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Inspection carried out on 19 February 2020

During a routine inspection

About the service:

27 The Lustrells is a small home care home registered to provide accommodation, care and support for up to four younger adults with physical disabilities, learning disabilities or autistic spectrum disorder. The service is a detached split-level bungalow with two floors and a garden. It is situated in a residential area, near to the local shops. At the time of inspection there were three people living at the home.

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 and physical 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:

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.

Systems supported people to stay safe and reduce the risks to them. Staff knew how to recognise signs of abuse and what action to take to keep people safe. There were enough staff to meet people's needs. Medicines were managed safely, and staff had been trained in infection prevention and control.

People were supported to maintain their health and had support to access health care services when they needed to. 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.

People were treated with kindness and we observed friendly interactions throughout the day. Staff knew people well and tailored their support accordingly. Staff had a good understanding of the care and support needs of people and had developed positive relationships with them. People were supported to live as independently as possible and told us their needs were met. Activities took place on a daily basis and people were encouraged to participate if they wanted to.

The registered manager had created an open and positive culture and staff knew people well. Staff felt well supported and the home had a welcoming atmosphere. People were fully involved in the service. Feedback about the registered manager was very positive. Staff were motivated and very proud of the service. Systems were in place to monitor the service and drive improvement. One relative told us the service was, “Well managed, relaxed, responsive and adaptable.”

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

Rating at last inspection: Good (report published on 17 August 2017).

Why we inspected: This was a scheduled inspection.

Follow up: We will continue to monitor the intelligence we receive about this home and plan to inspect in line with our re-inspection schedule for those services rated Good.

Inspection carried out on 29 June 2017

During a routine inspection

The Lustrells is a small home care home registered to provide accommodation, care and support for up to four younger adults with physical disabilities or learning disabilities or autistic spectrum disorder. The home is a detached split level bungalow with two floors and a garden. It is situated in a residential area, near to the local shops. The inspection took place on 29 June 2017 and was the first inspection since the service was registered in November 2015.

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.

Not all risks to people were being effectively assessed and managed. Potential risks associated with an enteral feeding system had not been identified and the care plan lacked guidance for staff in how to manage the system. Risks associated with pressure care had also not been assessed and plans were not in place to guide staff. This was identified as an area of practice that needed to improve.

Other risks had been assessed, managed and were regularly reviewed. People were supported to maintain their freedom and there were clear plans in place to guide staff. Staff had a firm understanding of how to safeguard people from abuse and understood their responsibilities in this regard. There were enough staff on duty and the provider had robust recruitment procedures to ensure that staff were suitable to work with people. People received their medicines safely. One relative said, “Any concerns are acted upon very quickly, I’m sure people are safe.”

Staff had received the training and support they needed to be effective in their roles. One staff member said, “The training is very good and gives us peace of mind that we are doing things right.” Staff understood the principles of the Mental Capacity Act 2005 and sought consent from people before providing care or support.

People were supported to have enough to eat and drink. Meals were provided according to the needs and preferences of each person. Where nutritional risks and needs had been identified there were clear plans in place to guide staff in how to support people. Staff were proactive in ensuring that people had access to the health care services they needed. A visiting health care professional told us that staff were “Helpful and knowledgeable about people’s needs.”

Staff knew people very well and had developed positive relationships with them. People were relaxed and comfortable in the presence of staff and we observed many interactions that demonstrated the closeness of their relationships. People were smiling and laughing with staff throughout the inspection and displayed affection openly. Staff treated people with respect and preserved their privacy and dignity. Staff encouraged people to make choices and to express their views.

Care plans were detailed and written in a personalised way. They provided a clear picture of the individual and guided staff in how to provide care that was responsive to the needs of the person.

People were being supported to lead full and active lives. Activities were arranged in response to people’s individual interests and included regular trips out in the local community. One relative told us, “I can visit at any time but I phone first because they are always out and about doing something nice.”

Feedback was used to improve the service and a complaints system was in place. Relatives told us they would feel comfortable to raise any concerns. The registered manager provided clear leadership and staff and relatives spoke positively of recent changes. One relative told us, “The new manager has different expectations, we have noticed the difference.” A staff member said, “There have been a lot of change