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Inspection carried out on 22 March 2019

During a routine inspection

About the service: Edenwood is a residential care home, providing accommodation and personal care to 9 people with sensory impairments and/or learning disabilities at the time of the inspection.

This service supported people with learning disabilities and/or autism. The service was a large home, bigger than most domestic style properties. It was registered for the support of up to ten people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area.

People’s experience of using this service: People felt safe and happy living at Edenwood. People’s risks were assessed and planned for, whilst also encouraging people to be as independent as possible. People were safeguarded from abuse and avoidable harm by well trained staff who cared about people’s wellbeing.

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.

People had choices about what food to eat, how to spend their time and were involved in all aspects of their care. Staff knew them well including their likes, dislikes and preferences and provided support to people in the way they liked.

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.

People’s care records were accurate and up to date and provided staff with the information they needed to provide safe and personalised care.

People knew the registered manager and staff shared their vision of providing good quality support to people. People and staff were engaged and involved in the service and had opportunities to share feedback that was listened to by both the registered manager and provider.

The service had made improvements since the last inspection and now met the characteristics of Good in all areas; more information is in the full report.

Rating at last inspection: At the last inspection the service was rated Requires Improvement (report published May 2018). The rating in all areas and overall has improved.

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

Follow up: We will continue to monitor the service and re-inspect accordingly.

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

Inspection carried out on 12 April 2018

During a routine inspection

We inspected this service on 12 and 16 April 2018. The first day of our inspection was unannounced. This was the first ratings inspection of this service.

The service is delivered from a three storey home in a residential area of Birmingham. It provides accommodation and personal care for up to 10 people who may have learning disabilities or autistic spectrum disorder, a physical disability or a sensory impairment. Ten people were living at the home on the day of our inspection.

There was a registered manager in post at the service. 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.

Staff were aware of the safeguarding procedures and knew what action to take to protect people should they have any concerns. However, there were gaps in risk management plans to ensure staff had the knowledge to manage risks to people health and wellbeing consistently and safely. Where people’s needs had changed, the records had not been updated to reflect this. Staff were not always aware of risks to people’s health, but supported people to attend appointments with other health professionals when a need was identified. People received their prescribed medicines.

The provider checked staff were suitable to support people before they began working in the home and completed an induction to ensure they understood their role and responsibilities. There was a training programme to refresh staff knowledge and ensure they continued to work in accordance with best practice. However, staff required further training specific to the needs of people who lived in the home. Staff did not have regular opportunities to discuss their personal development, but felt able to approach the management team at any time with any issues or concerns.

Mental capacity assessments had not always been conducted in order to determine capacity levels prior to decisions being made. People's involvement in decision making had not been consistently recorded, although we were told people were involved in making decisions about their care. Care plans did not promote person centred care and there were no plans to enable people to achieve their maximum potential. However, staff had considered ways of making day to day information accessible to people.

Staffing levels meant there were times of the day when staff were very busy and had limited opportunities to respond to people's social and emotional needs. However, when staff did interact with people, we saw it was caring. Staff sat with people when they needed to talk with them and asked people how they were feeling.

The home was clean and tidy but the environment was not fully supportive of people with a sensory impairment.

Systems to monitor the quality of care to people were not consistently effective. The provider had not always followed the latest regulations in line with the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. People's capacity to make decisions had not been assessed. The governance of the home was not always effective and needed improvement.

We found breaches 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.