them to communicate their consent to personal care, wishes and choices.

We spoke to a health care professional who told us that 'I really couldn't fault this home and I would recommend this home for my own family. Staff are very caring and know the residents very well.'

We spoke to one relative who told us that 'I am totally satisfied with the service and we could not fault the home. We are kept informed by the manager about my relative's care plans which we are fully involved with and staff are kind and very helpful."

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

The home had a robust recruitment procedure in place; this meant that people were cared for by people who were suitable to work with vulnerable people.

Where people did not have the capacity to consent,- the provider acted in accordance with legal requirements.

There was an effective complaints system in place.