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Inspection carried out on 15 August 2019

During a routine inspection

About the service

Red House is a residential care home providing personal care to five adults with learning disabilities, autistic spectrum disorder and/or mental health needs at the time of the inspection. The service is registered to support up to eight people.

The service has been developed 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. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. The registered manager told us up to seven people could be accommodated as the eighth room was small and used as a staff sleep room. The house is larger than current best practice guidance. However, the building design fitted into the residential area and was in keeping with other large domestic homes in the area. There were deliberately no identifying signs, intercom or cameras outside to indicate it was a care home. Staff did not wear a uniform when supporting people at home and when accessing the wider community with them.

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

People felt safe and staff treated them with respect and dignity. People were comfortable and relaxed when interacting with staff and they were happy to ask them for help or support. Staff were trained to meet their needs and had been recruited safely. Risks to people were managed through person-centred support plans, referral to health professionals and regular reviews of their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. When restrictions were needed to maintain people’s safety, for example, when going out into the community, the least restrictive approach was taken. Arrangements made on people’s behalf were made in line with Mental Capacity Act requirements when people could not consent to decisions about their care

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People reviewed their wishes and support needs regularly, with the staff member they chose to work with. Staff were committed to helping people achieve their goals and to ensuring people’s disabilities did not prevent them from living a fulfilled and happy life. People were supported to participate in activities they enjoyed and were interested in.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People who wanted to work or attend college were supported to do so and staff assisted people with developing life skills, such as cooking. People enjoyed regular visits to their local shop and their favourite places to eat or have drinks out. They had formed relationships with members of their local community through this regular contact. People were supported to maintain relationships with others who were important to them.

The service was caring and person-centred. People using the service and the staff supporting them, were valued and listened to. The provider and registered manager understood their responsibilities and monitored the serv

Inspection carried out on 11 January 2017

During a routine inspection

The inspection took place on 11 January 2017 and was unannounced. Our last inspection took place in January 2014 and no breaches of regulation were found at this time.

The home provides care and accommodation for seven people with learning disabilities.

There was a registered manager in place. 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.

There was a strong leadership team in place at the home and this had led to significant improvements in the home. This was reflected in the comments of staff who spoke positively about the changes that had been made. The improvements had impacted positively on people; for example staff told us that because people’s needs were being better met, the use of ‘as required’ medicines for behaviour relating to anxiety had reduced significantly. This was evident in people’s records. There had also been improvement in the environment of the home which had taken account of the views and wishes of people living there. Coffee mornings for families had recently been introduced as a way of involving them more and it was reported that this had been very successful.

People in the home were safe. There were risk assessments in place that promoted positive risk taking and guided staff in what measures were required to ensure people’s safety when carrying out particular activities. Staff were trained in and confident in respect of their responsibility to safeguard vulnerable adults. People experienced kind, caring and supportive relationships with staff. This was evident in our observations throughout the inspection. For example, we saw staff take an interest in one person’s birthday, discussing with them what they wished to spend their birthday money on.

People’s rights were protected in line with the Mental Capacity Act 2005. This is legislation that protects the rights of people who are unable to make decisions about their own care and treatment. There were records relating to mental capacity assessments that had taken place and best interest decisions when required. Staff were knowledgeable about the Act and identified some of the key principles when asked about them. We discussed with the registered manager how the records relating to the MCA could be improved further with more detailed recording.

Staff received good training and support so that their development needs were met. Supervision sessions took place regularly as a formal means of discussing staff needs and any issues they needed to address. Staff commented that the management team were very approachable and the door was always open. Some staff said they preferred face to face training rather than the online training system that was in place and this was fed back to the registered manager.

People individual needs were well met. Staff knew the people they supported well and felt confident about meeting their health needs. Care plans gave good information about people’s preferences and how they wished to be supported.

People were supported to be independent when they were able. We observed people preparing food and carrying out other duties in the home such as collecting mail and carrying out laundry. One person told us about how they had recently started taking the bus independently to college.

Inspection carried out on 9 January 2014

During a routine inspection

People told us that they thought their meals were good. One person said "I shop every week for food and I love it". Another person told us they "like to choose what to have, especially at weekends". One person told us they "have snacks in my room to have when I like".

