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Inspection carried out on 9 January 2018

During a routine inspection

Hob Meadow is a 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. 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.

Hob meadow accommodates six people in one adapted building. At the last inspection, the service was rated good.

There is a registered manager in place. 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 continued to receive safe care. Risks to people were considered and reviewed when needed. Infection control procedures were followed. Staff understood safeguarding and when needed referrals were made to the relevant people. There were enough staff available and medicines were managed in a safe way. When incident occurred evaluations took place to ensure lessons were learnt.

People continued to receive effective care. Staff were supported and trained to ensure that they had the skills to support people effectively. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible. People enjoyed the food available and were offered a choice. When needed people received support from health professionals. The home was adapted and decorated to meet people needs.

People continued to be supported in a caring way. People were encouraged to be independent and make choice in their lives. People privacy and dignity was maintained.

People continued to receive responsive care. People were involved with planning and reviewing their care that was responsive to their needs. Compliant procedures were in place and followed when needed. People had the opportunity to participate in activities they enjoyed.

The service remained well led. People were asked for their feedback on the quality of the service. Quality assurance systems were in place to identify where improvements could be made and when needed these changes were made. There was a registered manager in place who notified us of significant events that occurred within the home.

Inspection carried out on 12 January 2016

During a routine inspection

We inspected this service on 12 January 2016. This was an unannounced inspection. Our last inspection took place in June 2014 and we found no concerns with the areas we looked at.

Hob meadow is a residential home that provides personal care for up to eight people with a learning disability and or challenging behaviours. At the time of the inspection six people were receiving residential care and two people were receiving respite.

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.

People were supported in a safe way and where risks to people were identified they were managed to ensure people were safe. Staff knew what abuse was and how to recognise and report it. Medicines were managed safely and people had their medicines at the prescribed times. Equipment was tested and maintained to ensure it was safe to use and there were enough staff available to offer individual support to people. Staff had received an induction and training to ensure they were effective in their roles. Recruitment processes were in place to ensure that staff were suitable to work within the home.

The principles of the Mental Capacity Act 2005 were followed. When needed capacity assessments had been completed and decisions made in people’s best interests. When people were being unlawfully restricted this had been considered and Deprivation of Liberty Safeguards (DoLS) authorisations were in place.

People were treated in a kind and caring way. Their privacy and dignity was promoted by staff and they were encouraged to be independent. They were able to make choices around their day and were offered the opportunity to participate in activities they enjoyed, Friends and family could visit when they liked. People were supported to access health care professionals and health care services when needed. They were supported to receive enough food and drink and offered choices.

Quality monitoring checks and feedback from people who used the service was obtained to bring about changes. Staff felt listened to and were provided with the opportunity to raise concerns. There was a complaints procedure in place and this was followed by the provider.

Inspection carried out on 22 May 2014

During a routine inspection

This was a scheduled inspection. We also checked that the service had made the improvements it said it would following our previous inspection. During this inspection we spoke with people that lived at Hob Meadow, care staff and managers. We also spoke with some relatives and professional staff following our visit to the home.

We considered our inspection findings to answer the questions we always ask;

Is the service safe?

An effective recruitment procedure was in place. This made sure that all the necessary checks were completed to make sure that people were suitable to provide support to people. New staff completed training before they worked independently with people.

The medication arrangements at Hob Meadow were robust. All staff were trained and their ability to administer medication was checked. This made sure that people received the medication that was prescribed by their doctor in a safe way.

Systems were in place to analyse risks and to review accidents, incidents and complaints. Where shortfalls were identified these were addressed. This meant that risks to people were reduced and actions were taken to improve people's care.

The managers and staff were knowledgeable about the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff supported people to make decisions and were aware of when a Deprivation of Liberty application should be made.

Is the service effective?

Plans of care identified people's health and social care needs. These plans had improved since our last inspection. People were involved in decisions about their care and plans took account of their wishes.

People's health and care needs were addressed. People had a health action plan and were supported to attend for health care appointments and to have an annual health care check.

Support was provided to help people to understand information and make decisions. Pictorial information and easy read information was available. People could have an advocate to support them make decisions.

