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Inspection carried out on 10 October 2019

During a routine inspection

About the service

Sitwell Grove is a care home providing personal care and accommodation for up to four people who live with learning disabilities. There were four people using the service including one person who was receiving hospital care and treatment at the time of the inspection. Public transport services and a range of shops are located close to the home.

The service is also registered to provide personal care to people living in supported living services. At the time of this inspection the registered manager told us no one living in the supported living services needed support with their personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed 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 received planned and coordinated person-centred support that was appropriate and inclusive for them.

The Secretary of State has asked the CQC to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of the thematic review, we carried out a survey with the registered manager and deputy manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service did not use any restrictive intervention practices.

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

People's care was planned with the full involvement of people using the service and when applicable their relatives. People were encouraged and supported to lead and direct their care. They received a service which was personalised and met their individual needs and preferences.

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’s relatives told us that people were cared for by competent staff who were kind, understood each person’s individual needs and provided people with personalised care and support.

Management staff worked in partnership with relatives and other agencies to support people's needs including good health and well-being.

Staff knew what their responsibilities were in relation to keeping people safe. They knew how to recognise and report any concerns they had about people's welfare.

The service assessed and managed risks to ensure that people received personal care and support safely. People were provided with the support they needed to take risks safely without restricting their independence.

Staff undertook training that supported them to have the knowledge and skills to do their job well and effectively meet people's 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.

People chose what to eat and drink and received the infor

Inspection carried out on 13 June 2017

During a routine inspection

Sitwell Grove is a care home registered to provide personal care and accommodation for four people who have learning disabilities. On the day of our visit there were four people living in the home. Public transport facilities are located within walking distance from the home.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People told us that they felt safe living in the home. There were procedures for safeguarding people. Staff had received training on how to identify abuse and understood their responsibilities in relation to safeguarding and reporting concerns of possible abuse.

Arrangements were in place to make sure people received the service they required from sufficient numbers of appropriately recruited and suitably trained staff. Staff received the support and training they needed to carry out their roles and responsibilities in providing people with the care and support that they needed and wanted.

People’s individual needs and risks were assessed and identified as part of their personalised plan of care and support. Risks to people were identified and guidance was available for staff to follow to minimise the risk of people being harmed and to keep them safe.

People’s care plans were reviewed regularly and contained the information staff needed to provide people with personalised care and support. Staff demonstrated an understanding of people’s needs and involved people in decisions about all aspects of their care and were responsive to people’s preferences and changes in their needs.

Safe recruitment procedures ensured that only staff that were suitable working with vulnerable people were employed. Arrangements were in place to provide appropriate numbers of appropriately skilled staff to deliver the care people needed. Staffing levels were kept under review and adjusted when people’s needs changed and to provide the support people needed to attend appointments and to take part in their preferred activities.

People had the opportunity to take part in a range of activities that met their needs and interests. People received a choice of meals, which met their dietary needs and preferences.

People's medicines were managed safely.

Staff understood their responsibilities in relation to the Mental Capacity Act 2005 [MCA]. 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.

There were appropriate systems in place to monitor, evaluate and improve the quality of the service.

Inspection carried out on 02 June 2015

During a routine inspection

This unannounced inspection of Sitwell Grove took place on the 02 June 2015. At our previous inspection 27 December 2013, we found the provider was meeting the regulations in relation to the outcomes we inspected.

Sitwell Grove is a care home registered to provide personal care and accommodation for four people who have learning disabilities. On the day of our visit there were four people living in the home. Public transport and a range of shops are located within a walking distance of the service.

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.

The atmosphere of the home was relaxed and welcoming. People led busy lives. They participated in a wide range of activities of their choice, and were provided with the support they needed to maintain links with their family and friends.

Throughout our visit we observed caring and supportive relationships between staff and people using the service. Staff interacted with people in a friendly and courteous manner, and understood people’s varied communication needs.

Arrangements were in place to keep people safe. Staff understood how to safeguard the people they supported. People’s individual needs and risks were assessed and identified as part of their plan of care and support. People’s care plans contained the information staff needed to provide people with the care and support they wanted and required.

People were supported to maintain good health. People’s health was monitored closely and referrals made to health professionals when this was required. People were provided with a choice of food and drink which met their preferences and nutritional needs.

Staff received a range of relevant training, and were supported to develop their skills and gain qualifications so they were competent to meet people’s individual needs. Staff told us they enjoyed working in the home and received the support they needed to carry out their roles and responsibilities.

Staff had an understanding of the systems in place to protect people if they were unable to make one or more decisions about their care and other aspects of their lives. Staff knew about the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

There were effective systems in place to monitor the care and welfare of people and improve the quality of the service.

Inspection carried out on 27 December 2013

During a routine inspection

During our inspection we used a number of different methods to help us understand the experiences of people who used the service. This was because some of the people were not able to tell us how their care was delivered. We saw evidence from four care plans that people who used the service had been supported to make decisions about living in the care home. Staff we spoke with were aware of the Mental Capacity Act and the importance of gaining consent for care and treatment from people they were supporting.

We found that care and support was planned and delivered, in line with people's individual care needs and preferences. One person who used the service told us "It�s good, I like it.� We spoke with one relative who told us �The place is homely and X is happy and settled there.� The staff we spoke with demonstrated a good understanding of the needs of the people who used the service.

We found the provider worked in co-operation with other professionals to support people with their health and welfare needs.

Staff received training in relation to safeguarding vulnerable adults and knew what to look out for and how to report such matters should they arise.

We found that there was an effective recruitment process in place so people could be confident that the right people were employed in the service.

Inspection carried out on 8 February 2013

During a routine inspection

We spoke with the manager of the home, two other members of staff and two people who used the service. We found that people were involved in decision making about their care and about the day to day running of the home. People were supported to access a range of activities in the community and their independence was promoted. One person said, "the staff go with me to the shops" and we observed people going out for a pub dinner during our visit. We also saw that people had the opportunity to go swimming and bowling.

People's needs were assessed and care plans developed that ensured people's needs were met effectively. Any identified risks to people's welfare were assessed and plans put in place to minimise these while enabling people to maintain their independence. People's healthcare needs were monitored and met with the support of healthcare professionals.

We found that there were systems in place to ensure that medicines were stored and administered safely and all staff received training in the safe administration of medicines. Audits were taking place to ensure these systems were being adhered to by staff.

There were adequate numbers of staff working at the home to meet people's needs effectively. The duty rosters were organised to ensure there were enough staff available to enable people to engage in activities that they enjoyed.

There was an effective complaints management system in place and people were supported to raise any concerns that they had.

Inspection carried out on 19 May 2011

During a routine inspection

People told us that they liked living at the home. They said that they could speak with staff if they were worried about anything, and staff listened to them. People liked the food at the home and said they could choose what they want to eat. People told us that they go to day centres and also on outings to places of interest, and they enjoy these. Representatives we spoke with were very happy with the way the provider and staff were caring for and supporting their relative. They told us that there are lots of activities and outings, and that their relatives have gained in confidence and improved wellbeing since they have been at the home. They said that staff had the skills to manage different behaviours in a positive and effective way. Also that staff treated their relatives with respect, encouraging them to conduct themselves in a dignified manner.