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Inspection carried out on 9 October 2018

During a routine inspection

Eretz is a care home without nursing which is registered to provide a service for up to ten people with learning disabilities and some with physical disabilities. 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. There were seven people living in the service on the day of the visit. All accommodation is provided within a two-story building within a village style development.

This unannounced inspection took place on 9 October 2018. At the last inspection we rated the service as good in all domains except caring which was rated outstanding. 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. We were not provided with evidence to support the continued rating of outstanding in caring. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection .

Why the service is rated Good overall:

The previous registered manager left the service at the end of August 2018. There is a manager running the service who is in the process of registration. He is an experienced registered manager who is registered to manage another home located within the village development. Eretz will be added to this managers registration. 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.

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.

People’s safety was upheld by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff understood how to protect people and who to alert if they had any concerns. General operational risks and risks to individuals were identified and appropriate action was taken to eradicate or reduce them.

There were enough staff on duty at all times to meet people’s diverse, individual needs safely. The service benefited from a stable and experienced staff team. The provider had robust recruitment procedures. People were given their medicines safely, at the right times and in the right amounts by trained and competent staff.

The service remained effective. Staff were well-trained and able to meet people’s health and well-being needs. They were able to respond effectively to people’s current and changing needs. The service sought advice from and worked with health and other professionals to ensure they met people’s needs.

The judgement for caring had reduced to good. This was not because there had been any overall decline in the standard of care practice but because there were no current or ongoing examples of outstanding performance provided.

People were encouraged 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 practise.

The service continued to be responsive. The committed, attentive and knowledgeable staff team provided care with kindness and respect. Individualised care planning ensured people’s equality and diversity was respected. People were provided with a range of activities, according to their needs, abilities, health and preferences. Care plans were reviewed by management regularly. Care

Inspection carried out on 2 March 2016

During a routine inspection

This was an unannounced inspection which took place on 2 March 2016.

Eretz is registered to provide care for up to ten people. The service is situated in Ravenswood Village. The village is a community for adults with learning disabilities run by the charitable organisation, Norwood. People have access to the facilities and services provided in the village. These include a café, swimming pool and horse riding. The home provides a service for people with learning and associated emotional and physical disabilities. There were nine people living in the service on the day of the visit. The service offered ground and first floor accommodation. There was lift access to the first floor. One person lives in an annexe attached to the main house.

There is a registered manager running 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 2008 and associated Regulations about how the service is run.

People who use the service, staff and visitors’ safety was carefully considered by the service. Staff were trained in and understood health and safety matters and how to protect people in their care from harm or abuse. Any risks were identified and action was taken to minimise them, as far as possible. The service’s recruitment procedure checked, as much as possible, that staff were suitable and safe to work with the people who live in the home. There were enough staff to give people safe care.

People’s individual needs were met by a knowledgeable well trained staff team. Staff helped people to make as many decisions and choices for themselves, as they were able. People were supported to keep themselves as happy and healthy as possible.

The registered manager and staff of the service took any necessary action to ensure they were upholding and protecting people’s legal rights. The service understood the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care.

People were supported by a very kind, totally committed and exceptionally caring staff team who knew people and their needs extremely well. They had developed outstanding communication systems to ensure they fully understood people’s needs and wishes. People were respected and their privacy and dignity was promoted at all times.

The staff were attentive and responded in a timely way to people and their needs. People were treated with dignity and respect at all times. Individualised care planning ensured people’s equality and diversity was respected.

People were provided with a variety of activities which took account of their needs, preferences and wishes. People had regular opportunities to make their views, about the care they received, known.

People’s care was overseen by an effective registered manager. Comments about the registered manager included efficient, approachable and positive. People’s and others views were listened to and actions were taken to make improvements which benefitted people. The formal quality assurance system was being improved to ensure quality audits were completed regularly and monitored any required or completed developments.

Inspection carried out on 23 October 2013

During a routine inspection

There were eight people living in the home plus one living in the attached flat. We spoke to two people and observed the support to, and staff's interaction with, two others. We also spoke to five staff. People had limited verbal communication and we used prompts to enable people to respond. People told us that staff were kind and helpful and they were happy living in the home.

Staff appeared motivated and said they felt well supported. One person said they "loved" their job and another said "this is the best job I have ever had". Staff appeared proud of their work and were keen to support people by showing pictures from recent holidays they had shared.

The home appeared generally clean and in good decorative order. There was equipment available to ensure people's physical needs were met.

People were encouraged to make choices and staff were available to support them in this. We saw people spending time away from the home taking part in leisure and educational activities.

Staff were observed to interact with people in a friendly and respectful way and people appeared happy.

Staff said they felt safe and demonstrated a good understanding of their responsibilities in relation to safeguarding.

Support plans were personalised and detailed but some had been written some time ago and we were told there was a plan to review the care plans and risk assessments.

Inspection carried out on 3 January 2013

During a routine inspection

We spoke with relatives of some of the people living at the home. They told us they "couldn't fault" the staff at the home and the care given to their relatives. One relative told us "the level of care seems very good".

We found people living at the home were involved in planning and consenting to their care as far as they were able. We saw people were able to make choices and staff treated them with respect.

The facilities in the home met the needs of the people living there. On the day of our visit the lift was out of order. However there were suitable contingency arrangements in place to deal with the situation.

We spoke with staff about the training they received. We found training was up to date. Staff had regular supervision sessions and annual appraisals.

We looked at the system in place for dealing with complaints. We found people were aware of the complaints procedure. When complaints were made they were dealt with in accordance with the home's complaints procedure.

The provider may wish to note the manager at the home is not registered with the Care Quality Commission.

Inspection carried out on 30 November 2011

During a routine inspection

The service provides personal care to adults who have learning disabilities and the community was set up and remains a Jewish charitable organisation. The village consists of a number of small homes around the site and may of the people have lived in the village since they were children.

There are many on site facilities including a horse stables, small animal care centre, hydrotherapy pool, a cafe and educational facilities. There is a synagogue on site and a visiting Rabbi. Many staff are non Jewish but have agreed to observe the rules of the faith.

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During our visit people told us they liked living in Eretz house and the staff were very kind. People told us about some of the activities they are involved in and what they enjoyed doing.

Many people communicated non verbally so we spent time observing the interactions between the staff and people who live in the home.

We observed that people were given many choices and encouraged to be as independent as possible. Staff spoke to people with respect. The staff knew each person well and the staff told us that they liked working in the home.

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