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Inspection Summary


Overall summary & rating

Good

Updated 5 October 2018

The inspection took place on the 22 August 2018. The service was last inspected in December 2016, when it was rated ‘Good’. At this inspection we found the majority of the evidence continued to support the overall rating of good and there was no significant evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. However, we have made a recommendation for improvement in ‘effective’ and this key question has been rated ‘requires improvement’. This does not affect the overall rating which remains ‘good’. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service is a small service registered to provide care and support to people with a learning disability. It is registered to care for nine people. At the time of the inspection eight people lived there. Larwood House is a purpose built property all on one level with level access to a large outdoor space.

Larwood House 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 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.

There was 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.

Care plans were developed in line with current legislation and guidelines. They were person-centred and included the views and preferences of people. However, we found they were not always reviewed and up-dated in a timely manner when people’s needs changed. People had a varied and nutritious diet based on their preferences and staff knew if people needed further support or monitoring if they were at nutritional risk. However, we found the records were not always consistent with what was actually taking place and guidance was not always followed. We made a recommendation regarding nutrition and hydration.

The provider took responsibility to ensure that they were operating under the principles of the Mental Capacity Act 2005 (MCA) and were not placing unlawful restrictions on people. Where required, Deprivation of Liberty Safeguards (DoLS) were in placed or had been requested, and any conditions had been met. 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 how to keep people safe at Larwood House and there were policies in place to support this. Risk assessments were used to identify risks to people and plans put in place to reduce the likelihood or impact of such risks. Medicines were managed safely and people received their medicines as prescribed.

Staff were kind and compassionate and developed positive and friendly relationships with people. They respected people’s choices and personal space and promoted their independence and dignity.

Staff knew people’s preferences and encouraged people to access activities of their choosing, either within the home or in the local community. People were supported to become active citizens in their local community. People received information in a format that they understood and they were supported to participate in meetings and decisions about their care. Discussions ha

Inspection areas

Safe

Good

Updated 5 October 2018

The service remained safe.

Effective

Requires improvement

Updated 5 October 2018

The service was not always effective.

Weight, diet and nutrition records were not always accurate and were not always updated in a timely manner.

Guidance from specialist advisors regarding food was not consistently followed.

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.

Caring

Good

Updated 5 October 2018

The service remained caring.

Responsive

Good

Updated 5 October 2018

The service remained responsive.

Well-led

Good

Updated 5 October 2018

The service remained well led.