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Inspection carried out on 27 November 2019

During an inspection looking at part of the service

About the service

Wigginton Cottage is a residential care home providing accommodation and personal care to eight younger people who have a learning disability. The provider specialises in providing care and support for people who have Prader-Willi syndrome. Prader-Willi syndrome is a rare genetic disorder that results in a number of physical, mental and behavioural disorders.

People at the home have their own bedroom and had access to bathrooms, a lounge, dining area and a kitchen. A garden at the rear of the property was accessible to people.

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 receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Three out of four people told us they did not feel safe living in the home because of the behaviour of one person. The provider was aware of this and had taken action prior to our inspection visit to ensure people’s safety. The risk to the individual was assessed and a risk assessment put in place to mitigate the risk. People were cared for by sufficient numbers of staff who had been recruited safely. People were support by staff to maintain hygiene standards within the home. The provider was able to demonstrate when things went wrong that action was taken to avoid a reoccurrence.

The provider had systems in place to monitor the quality of service provided to people. There was a clear management structure in place and people knew who was running the home. People who used the service had the opportunity to be involved in the running off the home. The provider was able to demonstrate they engaged with other agencies to ensure people received a seamless service.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good published (18 April 2019)

Why we inspected

We received concerns in relation to the management of medicines and people’s care needs. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

The overall rating for the service is Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Wigginton Cottage on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about

Inspection carried out on 18 March 2019

During a routine inspection

About the service: Wigginton Cottage is a residential care home providing personal and nursing care to seven people with Prader-Willi syndrome (PWS) at the time of our inspection. This is a genetic condition with specific characteristics which include excessive appetite, poor muscle tone and some hormonal imbalance. People may also have a learning difficulty.

Registering the Right Support has values which include choice, promotion of independence and inclusion. This is to ensure people with learning disabilities and autism using the service can live as ordinary a life as any citizen. The home was meeting the principles of this policy.

People’s experience of using this service:

• People were protected from the risk of abuse and risks to safety were assessed and managed.

• People received effective care and support.

• Staff were trained and showed they had the skills to support people with meeting their needs.

• People were supported by staff that knew them well and had positive relationships with them.

• Staff were kind and caring.

• People’s needs and preferences were understood and their privacy and dignity was respected.

• People were encouraged to make choices for themselves and maintain their independence.

• People could go to places which interested them and do activities of their choice.

• People were involved in the service and any concerns were listened to.

• The systems in place to monitor the quality of care people received were effective and these identified improvements.

• The registered manager and staff created a positive atmosphere where people were central to the service they received.

• The registered manager understood their responsibilities.

• Learning and partnership were promoted to improve people’s quality of life.

• Everyone we spoke with about the service was positive about the changes they had seen and their experience.

The service met the characteristics of Good in all areas; more information is available in the full report below.

Rating at last inspection: At the last inspection the service was rated Requires Improvement (report published 19 June 2017).

Why we inspected: This was a scheduled inspection based on previous rating.

Follow up: We will continue to monitor the service through information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 20 April 2017

During a routine inspection

We inspected Wigginton Cottage on 20 April 2017 and it was an unannounced inspection. The home provides accommodation and support for eight people who have Prader-Willi syndrome (PWS). This is a genetic condition with specific characteristics which include excessive appetite, poor muscle tone and some hormonal imbalance. People may also have a learning difficulty. At the time of our inspection six people were living at the home. This was the home’s first inspection.

The home had 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.

Medicines were not consistently managed to protect people from the risks associated with them and to ensure that people received them as prescribed. The quality assurance systems did not always successfully improve the service. People and their relatives were not always communicated with so that their feedback could contribute to the development of the service. Staff did not always receive the necessary support to equip them to do their job well.

People were kept safe by staff who understood their responsibilities to protect them. Pictorial posters helped to explain to people how to raise a concern or make a complaint. They were also supported to make choices about their care and what they wanted to achieve. They planned their week to make sure they developed their independence and did the activities that they liked. People had busy, active lives which included education and leisure opportunities. They had care plans in place to support this and they were involved in reviewing these regularly.

Communication systems were adapted for each individual to ensure that they understood their plans and could make their own decisions. When they were unable to make a decision then these were made in their best interest in accordance with legal guidance.

There were enough staff available to be able to support people. The staff were knowledgeable about people’s condition and understood the risks to people’s health and wellbeing. They supported people to manage these risks and this included managing their food and drink. They also supported them to see healthcare professionals regularly to maintain good health.

Staff had been recruited following procedures to check that they were safe to work with people. They had positive relationships with people and respected their privacy and dignity. People were supported to develop relationships in the home and outside to ensure that they had a social network to support them.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.