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Inspection carried out on 8 March 2018

During a routine inspection

This inspection took place on the 8 and 9 March 2018 and was unannounced. Quantock 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 service provides accommodation for up to six people with learning disabilities in a house situated in its own grounds with an open front garden but an enclosed garden area at the back. Six people were using the service at the time of this inspection.

The service 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 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 using the service could live as ordinary a life and make the choices which were right for them.

We previously inspected the service in November 2015 and rated the service as 'Good'. At this inspection we found the service remained 'Good'.

Staff recruitment procedures were robust and included Disclosure and Barring Service checks and references. Staffing levels were appropriate to the needs of the people using the service to ensure they had access to the community and recreational activities.

One person told us the service was safe. Policies and procedures were in place to keep people safe such as safeguarding, whistleblowing, and accident and incident policies. Staff had received training in safeguarding and knew how to report any concerns they may have.

Medicines were managed safely by staff who were appropriately trained and the manager assessed the staff’s competencies.

Risks to people were assessed on admission and reviewed on a regular basis. Risk assessments were individualized and gave staff guidance about how to help keep people safe but the records would benefit from more detail.

People had personal emergency evacuation plans (PEEPs) in place in case of an emergency. Staff were trained in a range of subjects such as first aid, food hygiene and fire warden training. Staff had also received additional training to support them to meet the needs of people who used the service, such as specialist communication methods and epilepsy. Staff received regular supervisions and an annual appraisal.

Staff supported people to access appropriate healthcare, such as GPs and speech and language therapists. People's nutritional needs were assessed and their weight was monitored on a regular basis. The provider tried to give people a varied diet, however due people’s limited choices of meals the menus would benefit from being nutritionally assessed by a dietician.

People were encouraged to make choices in everyday decisions. Staff provided support, guidance and care in a dignified manner, showing people respect whilst ensuring privacy when necessary.

Care plans were personalised and contained clear information to cover every aspect of the person's daily needs. Personal preferences, likes and dislikes were acknowledged in care plans to ensure support was individualised to the person. Care plans were reviewed on a regular basis to ensure staff had up to date

information.

People enjoyed a varied range of activities both inside and outside the home. The service had positive links with the community; with people accessing local activities and leisure centres and shops.

The provider had a complaints procedure in place which was accessible to people in a pictorial format. Relatives felt the provider responded appropria

Inspection carried out on 26 November 2015

During a routine inspection

This inspection took place on 26 November 2015 and was unannounced. Quantock House is a residential home for up to six people with learning disabilities and associated conditions. At the time of the inspection there were six people living at the service.

There was a registered manager 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. Within this service the registered manager is also the team leader.

People had communication difficulties associated with their learning difficulty. We therefore used our observations of care and our decisions with people’s relatives and staff to help form our judgements.

People received their medicines in line with company policy. Staff received training in medicine administration and had good knowledge of the types of medicine and their purpose. The registered manager ensured that the medicine was securely stored and in line with legislation and good practice.

People at the service indicated that they felt safe. Staff had sound knowledge of how to identify abuse and who to raise their concerns to should they suspect abuse. The service had systems in place to ensure that suitable staff were employed by carrying out checks prior to employment. For example Disclosure and Barring Services (DBS) checks.

Staff told us they underwent a comprehensive induction process when first employed. Inductions were tailored to staff’s individual needs and could be extended should staff require additional support and training. Staff received on-going supervisions from the registered manager whereby they were supported to reflect on their work and identify training requirements.

The service had policies and procedures relating to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and these were followed by staff. These aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not deprive them of their liberty and ensures that people are supported to make decisions relating to the care they receive. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and lawful manner.

Care plans were person centred and where possible people were involved in the development of their care plan. Care plans covered all aspects of care delivered and were regularly updated and reviewed to reflect people’s changing needs. Both known and suspected risks were identified and recorded in the risk assessments which gave staff clear guidance on how best to support people when faced with the risk. Staff had a clear understanding on how to minimise these risks and were aware of the importance in following the set guidelines.

Staff told us they could approach the registered manager and the area manager should they need to. Staff stated that the registered manager operated an open door policy and that they found them to be supportive. One staff member told us, “It’s all about supporting the people and the registered manager ensures that’s what we do at all times”.

The service actively sought feedback on the delivery of care. Yearly quality assurance questionnaires were sent to people, their relatives and staff to seek their views on how the service is run. An action plan was then put together to act on appropriate suggestions received.

Staff told us that their complaints and concerns were listened to by the registered manager and the provider and that they could contact senior managers if they felt that they could not approach the registered manager. People’s concerns and complaints were recorded and acted upon appropriately.

Inspection carried out on 15 January 2014

During a routine inspection

During our inspection, we spoke to two people who use the service, one carer and the manager. Three of the people who use the service went out for the day with two other staff members. We looked at the care records of two people.

We saw that people were involved in planning and agreeing to their care and in setting their own personal goals. We saw that people were offered choices, from what they wore, to how they decorated their bedroom. We also saw that where people needed more information or support with decisions that advocacy services were used.

We saw that people had person centred care plans that were comprehensive and regularly reviewed and updated.

We saw that staff received safeguarding training and understood their responsibilities in protecting people who use the service from abuse.

We saw that the provider monitors the quality of the service provided at Quantock House. People that we spoke with told us "yes, I like living here" and "I can go out or stay in and listen to my music".

Inspection carried out on 13 February 2013

During a routine inspection

The manager told us the philosophy of care at Quantock House is to promote independence, individuality and personal development in all aspects of daily living. We saw the approach to care provision enabled each person to maximise their individual potential and risks were well managed.

At the time of the inspection there were six people living at the home. We spoke with three of the people who used the service and three members of staff. All the people we spoke with were complimentary about the service they received. They told us they were involved in making choices about their lives and were treated with dignity and respect. One resident said "it's good here. Staff are nice to us". All people we spoke with told us they felt safe at the home and were supported by kind staff.

Peoples' needs were met by competent staff who were supported by the manager and senior company management. Staff told us they received appropriate training in the care of people with challenging behaviours and supported them to live as fulfilled a life as possible.

We saw people were being helped to understand decisions about the care and treatment they were given. Each person who used the service had a written plan of care which reflected their individual needs. The plans gave clear information to staff about how to support people yet maintain as much of their independence as possible.