1 Stratton Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

1 Stratton Road accommodates three people with learning disabilities and complex needs in one adapted building. At time of our inspection three people were living there. Each person have their own ‘flatlet’, consisting of a bedroom, kitchen and living area within the home. There is also a communal lounge and kitchen on the ground floor.

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.

The inspection was unannounced and took place on 28 February 2018. We returned on 13 March 2018 to complete the inspection.

The service had 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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People told us they felt safe living at 1 Stratton Road. Staff had the knowledge and confidence to identify safeguarding concerns and act on them to protect people. Risk to people’s health and safety had been assessed and actions put into place to minimise the risks.

The service promoted people’s independence and people were involved in the service, for example with household tasks.

We observed staff interacting with people in a kind and caring manner, involving people in choices around their daily living. There were sufficient staff to meet people’s needs and staff were visible at all times. People looked relaxed and comfortable in the company of staff and did not hesitate to seek support and assistance when required.

Staff continued to monitor people’s physical and emotional wellbeing and ensured support was in place to meet their changing needs. Each person had a health action plan which described their health care needs. Where necessary, staff contacted health and social care professionals for guidance and support. People’s medicines were managed and administered safely.

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 support this practice.

People’s support plans were person centred with detailed information specific to each individual, including people’s likes, dislikes and preferences.

Staff told us they felt supported in their roles. Staff said they received appropriate training to have the correct knowledge and skills to meet people’s needs.

People had access to food and drink throughout the day and were supported to eat their preferred food choices.

The registered manager had systems in place to monitor the quality of the service provided. People and/or their representatives had opportunities to feedback their views on the quality of care.

At the time of our inspection there were two people living at One Stratton Road. One inspector carried out this inspection.

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?

This is a summary of what we found –

Is the service safe?

We spoke with one person living at One Stratton Road. They told us they felt safe living there. They said “I like it here, it’s all good.”

People were aware of, and had access to advocacy services.

Care plans provided guidance for staff on how to meet people's needs in a way which minimised the risk for the individual. Where people were at risk, staff followed effective risk management policies and procedures to protect the person. This ensured that staff were able to support people whilst respecting their dignity and protecting their rights.

People were safe because care staff knew what to do when safeguarding concerns arose. Staff had received appropriate training and followed policies and procedures. Information regarding safeguarding and what to do was available within the home.

There was a member of senior staff available on-call in case emergencies arose.

Is the service effective?

People and/or those that matter to them were involved in planning their care and support. We spoke with one person’s relative who told us “staff are trying everything to make X’s life full.”

Referrals are quickly made to health services when people’s needs change. One health professional we spoke with confirmed that the home were quick to respond to health issues raised by the person or their representative.

Is the service caring?

We asked one person if the staff asked them what sorts of things they liked to do. They told us “Yes.” A relative we spoke with said “The staff are lovely and friendly. It’s so good to see X looking so happy.”

We saw that staff showed concern for people’s well-being. Staff knew the people they were caring for and supporting, including their preferences and personal histories.

People were treated with dignity and staff respected people’s privacy. We saw that staff knocked on people’s bedroom doors before entering. Staff called people by their preferred name.

People could discuss their needs for end of life. We saw one person was being supported by their family to complete an ‘end of life’ care plan which included funeral arrangements.

People's care and welfare needs were assessed. It was clear from our observations and from speaking with care staff that they had a good understanding of the people's care and support needs. Care plans reflected people’s current individual needs, preferences and choices.

Is the service responsive?

People and those that matter to them were encouraged to make their views known about their care and support and these were respected. We observed staff asking people if they wanted to take part in activities and then respecting their wishes if they refused.

People living at One Stratton Road had information on how to make a complaint. We discussed with the registered manager that this was not available in an accessible format. We looked at how the service dealt with complaints. The service had not received any complaints since our last inspection.

The service worked well with other agencies, health professionals and family members to make sure people received consistent care. Records contained details of appointments with health professionals and any outcomes. We saw that referrals were made to the appropriate health services when people’s needs changed.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care settings. While no applications had been submitted, appropriate policies and procedures were in place. Staff had received training in the Mental Capacity Act and the application of DoLS.

Is the service well-led?

Care staff were motivated and caring and said they felt supported by management. They received regular supervision and appraisals were they could discuss personal development and learning opportunities.

Care staff were clear about their roles and responsibilities and the needs of the people they were supporting. This helped to ensure that people received a good quality service.

People who used the service received care and support from staff who were competent to carry out their roles. All staff received a comprehensive induction when they started their job. Further learning and development of staff was identified based on the needs of the people they were supporting.

The service had quality assurance systems in place which took into account feedback from people using the service or others acting on their behalf, observations of staff and complaints. Records we reviewed showed that where issues had been identified actions had been taken to resolve them.

There were some arrangements in place to deal with foreseeable emergencies. Staff had access to an on-call system at all times to support them in the event of an emergency and had received basic first aid training. There were fire evacuation procedures in place. There was an emergency contingency plan in place. This detailed such things as what to do in the event of staffing shortages, loss of utilities and infection control.

1 Stratton Road is a care home service registered to provide personal care for up to 3 people who have a learning disability. The home is a semi-detached house situated in a quiet residential area. It is part of Innovations Wiltshire Limited; a provider of several other care home services in the area. The ground and first floor of the home were divided up into three flatlets with the staff accommodation situated on the second floor.

The inspection was unannounced and the visit took place over the 9 and 10 September 2015.

The service had a registered manager who was responsible for the day to day running of 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.

Each person who uses the service had their own personalised care plan which promoted their individual choices and preferences. The great majority of these records were complete, accurate and up to date. However we found one key set of records was missing. The service took immediate steps to resolve this and the records were put in place on 11 September 2015. We have made a recommendation about auditing of record keeping which can be found in the full report.

Staff responded flexibly and sensitively to people’s changing needs which had a positive effect on their quality of life. People told us that they trusted staff, and would talk to them if they had a problem. The staff team worked in partnership with other organisations to promote people’s well-being and safety. This included providing advocacy when necessary.

The premises were safe, clean, homely and well maintained. Each person had their own bed room, bathroom and sitting room areas.

The service had arrangements in place to protect people from abuse and avoidable harm. People said they felt safe living at the home. Staff were aware of their safeguarding responsibilities and showed positive attitude to this, and also to whistleblowing.

People were assisted to go out into the community to enjoy leisure time and also to attend health appointments.

We saw people were well cared for and relaxed in the home. They were confident to ask staff for help and staff responded with kindness, humour and warmth. Everyone who lives at 1 Stratton Road spoke positively about the staff, and about living at the home.

There was a complaints procedure in place. The service had not received any complaints since the last inspection on 9 June 2014.

We observed that people were given choices and consulted about their care. Family members said they were kept informed by staff and felt welcome at the home.

Staff members said they were well supported and felt valued by the management team.

Other professionals informed us that the staff worked in good partnership with them and with people who use the service. One professional said the team was open to suggestion and always approachable. Another said that the team implemented agreed actions in an efficient and timely way.