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Inspection carried out on 7 March 2018

During a routine inspection

Lanrick Cottage is a residential care home for 4 people who have some learning disabilities and autism. It is in a central residential location with good access to local shops and leisure facilities.

At our last inspection we rated the service good. 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. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The care that people received was effective. Mental capacity assessments had improved to ensure that 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. Staff received training and support to be able to care for people well. They ensured that people were supported to maintain good health and nutrition; including partnerships with other organisations when needed. The environment was adapted to meet people’s needs.

People continued to receive safe care. There were enough staff to support them and they were recruited to ensure that they were safe to work with people. People were protected from the risk of harm and received their medicines safely. The risk of infection was controlled because the home was clean and hygienic. Lessons were learnt from when mistakes happened.

People continued to have positive relationships with the staff who were caring and treated people with respect and kindness. There were lots of opportunities for them to get involved in activities and pursue their interests. Staff knew them well and understood how to care for them in a personalised way. There were plans in place which detailed people’s likes and dislikes and these were regularly reviewed. People and their relatives knew how to raise a concern or make a complaint and the provider had a complaints procedure although they had not received any.

The registered manager had systems in place to receive feedback on the quality of care provided. There were quality systems in place which were effective in continually developing the quality of the care that was provided to people.

Further information is in the detailed findings below.

Inspection carried out on 26 January 2016

During a routine inspection

This unannounced inspection took place on 26 January 2016 and was unannounced. The inspection was undertaken by one inspector. At our last inspection on 8 February 2014 the provider was meeting the legal standards we inspected.

Lanrick Cottage provides accommodation and personal care for up to four people with a learning disability. There were four people living there at the time of our inspection.

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.

Staff understood their responsibility to keep people safe and protected from harm and the actions they should take if they had any concerns. Risks to people’s health and wellbeing were assessed. Staff were provided with guidance on the best way to manage people’s risks and support people positively. People’s medicines were administered, recorded and stored correctly to ensure they received their prescribed treatments.

There were sufficient staff to meet people’s needs and support them to take part in activities which interested them. There were processes in place to ensure staff who came to work at the home were suitable to work in a caring environment.

Staff received training to provide them with the skills they needed to care for people. Staff were supported to discuss their work and personal development on a regular basis. People were referred to other healthcare professionals when specialist support was required.

People were treated kindly by staff. Staff knew people well and were able to interact with people who could not communicate or express themselves verbally. People were given the opportunity to share their views on the service and the care they received. There was an audit programme in place to monitor the service and identify where improvements could be made.

Inspection carried out on 8 May 2014

During a routine inspection

We carried out an inspection on 8th May 2014. We talked with the registered manager, deputy manager, the staff and we reviewed information given to us by the provider. We met and spent time with two of the four people who lived at Lanrick Cottage. They were able to communicate with us in a limited way. They appeared to be happy, relaxed and comfortable with the staff who supported them.

Below is a summary of what we found. The summary is based on our observations during the inspection, observations of 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 our full report.

Is the service safe?

From our observations and from the information we saw set out in care plans, policies, procedures and audits the provider's safety monitoring systems were robust. The staff showed that they had a clear understanding of their role in providing care and safeguarding the people they supported. The staff demonstrated that they knew the people well and had read and understood the instructions set out in individual care plans.

We saw evidence that people were supported to make decisions for themselves. They were helped to develop their independence and life skills. The care plans set out detailed instructions for staff as to how each person should be respected. When people lacked the capacity to make important decisions, meetings were held to make decisions for them that were in their best interests.

The staff we spoke with understood about the risk management plans that had been written for all the people and how these met with their particular needs. Staff demonstrated that they understood how to show people respect and maintain people's dignity at all times.

The deputy manager told us that there were no deprivations of liberty safeguards in place for the people who lived at Lanrick Cottage.

We noted that the staffing levels were currently sufficient to support the needs of the people while they were at Lanrick Cottage and to go out in the community.

There were systems in place to make sure that management and staff learned from events such as accidents and incidents, complaints, and concerns. This meant that people were benefiting from a service that was taking on board lessons learnt.

Is the service effective?

People's health and care needs had been assessed and care plans were in place. There was evidence of people and their representatives being involved in assessments of their needs and planning their care. Specialist health care needs were always assessed and included in care plans and health action plans. Specialist health and social care professionals regularly gave input to the service. All care, activity and risk assessment plans were being reviewed regularly. Every person had a representative and advocacy services were available if required.

