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Inspection carried out on 13 June 2019

During a routine inspection

About the service

Stanway Villa is a residential care home providing personal care to seven people at the time of the inspection. The service supports people who have a learning disability, who may also have an autistic spectrum disorder and/or a physical disability.

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 principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

The service was a larger home, bigger than most domestic style properties. It was registered for the support of up to eight people. Seven were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

Stanway Villa provided a homely environment and promoted a positive and inclusive culture. People received planned and co-ordinated person-centred support that was appropriate for them. Management and staff supported people to have maximum choice and control of their lives in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Safe recruitment practices ensured the suitability of newly appointed staff coming to work in the service. People were supported by enough staff with the right experience, training and skills to meet people’s needs. Staffing levels were flexible and supported people to follow their interests, take part in social activities and, where appropriate, education and work opportunities.

People had the support they needed to manage their anxieties n a positive way. Management and staff had worked well with other professionals to ensure people received the support they needed to stay safe.

Medication was managed safely and administered correctly. People were supported to maintain good health. They received continuing healthcare support to meet their needs and had prompt access to healthcare professionals when they became unwell. Staff promoted healthy eating. They supported people to balance choice with healthy options and people's preferences contributed to the menu planning.

People’s communication needs had been assessed and the service was meeting the requirements of the Accessible Information Standards. This set of standards sets out the specific approach for providers of health and social care to meet the communication needs of people with a disability, impairment or sensory loss.

The registered manager was knowledgeable, inspired confidence in the staff team and led by example. Quality assurance systems were robust and helped to ensure the service was of good quality, safe and continued to improve.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 14 June 2018) and there were breaches of regulation. We received information from the provider after the last inspection telling us what they had done to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This

Inspection carried out on 18 May 2018

During a routine inspection

Stanway Villa is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Stanway Villa accommodates up to eight adults who have a learning disability, who may also have an autistic spectrum disorder and a physical disability. Stanway Villa is a large detached single storey house situated in Colchester and close to all amenities. The premises provides each person using the service with their own individual bedroom and adequate communal facilities for people to make use of within the service.

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.

At the last inspection on 31 July 2015, the service was rated ‘Good’. At this inspection we found the service was now rated overall ‘Requires Improvement’. This is the first time the service has been rated ‘Requires Improvement’.

This inspection was completed on 18 May 2018 and there were eight people living at Stanway Villa.

A registered manager was 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.

Improvements were required to the service’s governance arrangements to assess and monitor the quality of the service. These arrangements had not identified the issues we found during our inspection. The registered provider lacked oversight as to what was happening within the service required improvements. They had not provided suitable support to the registered manager to ensure compliance with regulatory requirements and the fundamental standards. Actions to address matters relating to the service’s premises [window frames] remained outstanding and we were concerned about the security of the service.

Improvements were required to the recruitment practices at the service to ensure these were robust. There was limited evidence to show staff employed at the service had received and completed training. Improvements were required to ensure newly employed staff received a robust induction and staff received formal supervision and an annual appraisal.

People were protected from abuse and people living at the service indicated they were safe and had no concerns about their safety and wellbeing. Policies and procedures were being followed by staff to safeguard people living at the service. People received their prescribed medication as they should. The majority of risks to people were identified and managed to prevent people from receiving unsafe care and support. Staffing levels and the deployment of staff was suitable to meet people’s needs. People were protected by the registered provider’s arrangements for the prevention and control of infection.

Staff understood and had a good knowledge of the key requirements of the Mental Capacity Act [2005] but required a better understanding of the Deprivation of Liberty Safeguards. Suitable arrangements were in place to ensure that people’s rights and liberties were not restricted and people’s capacity to make day-to-day decisions had been considered and assessed.

People were treated with kindness, dignity and respect. People received a good level of care and support that met their needs and they were supported to be as independent as possible. Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual ci

Inspection carried out on 31 July 2015

During a routine inspection

This inspection took place on 31 July 2015 and was unannounced.

