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Inspection carried out on 7 March 2018

During a routine inspection

Petunia Grove - Macclesfield is part of the David Lewis organisation and is registered to provide accommodation for four people who require support and care with their daily lives. The two-storey domestic type property is close to shops, public transport and other local amenities.

The home is a detached house in the area of Macclesfield, Cheshire. At the time of our inspection there were four people living there.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

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 had 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. We saw that people with learning disabilities and autism who used the service were able to live as ordinary a life as any citizen.

We spoke with three people who lived in the home and one relative who all gave positive feedback about the home and the staff who worked in it. We saw that people were living busy, independent lives, supported by a willing staff team who were encouraging, supportive and respectful.

Staff spoken with and records seen confirmed training had been provided to enable them to support the people with their specific needs. We found staff were knowledgeable about the support needs of people in their care. We observed staff providing support to people throughout our inspection visit. We saw they had positive relationships with the people in their care. There was a happy, warm atmosphere in the home. We saw that individuality was encouraged and supported and people were able to express themselves in the way that they chose and that their well-being was enhanced by this support.

Care plans were person centred and driven by the people who lived who lived in the home. They detailed how people wished and needed to be cared for. They were regularly reviewed and updated as required. Maximising people’s independence was a clear focus in all of the care plans we looked at.

The residential manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions. We saw that people were supported to make their own decisions and their choices were respected and at all times the least restrictive option was taken. Assistive technology was in place to maximise people’s independence and ensure that their privacy and dignity was respected.

The residential manager used a variety of methods to assess and monitor the quality of the service. These included regular audits of the service and staff meetings to seek the views of staff about the service. The staff team were consistent and long standing. They demonstrated that they were committed to providing the best care possible for the people living in the home.

Inspection carried out on 20 December 2015

During a routine inspection

The inspection was unannounced and took place on the 22 December 2015. Following this an announced visit to the head office of the David Lewis Centre to look at recruitment and training records and phone calls to the family members of the people living in the home took place on the 22 and 26 January respectively.

Petunia Grove is part of the David Lewis Centre’s ‘Community Programme’ and is registered to provide accommodation for four people who require support and care with their daily living. The home is located in a residential area on the outskirts of Macclesfield. The two storey domestic property is close to local amenities. Staff members are available twenty four hours a day. At the time of our visit there were four people living in the house.

Petunia Grove 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 registered manager, (their job title within the organisation was service manager), did not work in the home on a daily basis. Day to day management was provided by a residential manager who had responsibility for a total of four services operated by David Lewis and the team leaders who managed each shift.

Because of their communication needs we were unable to fully confirm from the people living at Petunia Grove what they thought about the home and the staff members supporting them. To help with this process we were able to speak to a visiting family member during our visit and have since spoken to two family members on the telephone.

The service had a range of policies and procedures which helped staff refer to good practice and included guidance on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This meant that the staff members were aware of people's rights to make their own decisions. They were also aware of the need to protect people's rights if they had difficulty in making decisions for themselves.

We asked staff members about training and they confirmed that they received regular training throughout the year, they described this as their mandatory training and that it was up to date.

The care plans, which within the David Lewis Centre were called common care files were reviewed regularly so staff knew what changes, if any, had been made. The files each had a ‘one page profile’ which explained what was important to the individual and how best to support them. This helped to ensure that people’s needs continued to be met.

Staff members we spoke with were positive about how the home was being managed. Throughout the inspection we observed them interacting with each other in a professional manner. The staff members we spoke with were positive about the service and the quality of the support being provided.

The relationships we saw were warm, respectful, dignified and with plenty of smiles. Everyone in the service looked relaxed and comfortable with the staff.

We found that the provider and the home used a variety of methods in order to assess the quality of the service they were providing to people. These included regular audits on areas such as the care files, including risk assessments, medication, individual finances and staff training. The records were being maintained properly.

Inspection carried out on 12 June 2014

During a routine inspection

We undertook an inspection of 3 Petunia Grove on the 12 June 2014. We spoke with the four people using the service, the team leader, two staff members and the residential manager during our visit.

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?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives; the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The home opened two years ago and was very well appointed and maintained throughout.

Training records highlighted that staff were up to date with all mandatory training needed to support people living at the home.

The residential manager and team leader advised us that appropriate procedures, including review were in place should anyone need to be subject to a Deprivation of Liberty Safeguard (DoLS) application or plan. DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests.

Is the service effective?

The people using the service who were able to tell us said that they were happy living in the home and that they were being well supported by the staff members working there.

The staff members we spoke with could show that they had a good understanding of the people they were supporting and they were able to meet their various needs.

Is the service caring?

We observed that staff interacted well with the people living in the home and the relationships we saw were warm, respectful, dignified and with plenty of smiles and laughter.

The staff members said that they felt supported to do their job and had received regular formal supervision. (These are regular meetings between an employee and their line manager to discuss any issues that may affect the staff member; this would include a discussion of ongoing training needs).

Is the service responsive?

The care plans had been written in a person centred manner. This meant that the individualised care plans focused on the person's individual assessed needs and on how they could be met. The care plans focused on providing support to an individual in different aspects of their daily life, for example how the person was to be supported with promoting their independence and any issues regarding their health so that they stayed as healthy as possible. We asked the people using the service if they were involved in planning their support and two people were able to tell us that they were.

Is the service well-led?

The staff members we spoke to said that the home was well managed and they enjoyed working there.

We saw that the provider had an effective system to regularly assess and monitor the quality of service that people received.

Inspection carried out on 9 May 2013

During a routine inspection

On our inspection carried out 9 May 2013, we spoke to the registered manager, the residential manager, two members of staff and one of the three people living at the house.

We were told that a weekly residents meeting took place to discuss activities for the forthcoming week. We saw that people wrote down things they may like to do and what food they would like to cook.

We also spoke with two members of staff employed by the service. They told us that they had received specialist training to equip them to deal with medical emergencies where they would be required to administer medication.

We saw that appropriate safeguarding policies and procedures were available and that there were leaflets clearly displayed in the poster folder giving information on the policy. Contact details for staff to alert safeguarding professionals were printed on the rear of each staff member's identity card.

We were shown staff training records which evidenced that all staff had received extensive training including; protecting vulnerable adults and children, food hygiene, infection control, manual handling, equal opportunities, health and safety, dealing with head injuries and specialist epilepsy training.

Systems were in place to audit and monitor the quality of care provided to people using the service. This meant that people using the service were protected against unsafe care.