Wellesley

People’s experience of using this service:

• The care service has been developed 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 were supported 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 practice.

• People received a service which fully promoted their wellbeing; they felt at home. Some people had been resident for most of their adult lives.

• Care and support was led by the registered manager, who was very visible at the service and led by example. People said they would go to (the registered manager) with any issue or concern, and this was witnessed throughout the visits. People’s privacy and dignity were supported. The culture of the service was one of respect.

• People were keen to talk about their achievements, such as work experience in the community and how they helped at their home. People were supported to enjoy a varied and interesting life, which promoted their confidence and independence.

• People and their family members felt the service was safe. Risk was understood and managed. Incidents had led to detailed investigation and lessons learned, with positive outcomes which protected people, with minimal restriction. People were protected from abuse and harm by a staff team who were skilled and experienced.

• People’s health and care needs were met and their care planned with them, their family or health care professionals, making decisions in people’s best interest where necessary.

• People knew staff well. Staff were quick to support people as needed. We saw banter and fun and there was a relaxed and happy atmosphere.

• Staffing needs were under regular review. There was an established staff team, supported by the registered manager and their business partner, who lived on the premises.

• The premises were kept in a safe, clean and fresh state and met the needs of people using the service.

• A health care professional praised the standard of support people received. Medicine management was safe and medicine use was kept under regular review.

• People received a nutritious diet in a relaxed and supportive atmosphere.

Rating at last inspection: Good (Report published May 2016)

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 any concerning information is received we may inspect sooner.

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

Wellesley is registered to provide care and support for up to 12 people with learning disabilities or autistic spectrum disorder. At the time of our inspection there were 12 people living at the service.

The registered provider is also 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.

People were very positive about living at Wellesley. They described some of the things they enjoyed doing and spoke warmly about the staff who worked with them. Comments included ‘‘(name of staff member) is my keyworker, I like them very much I like all the staff, they help us lots.’’ One person said ‘‘I love living here. I have been here a long time, it’s my home with all my friends here.’’

The service was extremely responsive and person-centred. Activities were tailored to suit individual’s interests, hobbies and wishes. Some people had been supported to do work experience, paid work and volunteer work. Others had been supported to take part in regular community activities such as local church coffee mornings and craft sessions. The registered manager was instrumental in ensuring there were opportunities for people to meet up with other services for people with learning disabilities as some of these people had been friends for a long time and enjoyed regular contact with each other. The service also worked hard to promote meaningful and fulfilling relationships with friends and families. The registered manager had helped facilitate visits for people to see people who were important to them who may not able to visit the home frequently. They were also responsive and sensitive to those who may not have such regular contact and did small acts of kindness to ensure each person felt special. This included sending them parcels, planning trips to places individuals were interested in seeing. For example several people were due to go to London to see the Harry Potter experience. Others had enjoyed several activities weekend holidays.

There was strong leadership from the registered manager and assistant manager who had worked hard to develop and support a team of staff who understood and followed the ethos of the home. This was about ensuring people had a caring environment and meaningful activities.

Since the last inspection the provider had thought of initiative ways to adapt the home to provide more space. He had invested in the building to build more bedrooms, which had enabled people to have their own rooms. Only one shared room remains and both people had opted to continue with this arrangement. There had also been a new office built which allowed the provider to then utilise the existing office into another area for people to use. They were in the process of making this into a music and activities room. They had also built a large gym and relaxation room for people to use. This included gym equipment and a massage chair. People said they enjoyed the new facilities. One person said ‘‘I like to go into the gym and relax, it’s very good.’’

There were sufficient staff with the right skills and support to enable them to provide safe, effective and extremely responsive care and support to people. Staff received training in all areas of health and safety as well as more specialised areas around people’s needs and health conditions. Staffing levels were flexible to meet people’s changing needs and wishes.

Staff confirmed they felt very well supported, valued and received training to do their job effectively. Staff described how they were inspired by the registered manager to provide high quality care and support to people. The staff worked as a team and often went above and beyond their paid hours to ensure people had meaningful experiences. This included asking people out and about and ensuring they were valuable members of their local community.

Care and support was well planned to ensure people had choice throughout their day and a whole variety of activities to suit individual needs. Some people had been supported to enjoy work placements. Others had a variety of tailored activities to suit their preferences, wishes and to pursue hobbies and interests. People enjoyed regular holidays.

People were offered a variety of meals and were involved in the menu planning and where possible in shopping and helping to prepare food. Where people were at risk of not eating enough, their food and drink intake was closely monitored. People spoke highly about the meals provided. One person said ‘‘My favourite meal is Chinese chicken curry, but I love all the food here.’’ Staff confirmed mealtimes were a social occasion with staff and people enjoying their meals together.

People were kept safe because staff understood what may place people at risk and what types of abuse to watch for. Staff were confident about how to report abuse and said the senior team took all concerns seriously and acted on issues quickly and appropriately. Recruitment procedures were robust which ensured only staff who were suitable to work with vulnerable people were recruited.

Medicines were being appropriately managed and monitored. Where minor errors had been made, these had been picked up quickly via audits.

Well managed systems were in place to ensure the quality of care and support were continually reviewed and monitored. Where improvements were needed, prompt action was taken to drive up improvements.

Risks were fully assessed and people were supported to be as independent as possible. Some people were able to access the local community without support and others needed staff support.

We looked at three care plans and daily records and saw care and support was well planned, with risks considered and measures in place to reduce any identified risks.

There were enough staff available who had knowledge and experience of working with people with learning disabilities. The registered manager and his wife live on the grounds and provide additional cover, working as part of the staff team throughout the week.

We saw there was a robust medication system in place to keep people safe and ensure they got their medications when needed. All records we viewed were accurate and up to date.

We found the service fully compliant with all five outcomes we inspected.

People we spoke to said that they enjoyed living at the home. Comments included ''I have been here a long time. I love it here, this is my home.'' ''It is good here, we go to club, we go to skittles and we go to tap. I love my room and I love all the staff.''

We saw that care and support was well planned and delivered in a person centred way, being mindful of individuals' likes, dislikes and preferred routines. We saw that where people's needs had changed, this had been clearly considered with all stakeholders. Where people lacked capacity best interests decisions were made with the right people being involved.

We saw that staff were well supported and trained to do their job and that their views and those of the people living at the home were fully considered.