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Inspection carried out on 14 December 2018

During a routine inspection

The inspection took place on 14 December 2018 and was unannounced. The inspection continued on 17 December 2018 and was announced.

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

The service is registered to provide accommodation for persons who require nursing or personal care. It is registered for up to 10 people with learning disabilities and autism. At the time of our inspection there were eight people living in the home.

At our last inspection we rated the service outstanding. At this inspection we found the evidence supported a rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

The care service at Barley Close 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.

The service had 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 responsibilities to safeguard people and knew how to raise concerns both internally or externally if required. There was a safeguarding policy and procedures in place to protect people from abuse or harm. There were enough staff to keep people safe and meet people’s individual needs. Staff had a good understanding of people’s individual risks and how to manage them positively without being unduly restrictive. There were processes in place to ensure safe recruitment of staff to reduce the risks to people living at the home.

People were supported by staff with the skills and knowledge to meet their individual needs. There were processes in place to ensure staff had a robust induction to the service. Staff competency was monitored on an ongoing basis through observation, appraisal, and supervision. Staff received mandatory and bespoke training that enabled them to meet people’s complex needs.

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 understood the principles of the Mental Capacity Act 2005 (MCA 2005) and how it applied to the people there. This provided protection for people who do not have capacity to make decisions for themselves.

Staff interacted with people in an extremely kind, inclusive and caring way. There was a relaxed and happy atmosphere at the home with staff observed consistently giving their time and responding to people in a patient and timely way. People’s right to privacy and dignity was respected at all times.

People were encouraged and supported to maintain relationships with relatives and actively participate in the community. Staff demonstrated a good understanding of the people living there. People’s support needs were identified, assessed and documented in personalised care plans.

People’s care needs were monitored and regularly reviewed. The provider had established good relationships with health and social care professionals and relatives who were consulted and involved. Relatives felt listened to and involved in their loved one’s lives.

People’s desire for independence and meaningful activity was met through a varied range of activities tailored to their abilities and tastes. This supported them to lead full an

Inspection carried out on 12 April 2016

During a routine inspection

The inspection took place on 12 and 18 April 2016 and was unannounced. We previously inspected the service in August 2013 and found no breaches of regulations in the standards we looked at.

Barley Close is registered to provide accommodation with personal care and support for up to ten adults. Seven people lived there when we visited, whose ages ranged from 23 to 65.

The service had 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.

People who lived at Barley Close had profound and complex learning disabilities, several people had autism, physical disabilities and were unable to verbally communicate with us. The service recognised the individuality of each person regardless of their level of disability or support they needed.

Staff developed exceptionally positive, kind, and compassionate relationships with people. People’s care was individualised, staff put them first and knew them really well, such as what made a good day for them. There was a relaxed, calm and happy atmosphere at the home with lots of smiles, good humour, fun and gestures of affection. People were relaxed and comfortable with staff who were attuned to their needs. Staff could recognise how a person was feeling from their non-verbal cues such as body language, gestures and vocal sounds and they responded appropriately. Staff spoke with pride about the people they cared for and celebrated their achievements.

A detailed communication plan identified each person’s preferred communication methods. Staff used a variety of non-verbal communication methods to help people to communicate effectively. For example, using a picture exchange system, Makaton (a form of sign language), and sensory objects. A ‘smiley face’ system was used to monitor people’s enjoyment of food and activities, so staff could be change and improve their approach in response to their feedback.

People enjoyed spending time in a newly developed sensory room, a special room designed to help them develop their senses through special lighting, music, and objects. One person looked relaxed listening to music and watching a light show, and another picked up their musical toy, held it to their ear, listened intently and smiled.

Each person had a support plan developed with the person, a relative or others who knew them well, which highlighted their positive attributes. Support plans identified family and friends important to the person’s emotional and psychological well-being. Each person had a key worker who took a lead role in the person’s care and was the main contact for relatives.

People received a consistently high standard of care because staff were led by an experienced, and proactive team. Staff were highly motivated and enthusiastic, and were committed to ensuring each person had a good quality of life. There was a clear management structure in place, staff understood their roles and responsibilities and were accountable.

The culture at the service was open and honest and encouraged staff to see beyond each person’s disability. Staff demonstrated the provider’s values of ‘passion for care, positive energy,’ and used their initiative to help people to succeed. The registered manager led by example, set high expectations and provided staff with a high level of support. They had an ‘open door’ policy, worked alongside staff using a coaching style of leadership and challenged them to continuously improve people’ s care and their quality of life. Professionals and staff consistently gave us positive feedback about the registered manager’s leadership, which they described as “brilliant.”

People's rights and choices were promoted and respected and staff explored new