Huntley

At this inspection on 19 November 2018, there were seven people living at the home. There were both men and women living at the home and people had lived at the home for many years. Accommodation is provided over two floors and people have their own rooms and share communal bathrooms, one person had a room with an en-suite. People had access to a large communal lounge, sensory room and garden.

The home had 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.

The care service has been developed 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 principles of Registering the Right Support were fully embedded within staff practice and the ethos of the home. People were active members of their local community and staff were proactive in supporting people to make choices which enabled their independence.

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.

People received an extremely responsive service where staff went above and beyond to ensure people's needs, wishes and aspirations were at the forefront of everything they did. Care was extremely personalised to meet the needs of individuals. People were at the centre of care planning and fully involved in the process. Staff were exceptionally responsive to people's individual's needs and allowed them to live their lives how they wanted. One relative told us, “she gets the most from life and as a parent I could not be happier, it is such a weight off my mind knowing she is in a home where she is able to be her”.

People had access to an extensive and wide variety of activities. Staff identified that activities were an integral part of people's lives and were led by people's choices. People received compassionate and dignified end of life care that respected their wishes. People were proactively supported to maintain relationships with people who were important to them. Staff went above and beyond to understand people’s family relationships and promoted people’s right to maintain and develop these.

People remained safe. A relative told us, “My daughter is totally safe living at Huntley. I know this because there are always staff around day and night and it is very secure. I have no concerns about her safety.” Staff continued to have a good understanding of safeguarding and there were systems and process in place to keep people safe. Medicines management continued to be safe. Staff who administer medicines were trained and had regular competency checks. Lessons were learned when things went wrong and accidents and incidents continued to be managed safely.

People's needs continued to be assessed prior to people moving into the home and regularly thereafter. People could make day to day choices and staff adapted their approach to enable this. A relative told us, “The care is always focussed around what she wants, they never make her do anything she does not want to do. She has full choice over daily decisions.” People were supported to have a balanced diet and had access to healthcare professionals as and when they needed them.

People continued to receive kind and compassionate care. One relative told us, “We are over the moon with the kind and compassionate care our daughter receives.” People's privacy and dignity were respected and maintained. People and their relatives, where appropriate, continued to be involved in decisions about their care and were given support to express their views. A relative told us, “I am full involved in decisions about his care and listened to, they make sure they involve him too and always give him choices.”

The home continued to be well-led. A relative told us, "The service is very well managed, the manager or deputy are always available to talk to me. You can tell how well it is managed through the excellent attitude of the staff.” The culture of the home remained positive and enabled people to live how they wanted to. People, staff and relatives remained engaged and involved in the service provided. Daily feedback was sought through people's engagement with staff, key worker meetings and care reviews.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer some of the five questions we always ask.

Is the service safe?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is the service safe?

The environment had posed a risk to the safety of people, staff and visitors to the service. The provider had taken suitable steps to minimise the risks to people. Where tiles had fallen from the wall, netting was in place to prevent the tiles falling to the ground. Roof tiles had been replaced and repaired where necessary. An area of the garden had new fencing and a new path. An area of damp in the dining room had been repaired and re-decorated so this room was safe for people to use.

A programme of refurbishment and repair for four bathrooms, a toilet area and a bedroom had been agreed by the provider. Funding for these works had been approved and the provider had put these out to tender with their builders. A scheme of works will be prepared and a timescale for achievement of this work will be required.

Staff received suitable training to help them meet the needs of people who used the service. There were suitable systems in place for supervising staff to ensure they could maintain the safety of people.

Is the service responsive?

We had found on our last inspection staff did not receive regular supervisions or appraisals. We found staff had been having supervision sessions every six to eight weeks. One member of staff told us, "I use my supervision to talk about the people and my training needs." We saw the appraisal system was in place for staff and staff were beginning to complete this prior to their appraisal meeting.

We had identified staff did not have the opportunity to gain relevant professional qualifications. The provider had sourced an organisation to provide this. Staff were pleased to tell us they were now accessing a diploma in adult social care.

Is the service well-led?

Staff told us they were able to talk to the manager or senior staff anytime they had any concerns. One member of staff said, "I know they (the manager) will always give me an answer if I ask them questions about people's care." Staff meetings were occurring every month where staff were able to discuss aspects of care for people and review care plans.

