Wide Cove

At our last inspection on 20 June 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good overall. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The registered manager demonstrated good leadership and was present for this inspection. They were actively involved in monitoring people’s health and wellbeing.

Staff training had been undertaken and training which needed to be updated was completed during this inspection. Staff were knowledgeable about people’s care needs and knew people’s preferences, likes and dislikes.

Prescribed medicines were administered according to people’s prescriptions appropriately by staff we observed.

People were seen by healthcare professionals and were supported to hospital appointments and to take care of their health as much as possible.

The care was person centred where people were supported with things that were important to them in a timely way. The culture was to be inclusive of people with a range of different needs.

Staff we observed were caring, kind and compassionate in their interactions with people. There was a relaxed and calm atmosphere within the home where people were observed walking around the home freely.

Staff were following the Mental Capacity Act 2005 and the registered manager had arranged best interest’s meetings when appropriate.

People were being supported to be as independent as possible to maintain their skills and live as fulfilling a life as possible.

There were enough staff to meet people’s care needs. People were seen being supported when they needed reassurance.

Activities were provided and people were supported to go out into their local community.

Further information is in the detailed findings below.

Wide Cove is a converted public house in Runcorn Old Town, providing care for up to eight adults with a learning disability. (There were seven people resident on the day of inspection.) It is close to local community facilities including shops, churches and leisure facilities. It has good access to public transport including bus and train stations.

The home has a registered manager who has been in post for 18 years. 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.

Prior to this inspection we received feedback from the local authority who commissioned the care for people who lived in the home. They told us that they thought the care was good.

We found that the experiences of people who lived at the home were positive. People told us they felt safe living at the home, staff were kind and they liked living there.

People were safeguarded from abuse and the risk of abuse because staff knew what constituted abuse and who to report it to.

People were supported to be as independent as they were able to be through the effective use of risk assessments and the staff knowledge of their needs and preferences.

There were enough suitably qualified staff, who had been recruited using safe recruitment procedures, to maintain people’s safety and to support people in hobbies and

activities of their choice.

Staff felt supported to fulfil their role effectively through regular support, supervision and training applicable to their role.

People’s medicines were stored and administered safely by trained staff.

People’s mental capacity had been assessed and staff knew how to support people in a way that was in their best interest and was the least restrictive. People and their representatives were involved in decisions relating to their care, treatment and support. Care was planned and delivered based on people’s preferences and regularly reviewed.

People were supported to have a healthy diet and could choose what they would like to eat and drink.

People had access to a range of health professionals and staff supported them to attend health appointments when necessary.

People were treated with kindness and respect and were consulted about how the service was run. They had opportunities to be involved in the community and to

participate in hobbies and interests of their choice.

The registered providers demonstrated a commitment to continuous improvement and had systems in place to monitor the quality of the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We asked staff members about their training and they all confirmed that they were receiving regular training and that it was up to date. We checked a sample of training records and saw that staff had undertaken a range of training relevant to their role. This included safeguarding, dementia, food hygiene, person centred care and moving and handling.

Wide Cove had a safeguarding policy in place. This included local procedures which staff would follow if they needed to report an alleged incident to the correct authorities.

There were effective recruitment and selection processes in place.

Is the service effective?

The home manager explained that the care plans needed to be reviewed and she was in the process of doing this. These had not been done because all of the staff, including her had been working a large amount of extra hours in order to meet the changing needs of the people living in the home. Additional funding had now been secured from the local authority and new staff members had been appointed recently.

The staff members we spoke with could show that they had a good understanding of the people they were supporting and they were able to meet their various needs.

Is the service caring?

The people we spoke with all told us that they liked living there and that the staff members supporting them were good. Comments included; 'This is the best place I have ever lived in'. People also told us about activities they were involved in; this included visiting a local church for baking and knitting sessions.

We observed that staff interacted well with the people living in the home and the relationships we saw were warm, respectful, dignified and with plenty of smiles and laughter.

Is the service responsive?

The rota we looked at during the inspection showed that there were two members of staff on duty between 8am and 10pm. In addition there were two waking night staff members on duty between 10pm and 8am. This was an increase in staffing levels since the previous inspection and reflects a change in the needs of the people living in the home.

We discussed the changing needs of the people using the service and the manager explained that they were looking at a variety of ways in which to meet these so that people could continue to live at Wide Cove for as long as possible. This included the building of a ground floor extension so that people no longer had to use the stairs.

Is the service well-led?

The staff members we spoke to said that the home was being well managed and described the manager as being supportive.

During the visit we were also able to speak to a social worker and a family member; both of them spoke positively about the home and the support their client and family member were receiving. The family member told us that their relative had; 'Never been happier'.

We spoke with the staff members on duty during the visit. They were knowledgeable about the different needs of the people living at Wide Cove and how they showed their feelings and views.

Menus and shopping for food were planned and undertaken with the people who lived in the home on a weekly basis. This was done by discussing likes/dislikes and what people felt like eating. This provided a very flexible menu for people.

Policies and procedures were in place to help ensure that people's medication was being managed appropriately and that they were being given their medicines as prescribed.

Information about the safety and quality of service provided was gathered on a continuous and ongoing basis from feedback from the people who used the service.