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Inspection carried out on 18 October 2017

During a routine inspection

Ava House provides personal care and accommodation for up to four people who may have a learning disability. The accommodation is provided in two semi-detached houses which have been adapted and turned into four separate self-contained flats. There is a communal dining kitchen and a staff office on the ground floor. People have their own flats that have a kitchen, bathroom, bedroom and a lounge. The ground floor units are wheelchair accessible.

The home was designed to provide a transitional service with a view towards moving people on to more independent living. This is sometimes termed a ‘Reablement Model’ as people were generally expected to stay up to two years, or less depending on their needs. This intent has changed somewhat as only one person is currently undertaking reablement. The registered manager was working with the local authority on future planning needs.

This was an unannounced inspection that took place on 18 October 2017. At the last inspection in June 2015, the service was rated as Good. At this inspection we found the service remained Good. We judged that the domain 'Responsive' was no longer outstanding because the previous outstanding elements of reablement work were no longer being carried out to the same extent in the home.

The service had a registered manager who also managed a domiciliary care service, Living for Life, which provides support to people living with learning disability in the community. 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 was suitably qualified and experienced to manage the service.

Staff had received training on ensuring people were kept free from harm and abuse. They were confident in management dealing with any issues appropriately. Staff knew how to contact outside agencies if necessary.

Good risk assessments and emergency planning were in place. Accidents and incidents monitoring was in place but there had been no recent issues in the home.

We saw that staffing levels were usually suitable to meet the assessed needs of people in the service. An extra member of staff was in place in the house because there was a problem with assistive technology. The registered manager had also increased staffing levels so that people could be taken out to activities more often.

Staff recruitment was thorough with all checks completed before new staff had access to vulnerable people. The organisation had robust disciplinary procedures in place.

Medicines were managed appropriately. People had their medicines reviewed by their GP and specialist health care providers.

Staff were trained in infection control and supported people in their own environment. The home was clean and orderly on the day of the inspection.

Staff were supported to develop appropriately. Staff told us they were keen to learn and we saw that induction, training, appraisal and supervision helped them to give good levels of care and support.

Staff received good levels of training around principles of care in relation to people living with a learning disability and/or autism. Restraint had not been used in this service. Consent was sought, where possible. The manager and the local authority worked together to ensure the service operated within the Mental Capacity Act 2005

People were supported to get good health care support from their own GP, specialist nurses and consultants. Staff worked with people to support and encourage them to visit dentists and other health care providers.

Staff we spoke to displayed a caring attitude. They understood how to support people and help them maintain their dignity and privacy. Staff showed both empathy and respect for people living a learning disability or

Inspection carried out on 12 & 17 June 2015

During a routine inspection

We carried out this unannounced inspection on 12 & 17 June 2015. The service was opened and first registered with Care Quality Commission (CQC) in October 2013 and this was the first inspection visit that had been carried out.

Ava House provides personal care and accommodation for up to four people who may have a learning disability. The home is designed to provide a transitional service with a view towards moving people on to more independent living. This is sometimes termed a ‘Re-ablement Model’ as people were generally expected to stay up to two years, or less depending on their needs.

The accommodation is provided in two semi-detached houses which have been adapted and turned into four separate self-contained flats. There is a communal dining kitchen and a staff office on the ground floor. The home is located in a residential area of Maryport in West Cumbria. People have their own flats that have a kitchen, bathroom, bedroom and a lounge. The ground floor units are wheelchair accessible.

There was a registered manager employed at the home. 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 that they felt safe living in this home and said that the staff supported them to stay safe in the local community. We saw that people who lived in the home were comfortable with the staff who worked there, with a supportive working relationship. They told us that they would speak to a staff member if they felt unsafe or anxious.

People were protected from the risk of abuse because the staff in the home understood their responsibility to keep people safe and were aware of the actions to take if they were concerned a person may be at risk of harm.

The service had developed its own model of on-going assessment to promote the skills people required in order to make them more independent.

People told us that this helped them to feel part of the process and in control. One person said that this meant they understood and knew why some goals had been met and why others had been less successful. They also said that this helped them to develop strategies to cope when they were living in a more independent setting.

We found there were enough staff to provide the support and supervision that people needed to develop and to move onto more independent lives.

People told us that they liked the staff and said the staff treated them with respect and understanding. They told us that the staff were good at their jobs and they knew they had received training to assist them in carrying out their jobs.

All the staff employed in the home had received training to ensure they had the skills and knowledge to provide the support people needed. The staff knew how to support people to make choices about their lives and how they communicated their wishes.

Staff conveyed enthusiasm about the ethos of the home and said they were committed as a staff team to make a difference to people’s lives. This was shared and confirmed by people in the home, one person said the staff team were “awesome”, while another said after living at a number of other services the big difference here could be summed up in one word “respect” from the staff team.

The registered manager of the home was knowledgeable about the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). The focus of the home was on promoting individuals’ rights and independence and no one in the home had any restrictions on their right to make their own choices.

People in the home were assessed as having capacity to make choices in their life and staff support was around informing and educating people as to risks.

Medicines were handled safely in the home and people received their medication as prescribed by their doctor. People were supported to maintain good health because they had access to appropriate health care services.

We saw that people in the home were central in decisions about how the support that was provided. The atmosphere was open and inclusive. People had been asked for their views about the service and the care they received and action was taken in response to their comments. House rules had been developed by the four people in the home, and they reported that this way they were more likely to stick to them.

When we contacted heath and adult social care professionals working with the home they reported that the home had worked creatively and flexibly with people with complex and high support needs. They told us, “The staff team have been very responsive and engaged. Their care planning is very person centred and collaborative with the client. This had resulted in a very successful transition – particularly given a context when transition could have been difficult.”