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Inspection carried out on 30 April 2018

During a routine inspection

Abelands is a residential care home registered for nine people living with a learning disability, complex needs, autism, sensory impairment or mental health conditions. At this inspection on 30 April 2018, there were eight young men living at the home. The registered manager said it was “not planned to be all male but has evolved that way”. Accommodation is a mixture of individual rooms with en-suites and self-contained premises. 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 our last inspection on 01 December 2015, we rated the service good. At this announced inspection on 30 April 2018, 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.

Systems and processes were in place to safeguard people from abuse. Staff had a good understanding of the signs of abuse. Accidents and incidents continued to be recorded and analysed and action taken to improve and learn when issues were identified. Risks, including risks from medicines and behaviour that could challenge, continued to be identified and action taken to reduce these. People were supported to take positive risks which improved their quality of life. For example, one person with complex needs could not go out into the community at a previous home. Staff worked with the person to understand their needs, risks and supported them in managing their behaviour. This person can now access the community safely with the support of staff which has had a positive impact on their life.

People's care was provided in line with the Mental Capacity Act (2005) and staff understood the importance of gaining appropriate consent for care and treatment. Staff were knowledgeable and trained to meet the needs of people living at the home. Assessments of people's needs were in place and included assessments of any health-related needs as well as any behavioural needs. People's dietary needs continued to be met and any specific dietary needs were identified. When people required healthcare from other professionals this was arranged to ensure people received timely support. One person was supported to have their blood taken in a way that supported their needs and reduced their anxiety. The bloods were taken at the home in a safe environment for the person and a member of staff had their blood taken to show the person what would happen. This reduced their anxiety and ensured they had access to the healthcare they required.

Staff continued to have a caring approach with people and understood them well. Staff promoted people’s independence and respected their individuality. One relative said of their son, “He has been given independence by living at Abelands and is able to take opportunities to broaden his horizons. Abelands has given us all a life it has changed the whole family’s life in a positive way.” People were supported to be actively involved in decisions about their care, support and wellbeing. People’s privacy and dignity continued to be respected. People were protected from discrimination. One relative said “‘My son is treated fairly, there is no discrimination at Abelands. Everyone is accepted for who they are.” Staff respected people’s human rights, equality and diversity. Staff gave us examples of how they supported people’s diverse needs including those related to disability and sexual orientation. One staff member said, “people are supported to express their feelings and we discuss topics such as sexuality and gender at resident’

Inspection carried out on 1 December 2015

During a routine inspection

Abelands is a residential care home which is registered to provide accommodation for up to Eight people living with a learning disability. The service supports people who have complex and high support needs. On the day of our visit six people were living at the home.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

People felt safe with the home’s staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults. Staff knew what action to take if they thought anyone was at risk of potential harm. Risks to people’s safety had been assessed and care records contained risk assessments to manage identified risks.

People were supported to take their medicines as directed. Records showed that medicines were obtained, stored, administered and disposed of safely. There were appropriate arrangements for obtaining, storing and disposing of medicines.

Thorough recruitment processes were in place for newly appointed staff to check they were suitable to work with people. Staffing numbers were maintained at a level to meet people’s needs safely. Relatives told us there were enough staff on duty and staff also confirmed this.

Food choices on the menu was good and there was a three week rolling menu. Staff went round each morning to check people’s choices for the main meal of the day which was provided at lunch time. People were able to make their own choices for breakfast and tea.

Staff were aware of people’s health needs and knew how to respond if they observed a change in their well-being. Staff were kept up to date about people in their care by attending regular handover meetings at the beginning of each shift. The home was well supported by a range of health professionals.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We checked whether the service was working within the principles of the Mental Capacity Act (MCA) 2005 and whether any conditions on authorisations to deprive a person of their liberty were being met. The registered manager understood when an application should be made and how to submit one. The provider had suitable arrangements in place to establish, and act in accordance with the MCA.

Each person had a care plan which informed staff of the support people needed. Staff received training to help them meet people’s needs. Staff received an induction and there was regular supervision including monitoring of staff performance. Staff were supported to develop their skills by means of additional training such as the National Vocational Qualification (NVQ) or care diplomas. These are work based awards that are achieved through assessment and training. To achieve these awards candidates must prove that they have the ability to carry out their job to the required standard. All staff completed an induction before working unsupervised. Relatives said staff were knowledgeable about their family member’s care needs.

People’s privacy and dignity was respected. Staff had a caring attitude towards people. We observed staff smiling and interacting with people and offering support. There was a good rapport between people and staff.

Staff told us the registered manager operated an open door policy and welcomed feedback on any aspect of the service. There was a stable staff team who said that communication in the home was good and they always felt able to make suggestions. They confirmed management were open and approachable.

There was a clear complaints policy and the provider had a policy and procedure for quality assurance. An operations manager employed by the provider visited the home regularly to carry out quality audits. Weekly and monthly checks were carried out to monitor the quality of the service provided. There were regular staff meetings and feedback was sought on the quality of the service provided. People and staff were able to influence the running of the service and make comments and suggestions about any changes. Regular one to one meetings with staff and people took place. These meetings enabled the registered manager and provider to monitor if people’s needs were being met.