Is the service caring?

People's care was provided by staff that were caring and friendly. We saw that people were treated with respect and their privacy and dignity was promoted. One person who lived at Hob Meadow said: "The staff are very kind". A relative told us: "It is like an extension to my family".

The preferences, wishes and interests of people were recorded in their plans of care. People had their preferred daily routine fully recorded. We saw that people's care and support took account of their preferences.

People that used the service and relatives had the opportunity to complete an annual survey. The results of these were analysed and any concerns acted upon.

Is the service responsive?

Information about complaints was available in an easy read format. The provider kept a record of complaints. We saw that a previous complaint had resulted in a number of changes in the way the service provided support. This meant that people's views were listened to and acted upon to improve the service.

People had the opportunity to take part in a range of activities both in and out of the service. There was scope for people to have more access to the community.

Is the service well led?

Changes were made in the management arrangements last year. Relatives and professionals reported that this has led to an improvement in the care provided to people.

The managers and staff were clear about their roles and responsibilities. They were aware of their role in promoting people's independence including encouraging and supporting them to make choices about their lifestyle.

Systems were in place to review and check the quality of the service provided to people. Where areas for improvement were identified these were acted upon. This meant that the service had a system in place to continually improve the service provided to people.

Inspection carried out on 4 July 2013

During a routine inspection

We carried out this visit to check on the care and welfare of people using this service. The visit was unannounced which meant the provider and the staff did not know we were coming.

Eight people were in residence when we visited. We spoke with three people living in the home and five staff. There were no visitors during our inspection.

We saw that there was good interaction between the staff and the people who used the service. One person told us: �I like living here�. Another person we spoke with told us: �They (the staff) look after me�.

We found evidence of people being involved in decisions about how their care and treatment was provided.

We found that care records did not provide sufficient information to staff on how to meet the needs of the people who used the service.

People were protected from abuse. Staff understood the signs of abuse and were able to explain how to report any suspicions of abuse.

We found that staff were trained and supervised to meet the needs of the people who used the service.

Inspection carried out on 15 November 2012

During a routine inspection

We visited the service to check on the care and welfare of the people who were living at Hob Meadow. The visit was unannounced.

During our visit we used different methods to help us understand the experiences of people using the service. We spoke with people living at the home, relatives, staff members, and the manager, and we spent time observing the care provided in the home.

People we spoke with were positive about the care and support that they or their relative received. We found that the home was comfortable and that people were able to personalise their bedrooms as they chose to, to reflect their own taste and interests. People were consulted about their care, and relatives were kept informed by staff if there were any changes in their relative�s condition.

We saw that there was a planned programme of activities each week.

We were told that the food in the home was good, and we saw that there was a weekly menu which was changed according to people's wishes.

There were systems in place to gain and review consent from people who lived in the home, and act upon them.

Individual care support plans and risk assessments were comprehensively and clearly documented.

We found that the home had a robust recruitment system in place, and staff told us they were supported and inducted into their role and responsibilities.

We saw that there had been regular audits of the service.

Inspection carried out on 15, 19 December 2011

During a themed inspection looking at Learning Disability Services

There were seven people using services at Hob Meadow when we visited. We met and introduced ourselves to all the people using services over the two days we visited. We spoke to three people using services in more depth to get their views of the service.

One person told us about their activities. They told us, �I like going out but I do not like the bus, I use a taxi but would like a car. I like shopping when I go out and a cup of tea.�

Another person told us, �I like going to college, I do painting and have dinner there.�

We saw photographs on display in the lounge and a person told us about the holiday photographs. They said, �I went on holiday with X to Blackpool this year. We had a good time.�

We spoke with four relatives and asked them about the care and support given by staff at Hob Meadow to their family member and they told us;

�I feel Hob meadow is right for XX because of the space and that everything is on the ground floor. I feel involved in his care and treatment.�

�He has come on in leaps and bounds since he moved into Hob Meadow�.

�They do a brilliant job, and they have brought her out of herself�.

We spoke with the advocate of one person using the service at Hob meadow. They told us, �XX appears to be getting good care at Hob Meadow.�

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