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Inspection carried out on 8 March 2018

During a routine inspection

Five-Ways provides accommodation and personal care for up to three people living with a learning disability, physical disability, autism and/or mental health needs. The home is a bungalow at the end of a cul-de-sac. It is within walking distance of local shops and amenities. The accommodation comprises three bedrooms, a cosy lounge, dining room and a kitchen. At the time of our inspection three people were living at the home.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People were protected from abuse. Relatives and staff told us they felt the home was safe. Staff had received safeguarding training and knew how to report any concerns.

People received their medicines as prescribed from staff who were trained to do so safely.

There were sufficient staff deployed to meet people’s needs and additional staff were brought in for community support when required.

Individual and environmental risks relating to people’s health and welfare had been identified and measures were in place to reduce these. Emergency plans were in place and understood by staff if required.

People’s rights were protected because staff understood and followed the Mental Capacity Act 2005. Deprivation of liberty safeguards had been submitted to the local authority for authorisation when required.

People had a choice of nutritious food and drink and were supported to maintain a healthy diet. People had access to health care services when required.

Staff received training, supervision and appraisal to support them in their roles and deliver effective support.

The provider met the Accessible Information Standards. Staff used a range of communication methods and provided information in a way people could understand, such as pictures, which helped them to make informed choices.

People took part in a wide range of activities in line with their interests and which increased their skills and independence. Staff knew people well and empowered them to make choices and take control of their lives.

People were supported to maintain important relationships and visitors were welcome at any time. Staff were patient, kind and caring and respected people’s privacy. They treated people with dignity and respect.

People had detailed support plans which provided guidance for staff. People and their relatives were involved in planning and reviewing their care.

Systems were in place to monitor and assess the quality and safety of the care provided. There were opportunities for people and relatives to feedback their views about their care and this was used to improve the service.

Complaints procedures were produced in picture format and displayed throughout the home. People and relatives knew how to raise a complaint if they needed to. There had been no complaints in the previous twelve months.

There was a positive, supportive and open culture within the home. Staff felt involved in the development of the service and felt supported by the registered manager. The registered manager understood their responsibilities and reporting of incidents to the commission.

We last inspected the service in April 2016 and rated the service as good overall. At that time we rated the well led domain as requires improvement as the manager was in post but had not yet registered with the Care Quality Commission. This inspection found that the required improvements had been made.

Inspection carried out on 15 April 2016

During a routine inspection

Fiveways is a small residential home for up to three people with a learning disability and autism. The home is set in a quiet cul-de-sac location on a residential estate. It has a small, cosy living room, dining room and large kitchen leading out into an enclosed garden. At the time of the inspection, two people were living at Fiveways. A third person had a permanent home at Fiveways but was temporarily living at a nearby service managed by the provider due to their current state of health.

The home did not have a 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. A manager had been appointed in the summer of 2015 and managed Fiveways, and another small home a few miles away but had not yet applied for their registration with the Care Quality Commission (CQC).

Staff understood how to recognise the signs of abuse and how to report any concerns within the service and to external agencies such as CQC and the Local Authority. There was a safeguarding and whistleblowing policy in place which included relevant contact details and telephone numbers for reporting concerns.

Staff felt supported, and were listened to by the manager who involved them in the development of the service. Training and supervision was in place to support staff and ensure they were competent to carry out their role.

Recruitment practices were robust and staff were checked for suitability to support people in an adult social care setting before starting work. Staffing was managed across the two homes that the manager was responsible for which enabled more opportunities for activities to take place outside of the home.

There was a calm, positive and homely atmosphere at Fiveways. Staff interacted with people with kindness and respect and promoted their independence.

People had person centred plans which included pictorial versions with photographs of people and activities. This helped to ensure that people’s wishes and skills were recorded along with their support needs.

There was evidence in care plans that the home had responded to people’s health needs and this had led to positive outcomes for people. Risks to people had been appropriately identified and assessments were in place to manage these which staff were aware of.

Medicines were managed, stored and disposed of safely and administered by staff who had been trained to do so. The manager had put new systems in place to manage medicines more effectively.

People were asked for their consent before care or support was provided and where people did not have the capacity to consent, the provider acted in accordance with the Mental Capacity Act 2005. People’s mental capacity was assessed when specific decisions needed to be made, and the outcome recorded to confirm whether they had capacity to make the decision. The manager was aware of their responsibilities under the Deprivation of Liberty Safeguards (DoLS). However, no one at the home currently required a DoLS.

Systems were in place to assess and monitor the quality of the service such as medicines audits, staff surveys and gaining feedback from people using the service. Regular checks were carried out in relation to the environment and equipment, and procedures were in place to report any defects. Learning took place from any incidents and accidents which were recorded.

Inspection carried out on 13 February 2014

During a routine inspection

In this report the name of a registered manager appeared who was not in post and not managing the regulatory activities at this location at the time of the inspection. This was because they were still a registered manager on our register at the time of this inspection.

We spoke with the three people who used the service, the manager and a member of staff. We observed support given to all people who used the service during our inspection. People told us they were very happy and liked living at the home. They gave examples of how they got to do what they wanted and were supported to make their own decisions and choices. One person told us they enjoyed �gardening outside,� another said �I like cooking� and the third told us �sometimes we go to a house in Cornwall,� on holiday. People appeared happy and contented, and care and support were observed to be respectful and responsive to individuals� needs.

Staff practices ensured people were enabled to give their consent to care and support whenever possible. Where people did not have capacity to consent, effective systems ensured their rights and well-being were protected in line with legal requirements.

People who lived at the service and staff knew and got on well with each other. We reviewed care plans and they were detailed, up-to-date and person-centred.

The premises were laid out and effectively maintained so as to be safe and suited to the specific needs of people living there. We found there were enough qualified, skilled and experienced staff to meet people�s needs at all times. There were appropriate systems for recording and responding to complaints, and an easy-read guide to the process was available to people who used the service.

Inspection carried out on 15 March 2013

During a routine inspection

We looked at care plans which showed us the home had involved other agencies and medical professionals in the care of service users. This ensured that the health, welfare and safety of people using the service was maintained and information was shared to benefit their individual needs.

During the inspection we observed that the house was clean and that people using the service were involved in maintaining the cleanliness. One person told us "I am quite independent and so I do a lot of cleaning myself" and another said "it is always very clean here."

We looked at three staff records to assess the recruitment procedure the provider had in place. We observed that recruitment procedures were followed in order to ensure no person was employed without the necessary checks. Staff completed an application and the manager confirmed references were sought including those from their last employers. We saw that references and criminal record bureau checks (CRB's) were completed and records of these were maintained. One person told us "the staff are great, they always ask what we want and what we need - they treat us like human beings."

During the inspection we spoke to people using the service and they told us "if I have a problem I can talk to someone. When I had a problem they fixed it. Staff always listen if I have any problems" and another told us "I have never had to make a complaint but we know that they would listen to us if we weren't happy."

Reports under our old system of regulation (including those from before CQC was created)