Each person was given the opportunity to sign their care records to denote that they agreed with the contents. Some people had declined. One person told us "I don't want to". Care records were reviewed monthly and people were involved in these reviews. One person said "I sign my care plans because I like to see them".

Staff told us that they felt well supported by the manager and their colleagues. One staff was new to the service and told us "The induction is good. It's giving me all the information I need to work with the people who live here".

Staff employment records were well maintained. All statutory documentation was present and correct in the records we viewed.

Each person's medication was managed according to current national guidelines, and any errors were dealt with by the manager. The service had a good auditing system in place to manage the safe handling of medication.

Inspection carried out on 19 December 2012

During a routine inspection

We saw evidence that consent was routinely sought from people in a number of areas relating to their care. This included who their information could be shared with and how their medications would be managed. Where ever possible people had signed their records to indicate that they agreed with the care planned for them. Risk assessments and care plans had been reviewed regularly. We observed that people�s individual plans were followed by staff when supporting them with everyday activities.

The people we spoke with at Red House told us that they felt safe and we observed that they were confident and comfortable when interacting with staff. People readily made their needs and feelings known to staff and openly questioned things when they were unhappy or uncertain. We spoke with three members of staff who had been in their roles for a varying amount of time. All three said that staff worked well together as a team and they felt supported by their colleagues and managers. People told us that they felt confident that staff knew how to support them.

A detailed monthly quality audit was carried out at Red House by the deputy manager. These audits identified areas of good practice and areas for development and were reviewed by the manager and operational director for the service. At our previous inspection in September 2011 we found that care records and staff files were not always stored securely. At this inspection we found the home was now compliant with this standard.

Inspection carried out on 6 September 2011

During a routine inspection

We used an expert by experience to help us with this inspection. An expert by experience has personal experience of using or caring for someone who uses a health, mental health and/or social care service.

People said they were given choices about everyday things. One person described how they had had a choice about coming to live at the home. They said, "It was all my own choice. I met the staff and had meetings with my Dad and workers. They talked to me so I understood".

People said that staff respected their privacy and dignity. Before entering their rooms, staff will knock and wait first. One person said "all the staff wait, it's rude not to". Another person said that staff do not interfere when they are showering and told us that "staff let me get on with it". One member of staff told us "it's their home, after all."

Residents have their say though a monthly meeting. People said, "everyone in the home goes each month but sometimes I talk to the staff by myself about things", "we talk about our opinions, things about the house and garden�, and "we discuss what we want for the home". People also said they also felt able to speak to staff on their own if they wanted to. One person said that staff "sometimes have a meeting with just me because I'm private. If there�s any big problems I talk to the manager or staff. They take me seriously, they�ve got to because they�ve got to be professional".

People are encouraged to take part in daily activities, such as cooking. One person said "I put in cheese and bacon, I do it all by myself but staff sometimes help if I get stuck". Another person told us "I empty the dishwasher a lot and I�m good at washing up". A third person told us that they did not have many chores around the home, but said "it's your own personal choice what you do in this house."

People are encouraged to take part in activities in the community. One person said �I like walking, I do it every Tuesday, a member of staff goes with me�. The same person also told us about their local paper round � �every Wednesday I fold up the papers and then on Thursday I deliver them�. Another person said, "I did my shopping, this is my newspaper and my snacks. I pay myself, I have my own money". Another person told us how they liked to go out for lunch. They said, " I pay myself and staff help me at the till.

We asked people what they would do if they felt unsafe at the home, and they told us they would "go to the staff or the key worker to talk to them, then I feel better." People that we spoke to said that if they go to their room, staff know they want to be alone and do not interrupt them unless they need to. One person said "staff sometimes check on me after a while".

People said they felt supported by the staff; they felt that staff would listen to them and take them seriously if they had a problem. One person said if they were worried, they would "tell a member of staff, that's their job to keep me safe." Another person said "having a good staff team, that's really important, that's what works here."

Staff told us "there is a good team here, we all pull together", and said that the provider was "brilliant for training".