The Leys

The Leys is a registered care home and provides accommodation and support for up to nine people living with a learning disability. There were nine people living at the service when we visited.

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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s experience of using this service:

¿ People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns. People had risk assessments in place to enable them to be as independent as they could be in a safe manner. There were sufficient staff with the correct skill mix on duty to support people with their required needs and keep them safe. Effective and safe recruitment processes were consistently followed by the provider.

¿ Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Effective infection control measures were in place to protect people.

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

¿ Staff received an induction process and on-going training. They had attended a variety of training to ensure they were able to provide care based on current practice when supporting people. They were also supported with regular supervisions.

¿ People could make choices about the food and drink they had, and staff gave support if and when required to enable people to eat a balanced diet.

¿ People were supported to access a variety of health professionals when required, to make sure they received additional healthcare to meet their needs.

¿ Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

¿ People’s privacy and dignity was maintained at all times. Support plans were written in a person-centred way and were responsive to people’s needs. People were supported to follow their interests and join in activities.

¿ People knew how to complain. There was a complaints procedure in place which was accessible to all.

¿ Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

Rating at last inspection: Good (report published 12 May 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up:

We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

The Leys provides care and support for up to eight people with a learning disability and autistic spectrum condition. There were seven people living at the service when we visited.

The service has 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.

People told us they felt safe living at the service. We found that staff had been trained to recognise signs of potential abuse and how to report them. Processes were in place to manage identifiable risks. People had personalised risk assessments in place to enable them to maintain their independence.

Sufficient and suitable staff with the appropriate skill mix were available to support people with their needs. Recruitment checks were carried out on new staff to make sure they were fit and suitable to work with the people who used the service.

Medicines were managed safely. The service had processes in place to ensure that the administration and handling of medicines was suitable for the people who used the service.

There was an induction and ongoing training for staff to keep their skills up to date. A supervision and appraisal framework was in place to support staff.

People’s consent was sought by staff in line with current legislations before providing them with care and support. People were supported to make decisions on all aspects of their life. This was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of the guidance and followed the correct processes to protect people.

People were enabled to make choices on what they wished to eat and drink; and were supported to maintain a balanced diet. They were registered with a GP and had access to healthcare facilities if required.

There were positive and caring relationships developed between people and staff. The staff team knew people well and provided care and support in a caring and meaningful manner. Processes were in place to ensure that people’s views were acted on. Where possible people were encouraged to maintain their independence and staff ensured their privacy and dignity were promoted.

Before people came to live at the service pre-admission assessments were undertaken. This ensured people’s identified needs would be adequately met. The service had a complaints procedure to enable people and their relatives to raise concerns if they needed to.

The culture at the service was transparent, positive, open and inclusive. This inspired staff to provide a quality service. Effective quality monitoring systems were in place and were used to drive continuous improvements.

We therefore imposed compliance actions and told the provider they needed to make improvements in these areas. On 5 March 2014, we reviewed the action the provider had taken on the non-compliance to ensure this had been addressed effectively.

We found that improvements had been made in respect of the staff ratio within the home, staff rotas showed that three staff were consistently on duty during the day, in accordance with the provider policy. This meant that people were now supported and enabled to undertake activities of choice, because the staff ratio supported this.

We found that the provider had made improvements within their systems and processes, for the recording of actions taken in response to feedback. They had strengthened their internal monitoring system and now had more frequent quality checks undertaken by management, therefore driving future improvement.

We observed that people were relaxed with the staff and happy. One person said, 'All the staff are nice.' Another person smiled when we talked about the staff. We observed that staff were respectful in their approach to people and treated them with dignity and respect.

We looked at care records to establish whether people's care needs were met. We found the records were written in detail. However the information for each individual was located in a number of different files. This made it difficult to see the complete picture for each person.

During the inspection, we also reviewed the medication systems. These demonstrated the processes for the storage, administration and disposal of medication was safe and appropriate.

We looked at the staffing rotas which indicated that at times there were insufficient staff on duty to meet the assessed needs of the people living at The Leys. As a consequence the activities available to them were restricted.

We found the provider had systems in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. However the actions taken to mitigate identified risks were not clearly recorded.