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Inspection carried out on 14 May 2019

During a routine inspection

Charlotte House is a 'care home'. It provides services for adults with a learning disability and autism, Charlotte house is registered to provide support for two adults and at the time of the inspection one person lived in 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 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

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 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.

Care and support was delivered on an individual basis and the occupant of the home decided the daily routines. Care, support and activities were planned around individual likes and dislikes. People were encouraged to participate in activities that were meaningful to them for example charity work and to experience new activities with varying degrees of success due to people’s general dislike of change.

The person being supported told us that they had opportunities to connect with other people using the U&I Care Limited services with attendance at social clubs, discos, and dinner clubs but often preferred not to go. They told us of connections they had made with the wider community.

We were told that relatives had concerns around the level of activities their relative attended and that they should be “made” to do things. We discussed with the manager ways to improve people’s understanding of how individuals are supported with choice. This aspect of people’s care across all U&I Care services needs to be reviewed, to be able to manage families expectations in line with legislation as people transitioned from children’s service and receive support in adult services.

The person told us that they felt safe with the support from staff, they told us that the manager had arranged for staff to support them with whom they got on best. The service worked very hard to promote inclusivity and people’s diversity was embraced. Staff demonstrated this with their knowledge of how people communicated, made their needs and wishes known, and what worked best to ensure they had a good day.

Staff told us that they were proud to work for U&I Care Limited and we saw there was a genuine affection for the people they supported. There were processes in place for staff to access support at any time and we were told by staff that they felt supported by the management team. Records clearly showed that staff also received formal supervision, appraisal and regular training.

For more details, please see the full report which is on the CQC website at

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 02 May 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by wh

Inspection carried out on 22 January 2018

During a routine inspection

The inspection took place on 22 and 26 January 2018. It was unannounced on the first day and announced on the second day and was carried out by one adult social care inspector. This was the first comprehensive inspection at the service since it was registered in December 2016.

Charlotte House is a care home registered for two adults that provides support to adults with learning disabilities, autism and complex needs. The home is located in a residential area of Warrington, close to shops, transport links and other local amenities. There was one person living at the home at the time of the inspection supported by staff on a 24 hour basis.

Charlotte House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this 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.'

A registered manager was 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.

At this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered providers audit systems had not identified the areas for development and improvement found during the inspection process. Incident and accidents were not consistently reviewed and analysed to identify trends and patterns.

The policies and procedures did not all include current best practice guidelines. The recruitment procedures were not consistently robust. You can see what action we told the provider to take at the back of the full version of the report.

Medicines were ordered, stored and administered safely by competent and trained staff. Medication administration records (MARs) were fully completed and signed by staff in accordance with good practice guidelines. PRN 'as required' medicines did not have protocols in place for their safe management. We have made a recommendation in relation to this.

The person supported had a comprehensive care plan and selection of risk assessments. The documents had not been reviewed or updated and held out of date and incorrect information. This meant staff did not have up to date guidance to support the person and mitigate any risks identified. We have made a recommendation regarding this.

Staff had all completed an induction and undertaken mandatory training. Not all staff felt competent to support the person living at Charlotte House. Due to the complexities of the person supported the registered manager was reviewing staff training to ensure staff had sufficient skills and knowledge to undertake their role.

All staff had completed safeguarding training and demonstrated a good understanding of abuse and what they would do if they had any concerns about a person. The registered provider had a safeguarding policy and procedure in place to protect people from abuse.

Sufficient staff were available to meet the needs of the person supported.

The person was supported with their food and fluid intake. The person prepared some of their own meals and snacks. They made their own food and drink choices.

Activities were available to meet the needs of the person supported. The person was supported to maintain regular contact with their family members.

The home was clean and decorated to a good standard. There were hand washing facilities at the home and it was free from