The manager had responded to the non compliant outcomes and had worked with the provider to minimise risks to people from the environment. The provider had acknowledged the problems with the environment and had put in place suitable actions to improve the environment for people who used the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is the service safe?

People showed us they felt safe by the way they communicated with the staff and how they responded when staff asked them questions. We saw people responded positively as they allowed staff at Huntley to support them with their care. One person had shown they wanted to go out as an activity and was very happy to leave the building with the member of staff supporting them. Staff followed guidelines on supporting people with moving and handling and we saw there were other risk assessments in place to ensure the safety and welfare of people.

We saw staff had completed training in the safeguarding of vulnerable adults when we looked at training records. All the staff we spoke with were knowledgeable about the service's safeguarding policy and local procedures for reporting suspected abuse and felt confident to use these. Risks to people's health and safety in their home had been assessed and management plans were in place to reduce these risks. Appropriate checks were carried out on staff before they began working with people.

The service had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had received training to enable them to understand when an application should be made.

The environment posed a potential risk to the safety of the people who used it. Tiles had fallen from the external walls and were contained by netting which prevented them from falling to the ground. Whist this was a temporary measure this area needed to be addressed as a matter of urgency to ensure the safety of people and others who visited the service. We have asked the provider to take action in this area.

Is the service effective?

Staff we spoke with told us how they involved people in the planning of their care. People were offered choices by a range of communication aids. Staff had received training to ensure they had the skills to care for people living in the home. Where appropriate, the service sought advice from appropriate professionals to assist with the care provided for people. People's needs were assessed and these were regularly reviewed. The care plans reflected areas identified within the assessments.

Is the service caring?

People were supported by staff who were aware of their needs and knew how they wished to be supported. One member of staff told us, "We have good teamwork and everybody treats the service users well and they are respected." We saw staff talking to people in a calm, quiet and responsive manner. We observed one member of staff who took a lot of time to make sure the person they were supporting was happy with a choice they had made around their meal. Staff were knowledgeable about people's likes and dislikes and how they communicated their choices.

Is the service responsive?

An assessment of needs was carried out when people moved into the service. This was reviewed on a monthly basis and changes were made as required to reflect changes of need. The care records contained details of how each person wished to be supported, including their personal likes and dislikes. Staff told us they involved people in identifying changes to the person's care and discussed this with the manager. The service responded to concerns and complaints and ensured the person was made aware of their response. There were some communication systems in place to support people if they wished to make a complaint.

Is the service well-led?

Quality assurance systems were in place. The provider carried out regular audits which looked at the care and support people received along with checks of people's care plans. We saw some relatives had completed an annual questionnaire about the quality of the service. The main concern was about the environment and repairs and re-decoration that were needed. Some areas had been re-decorated but improvements to bathroom and shower rooms had been carried out.

Staff told us the management team were supportive and always available for advice and help. However, we found supervisions were not occurring regularly and staff did not receive an annual appraisal. Staff were unable to access further professional qualification training through the provider. We have asked the manager to take action to address the frequency of supervisions, appraisals and staff accessing professional qualification training. We have asked the provider to take action concerning supervisions and staff accessing professional qualifications.

We found evidence by talking to staff and the local fire officer that the home was not protecting people who use the service against the risks associated with unsafe or unsuitable premises.

We spoke with one relative who said "A very warm and caring environment, with lovely staff ", "Really lovely, calm and happy atmosphere. Interesting activities for residents and annual events to include families. Staff always pleasant and good relations between residents and staff" and "a caring environment well run". Another person told us "it is a home from home".

During our inspection there were nine people living at the service. We found people's nutritional needs were being met and supported.

We inspected records of staffing and found the service was operating effective recruitment procedures when employing staff at the home. Staff had received training and supervision to provide them with the knowledge and skills to meet the needs of the people living at the service.

We viewed the complaints records and policy and found the service was taking appropriate steps to investigate and manage complaints received.

We saw that people's privacy and independence were respected, people experienced safe and effective care based on detailed care plans and risk assessments that documented peoples preferences and met individual needs.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding adults. We saw policies on whistle blowing and safeguarding. People's rights were respected.

We saw evidence that staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of the people they were supporting.

The Provider had effective systems in place to monitor quality assurance and compliance.