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Inspection carried out on 15 January 2018

During a routine inspection

Aurora is a residential care home for up to eight adults with learning disabilities. Aurora is a large Edwardian house with accommodation on three floors and a large communal open-plan lounge/dining-room/kitchen in a ground floor extension at the rear of the property. There were eight people in residence when we visited.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good

People felt safe living at Aurora, with the staff, the support the staff gave them and with the environment. Staff were trained and competent to recognise and report any abuse or avoidable harm so that people were protected. Staff’s positive risk-taking approach meant that risks were minimised without limiting people’s freedom to take appropriate risks.

There was a sufficient number of staff with the right experience, skills and knowledge deployed to make sure that people were kept as safe as possible. There was an effective recruitment process in place to reduce the risk of unsuitable staff being employed. Staff were clear about their responsibility to report accidents, incidents and concerns and they followed the correct procedures to prevent the spread of infection. Medicines were managed safely.

Staff received induction, training and support to enable them to do their job well. Staff supported people to do their shopping, cook their meals and encouraged them to eat a balanced, nutritious diet. External healthcare professionals such as GPs, dentists and opticians worked with staff to help people maintain their health.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People and their relatives liked the staff and described them as really kind, helpful and nice. Staff made people feel they mattered and knew each person, and the details about the support the person needed, very well. Relationships between people and staff were based on mutual trust and respect.

People were involved in planning their support and information about advocacy services was available if anyone wanted an independent person to assist them with their affairs. Staff respected people’s privacy and dignity and encouraged people to remain as independent as possible. People could have been supported to be more independent with preparing their own, healthy meals.

Each person’s support plan was fully personalised, agreed with the person and gave staff sufficient guidance to support the person in the way that would help them attain their goals. People planned their own activities and outings, with support from their keyworkers. The service had been responsive to people’s needs in a number of ways.

A complaints process was in place and people, their relatives and staff were confident that any issues would be addressed by the registered manager. End-of-life care had not been provided but would be discussed with the person, their relatives and external professionals if the need arose .

The registered manager provided good, pro-active leadership and ensured that staff were clear about their role to provide people with a high quality service, thus upholding the values of the service. Staff felt well supported, fully included and happy to be working at Aurora.

A quality assurance system was in place, including a number of ways in which people, their relatives, staff and other stakeholders were asked to give their views about the service and how it could be improved. Audits and monitoring checks on various aspects of the service were carried out.

The registered mana

Inspection carried out on 12 November 2015

During a routine inspection

This inspection took place on 12 November 2015 and was unannounced.

Aurora provides care and support for up to eight people with a learning disability. There were eight people living at the service when we visited.

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.

Staff had been provided with training to recognise the signs of potential abuse and to keep people safe. People felt safe living at the service.

There were processes in place to manage identifiable risks within and outside the service to ensure people did not have their freedom restricted unnecessarily.

Recruitment checks were carried out to ensure that staff were suitable and fit to work with people at the service.

There were systems in place to ensure people’s medicines were managed safely and given at the appropriate times.

There were processes in place to ensure that staff were provided with induction and essential training to keep their skills up to date and to support them in their roles.

People’s consent to care and support was sought in line with the Mental Capacity Act (MCA) 2005.

People were supported to prepare their meals and to maintain a balanced diet.

People were registered with a GP. If required they were supported to access other healthcare facilities with support from staff.

Positive and caring relationships had been developed between people and staff who treated them with kindness and compassion.

The service had systems in place to ensure that people’s views were listened to and acted on.

Staff supported people to maintain their independence and to promote their privacy and dignity.

Before people came to live at the service their needs had been assessed to ensure the care provided would be personalised and responsive to their identified needs.

The service had a complaints procedure which was accessible to people and their relatives to enable them to raise a concern if they needed to.

There was a positive, open, inclusive and transparent culture at the service.

The leadership at the service was visible and as a result staff were inspired to provide a quality service.

The service had a quality assurance system in place to monitor the care provided and to drive continuous improvements.

Inspection carried out on 15 April 2014

During a routine inspection

We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Is the service safe?

People told us they felt safe. They had been cared for in an environment that was safe, clean and hygienic. People's needs had been assessed, and risk assessments described how any identified risks to people were minimised. The service had sufficient staff who were knowledgeable about people's care and support needs.

Is the service effective?

People’s health and care needs had been assessed and care plans were in place. They were happy with the care that had been provided and their needs had been met. Staff had received training to support people with various care needs. Some of the people had complex needs that meant they were not able to understand their care plans, we saw that some of these had been written in a 'easy read' format to enable people to understand their planned care and support. The service provided people with adequate and nutritious food and drink that ensured they maintained good health.

Is the service caring?

People were supported by kind and attentive staff. It was clear from our observations and from speaking with the staff, that they had a good understanding of the needs of the people living in the home and that they knew them well. They were able to communicate effectively with people with limited verbal communication.

Is the service responsive to people's needs?

We observed that staff responded promptly to people's needs. We saw that care plans had been updated when people's needs had changed, and that referrals had been made to other health and social care professionals when required. The service took account of individual preferences, and people were supported to access a variety of activities of their choice.

Is the service well-led?

The service had a registered manager in post. We saw that the provider had effective systems to assess and monitor the quality of the service they provided. They regularly sought the views of people using the service and their representatives, and took account of these to improve the service.

Inspection carried out on 22 April 2013

During a routine inspection

We carried out an inspection of Aurora on 22 April 2013 to review improvements following previous concerns identified by us in November 2012.

We saw evidence that improvements had been made, including changes to the management within the home and recruitment of additional, permanent staff.

We observed a relaxed, friendly environment with staff engaging positively and respectfully with people who lived there. At the time of our visit, three people lived at Aurora, these being the same three people we had met with at our previous inspection. We were therefore able to directly see the improvements in the care provided and observed the three people all being more relaxed and engaged with staff and activities. Not everyone was able to tell us about their experiences due to their communication difficulties, although one person said they were “…happy.”

We found improvements in the care planning and risk assessments in place and saw these were now regularly reviewed and reflective of people’s needs.

We looked at the processes in place for safeguarding vulnerable people, and also the management of medicines, and found these to be comprehensive and followed by staff.

Staff had received additional training since our last inspection and also now received regular supervision and support.

The provider had implemented systems for assessing and monitoring the quality of service and care provision, and we saw evidence of these during our visit.

Inspection carried out on 23, 26 November 2012

During a routine inspection

We visited Aurora on 23 November 2012 and again on 26 November 2012 due to some of the concerns we identified during our first visit. The home had opened the previous year and we saw it was spacious, designed with sensory features to assist people with dementia needs, and each room had en suite facilities.

At the time of our visit, three people lived at the home and were supported by staff on a one to one basis. People who lived at Aurora had varying communication abilities but were able to tell us they were happy living at the home.

During our first visit on 23 November 2012 we saw people were not always offered choices or involved in decisions regarding their care and support. We observed staff behaviour which was not always appropriate or adapted to meet people’s individual needs; one example included the use of aprons at mealtimes whether people required them or not. There were three members of staff on duty, two of whom did not usually work in the home and were not familiar with peoples’ needs.

We returned for a second visit on 26 November 2012 and found the atmosphere in the home was much improved. The staff on duty were permanent staff, familiar with peoples’ needs, and were interacting and engaging with people in a positive, respectful way. Residents looked more relaxed and they were communicating more openly than during our first visit.