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Inspection carried out on 2 August 2018

During a routine inspection

This inspection took place on 2 August 2018 and was unannounced.

At the last inspection on 1 June 2017 the service was given an overall rating of Requires Improvement. At this inspection we found improvements had been made and we have given the service an overall rating of Good.

Redlands 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.

Redlands provide accommodation and personal care and support for up to eight adults who have learning disabilities or autistic spectrum disorder. The accommodation is spread over two floors. There were seven people living in the home at the time of our 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.

The service has a registered manager. 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.

There was a friendly atmosphere in the home and staff supported people in a kind and caring way that took account of their individual needs and preferences. People and their families were supported to express their views and be involved in making decisions about their care and support.

There were systems and processes in place to protect people from harm, including how medicines were managed. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team.

Safe recruitment practices were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people in the home. There were sufficient numbers of experienced staff to meet people’s needs.

Staff were supported to provide appropriate care to people because they were trained, supervised and appraised. There was an induction, training and development programme, which supported staff to gain relevant knowledge and skills.

People were supported to have 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 received regular and on-going health checks and support to attend appointments. They were supported to eat and drink enough to meet their needs and to make informed choices about what they ate.

The service was responsive to people’s needs and staff listened to what they said. Staff were prompt to raise issues about people’s health and people were referred to health professionals when needed. People could be confident that any concerns or complaints they raised would be dealt with.

The registered manager was promoting an open, empowering and inclusive culture within the service. There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.

Inspection carried out on 1 June 2017

During a routine inspection

This was an unannounced inspection and took place on the 01 June 2017.

The service provides care and support for people who may have a learning disability, a mental health condition or physical disabilities. Some people living at the home displayed behaviours that were challenging to others and required interventions from staff to keep them and others safe. Some people could not speak with us due to their difficulty in communicating effectively.

There is a registered manager at Redlands. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

This inspection was carried out in response to concerns raised by healthcare professionals and the general public. They told us they had concerns about staff deployment and safeguarding.

We received conflicting information about the deployment of staff and could not be assured people’s needs were consistently met at all times.

Systems and processes were in place to drive improvement and arrangements were in place to obtain feedback from relatives, however staff working in the home and healthcare professionals told us improvements were needed.

Staff knew people well and communicated with them in a kind and relaxed manner.

Good supportive relationships had been developed between the home and people’s family members.

People were supported to maintain their dignity and privacy and to be as independent as possible.

Staff were knowledgeable about the requirements of the Mental Capacity Act 2005 and worked with advocacy agencies, healthcare professionals and family members to ensure decisions made in people’s best interests were reached and documented appropriately

People were not unlawfully deprived of their liberty without authorisation from the local authority. Staff were knowledgeable about the deprivation of liberty safeguards (DoLS) in place for people and accurately described the content detailed in people’s authorisations.

Staff received training appropriate to people’s needs and were regularly monitored by a senior member of staff to ensure they delivered effective care.

Staff interacted with people and showed respect when they delivered care. People’s records documented their hobbies, interests and described what they enjoyed doing in their spare time.

Records showed staff supported people regularly to attend various health related appointments. Examples of these included visits to see the GP, hospital appointments and assessments with other organisations such as the community mental health team.

The registered manager responded appropriately to any complaints.

Staff were complimentary about the registered manager and told us they could access support when needed.

Records showed care reviews took place on a regular basis or when someone’s needs changed.