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Inspection carried out on 4 December 2019

During an inspection looking at part of the service

About the service

Leonard’s Croft is a residential care home registered to provide accommodation and personal care to eight younger people who have a learning disability. On the day of the inspection six people were living at the home.

Leonard’s Croft consists of five one bedroom self-contained flats. Three single bedrooms, a bathroom, communal lounge area, kitchen and a garden at the rear of the property.

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

Since our previous inspection in October 2018, the provider has taken action to improve the management of people’s prescribed medicines. People were supported by skilled staff to take their prescribed medicines.

People told us they felt safe living in the home and staff were aware of their responsibility of safeguarding them from the risk of potential abuse. The risk to the individual was identified and risk assessments put in place to mitigate the risk of harm. People who used the service were supported by staff to keep their home clean and tidy. Lessons were learnt when things went wrong, and action was taken to avoid a reoccurrence.

There was a clear management structure in place and people were aware of who was running the home. The provider had systems in place to review, assess and monitor the quality of service provided to people. The culture of the home was observed to be warm and friendly. Information relating to people were person-centred and reflective of the person’s current needs.

Systems were in place to obtain people’s views in relation to the service provided to them. People were supported by staff to maintain links with their local community. The provider worked closely with other professionals to ensure people received a seamless service.

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.

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

Rating at last inspection

The last rating for this service was Good published (14 November 2018)

Why we inspected

We received concerns in relation to the management of medicines and people’s care needs. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Leonard’s Croft on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as pe

Inspection carried out on 15 October 2018

During a routine inspection

The inspection took place on 15 and 18 October 2018. The first day of our inspection visit was unannounced. We announced to the provider we would be returning to the home on the 18th October 2018 to complete the inspection.

Leonard’s Croft 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.

Leonard’s Croft is registered to provide personal care and accommodation for a maximum of eight people who may have a learning disability, autism and /or complex needs. At the time of our inspection there were five people living at the home. The home is divided up into five flats and three individual bedrooms.

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 and was present at the time of lour inspection. 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.

Storage of people’s medicines was not always appropriate to ensure best practice was followed. Medicated creams needed to be stored in a separate medication cabinet. When people had their as necessary “PRN” administered it was not always recorded with dates and times on the back of the MAR sheet. Therefore there was an increased increase people would not receive their medicines safely. We were given assurances this would be addressed immediately by the registered manager.

People's individual risk assessments were reviewed and updated to take account of changes in their needs. Staff knew how to recognise and report any concerns to keep people safe from harm.

People were supported by staff who knew how to reduce the risk of infections and people were complimentary about how clean the home environment was.

There was evidence of organisational learning from significant incidents and events. Formal complaints were rare and responded to in line with the provider’s complaints policy. Any informal concerns were handled effectively with learning taken to continually improve care.

Staff worked well together in a mutually supportive way and communicated effectively. Training and one to one support systems were in place to provide staff with the knowledge and skills they required to meet people's needs effectively.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice

People were provided with food and drink of good quality which they enjoyed and met their individual needs and preferences. Staff worked closely with local social and healthcare services to ensure people had access to any specialist support they required.

People were provided responsive care and support which met their individual needs. There was a planned programme of things for people to do for fun and interest of their choice. Staff spent time with people on a spontaneous basis chatting about their families and lives. Staff knew people well and had built up trusting relationships.

People, relatives and staff were complimentary about the registered manager and felt the home was well managed. Systems were in place to manage the quality of the care and support people received and drive continuous improvement.