Stanway Villa provides care and support for up to a maximum of eight people who have either learning disabilities or have experienced a life changing illness. On the day of our inspection there were eight people living at the service.

The service has a manager registered with the Care Quality Commission (CQC). 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 service had robust recruitment procedures in place and supported staff through an in-depth induction period. Staff were then supported through supervision, appraisals and on-going training.

There were suitable arrangements in place for the safe storage, receipt and administration of people’s medicines. Medicine profiles had been produced which provided staff with guidance as to people’s medical conditions, medicines that had been prescribed and for what reason, such as allergies and how people chose to take their medicines.

There were sufficient numbers of staff to meet people’s needs. Staffing levels were flexible to provide for people’s changing needs and provide support for them with their social and leisure interests where one to one support was required. Rapport between staff and people was supportive, warm, kind and respectful. People were comfortable in the company of staff and demonstrated their enjoyment of being with staff with lots of laughter expressed.

The manager and staff demonstrated a good knowledge of their roles and responsibilities with regards to the Mental Capacity Act 2005 and the steps to take to enable people’s best interest to be assessed if they lacked capacity to consent to their care and treatment.

Staff were skilled in communicating with people. They showed understanding, kindness and were respectful when communicating with people.

People were provided with regular opportunities to express their needs, wishes and preferences regarding how they lived their daily lives. This included meetings with their keyworker and group meetings with the manager.

People were supported to access and attend a range of personalised social, educational and occupational activities. Staff supported people to access the local community and encouraged activities which promoted their independence.

Staff demonstrated a thorough knowledge of the needs of people and had been trained in a range of relevant subjects to support them to provide safe, effective and responsive care to people.

People’s needs were assessed before they came to the service. The support plans which were regularly reviewed gave clear guidance to staff on how people were to be supported. Support in planning people’s care, treatment and support was personalised to reflect people’s preferences and personalities.

The service was well led with systems in place to assess people’s views about the care they received. The manager empowered people to be involved in making decisions about how the service was run and how their care was provided. The service staff were working with other professionals to provide the required support to people and to plan future support needs. The manager and the provider had quality and safety monitoring systems in place. Where shortfalls were identified, action plans were produced with timescales. This showed that the provider responded to protect and ensure the health, welfare and safety needs of people were met.

Inspection carried out on 26 June 2013

During a routine inspection

We spoke with three people who used the service and three members of staff as part of the inspection. People who used the service told us that they were happy with the support they received and felt it was a nice place to live. This was because the staff were friendly.

One person told us, "The meals were very good and I enjoyed playing games especially cards with the staff."

We found the service was meeting the personal, emotional and healthcare needs of the people using the service. People were encouraged to make decisions and their choices were respected. The care plans were detailed and staff were trained and had regular supervision to support the people living at the accommodation. The environment was clean and we found the records required to keep the service safe such as fire safety were all in order and up to date.

Inspection carried out on 30 January 2013

During a routine inspection

During our visit to Stanway Villa on 30 January 2013, we met with five of the eight people living at the home. We used different methods, including observation, to help us understand the experiences of the people living at the home. This was because some people had complex needs which meant they were not able to communicate verbally with us.

We saw evidence that people, or someone on their behalf were asked to consent to any care that was provided and the provider acted in accordance with their wishes. People told us that they were satisfied with the care they received. One person said "They are all so caring and polite and always tell me what they are doing and why."

The majority of the people living at Stanway Villa had lived together for a number of years and many of the staff had worked with them for a long time. One person said, "We are more like a family. Everyone here knows about each person and what they need doing." Despite this familiarity we observed care files clearly documented people's needs and ensured care and treatment was planned and delivered in a way that kept people safe.

Stanway Villa had good systems in place to ensure medication was administered correctly and safely and that people received any additional health support they needed.

The staff we spoke with told us that there was always sufficient staff on duty to meet the needs of the people using the service.

Inspection carried out on 31 January 2012

During a routine inspection

People who lived at Stanway Villa told us that they were happy living there, the staff were nice and they got to do things they wanted to do. We saw that the staff were kind, caring, respectful and patient and spent quality time with people.