We saw that the people who lived at Lanrick Cottage were being supported to develop their learning and independence. We were told about the activities they enjoyed and the plans for a holiday. The staff we spoke with told us how they worked with each person to support them to undertake the things they wanted to do.

Is the service caring?

We observed during our visit and saw in people's care plans that people were supported and encouraged to live full and active lives. People took part in a wide range of leisure and social activities. We saw that everyone was supported to access the activities they enjoyed.

The staff we spoke with demonstrated to us that they were committed to providing the best levels of care and to facilitate activities for the people who used the service. They demonstrated that they were aware of potential risks, people's rights and their responsibilities.

Is the service responsive?

We found that care plans were person centred and contained lots of information about people's choice and preferences. We saw that everyone's care plans contained detailed information about each person's support preferences.

We found that people's health and care needs were being regularly assessed. There was regular input from external social care and health professionals when needed.

We were told that there had been no complaints or concerns made in the last 18 months. We were told by the deputy manager that any complaints or concerns would be taken very seriously and action taken to resolve the issue.

We were told about and we saw that staff received regular training to meet the support needs of the people who used the service.

Is the service well-led?

There have been changes in the management of the home and a new manager has recently taken up the post. There are now two deputy managers and there is a clear management structure within the service and the provider organisation. From the discussions with the registered manager and deputy, they were knowledgeable about the service, the people and staff. They met with their managers and peers regularly to maintain up to date knowledge.

The deputy manager told us that the new registered manager and the owner of the provider organisation regularly visited the premises to speak with the staff and the people who lived there. The provider had a quality assurance system in place. There were systems in place to provide feedback to staff about changes and developments at team meetings and recorded in the communications book.

The staff we spoke with had a good understanding of the provider's policies and procedures. Information was readily available which all the staff were able to access. The staff we spoke with said that if they witnessed poor practice they would report their concerns.

Staff we spoke with told us that enjoyed their work. They told us that there was a good team spirit and everyone stepped up to take on responsibly while they were without a manager. The said that they now felt they were supported by new management structure and involved in the development of the service.

Inspection carried out on 18 October 2013

During a routine inspection

Our visit to Lanrick Cottage was an unannounced scheduled inspection.This meant that the home was not aware that we were going to visit. We met with the manager, two members of staff, and four people who lived at the home.

People had difficulty communicating verbally with us due to their complex health needs but we observed the care and support they received. We observed that people were cared for in a sensitive and compassionate way and the care they received was as described in their care plans. People were treated with respect and the care that was provided met their needs.

We saw that the service had systems in place to reduce the risks of people coming to harm.

Staff received training in order for them to provide care and support to meet the individual needs of people living at the home. Staff told us that they felt well supported and said that the manager was approachable.

We saw that records were up to date, accurate, kept securely and could be located promptly when needed.

Inspection carried out on 6 February 2013

During a routine inspection

At the time of this inspection four people were using the service. They were supported by four members of staff. We spoke with people who used the service who were able to talk with us and observed the interactions and activities of people who found it difficult to communicate.

We saw that the principles of the Mental Capacity Act 2005 had not been followed in relation to obtaining and gaining the consent of people for the care, support and treatment that was provided at the service. We saw some working practices that may be depriving people of their liberty and possibly an invasion of their privacy.

We saw people were supported with their daily nutrition and systems were in place for monitoring the diet of people where this was identified as a support need.

We saw that the systems in place for the adminstration of medication was safe and secure.

We found that sufficient staff were on duty to meet people's needs in a timely manner.

We saw that some records relating to the care and support of people had not been updated in a timely way. Other records for maintaining the health, safety and welfare of people had not been reviewed.

Inspection carried out on 29 September 2011

During a routine inspection

People living at the home were not able to tell us much about the care they received. We observed that people appeared relaxed and that there were positive interactions between the staff and the people who lived there. We observed that people were appropriately dressed and their hair was tidy and their nails were clean and trimmed.

People had a person centred plan that showed their needs and their preferred daily routines. Health action plans were in place and we saw evidence that people's health care needs were being met. People attended for hospital check ups and received support from primary health care staff. People were offered oral and eye check ups.

People's choices were being promoted and people decided on activities they wanted to do and the food they liked to eat.

People were supported by staff that were well trained and had the knowledge and skill to meet their needs. Staff felt supported but the service could provide staff with more formal support such as regular supervision and regular staff meetings.

Systems were in place to review and monitor the service to make sure that people received safe and effective care. The manager intended to further develop this aspect of the service.