4 Old Barn Close is a residential care home for four people with learning disabilities. Accommodation is provided on the ground floor with shared facilities such as a kitchen, bathrooms and lounge. Each person had their own bedroom. At the time of the inspection four men were living in the service.

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 ongoing 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. At this inspection we found the service remained Good.

Why the service is rated Good:

People's safety and well-being had been considered by the service and steps had been taken to minimise the risk of harm. Care plans and risk assessments had been completed to minimise the risks associated with the delivery of care. Records were up to date and trained staff administered medicines to people. Supplies and equipment used in the service were maintained and checked.

Prior to moving into the service, each person had their needs assessed. People are 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 relatives spoke positively about the food available in the service.

Staff training was not always provided in line with the demand, meaning staff had to wait to refresh or attend training. We have made a recommendation about this. Staff were supported through supervision, training and appraisals to carry out their role. Staff meetings were provided to encourage clear communication and updates.

We were told and we observed how staff showed kindness and a caring approach towards people. People’s privacy and dignity were protected. Care plans detailed how people communicated with staff. This allowed staff to understand the simple gestures people made which indicated pleasure or dislike. Staff knew people well and understood their preferences. People’s care plans were personalised and focussed on their specific needs.

Information was obtained from people’s relatives verbally and through a questionnaire as to how the service could be improved. Staff told us the managers were accessible, open and honest. They felt supported by the management and spoke positively about their management skills.

Further information is in the detailed findings below.

This unannounced inspection took place on the 16 and 17 May 2016. 4 Old Barn Close is registered to provide accommodation for up to four adults with learning disabilities who may also live with autism.

There was a registered manager in place, who over saw the management of two homes including 4 Old Barn close. An assistant manager oversaw the running of 4 Old Barn Close on a daily basis with the support of the 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.

One person and the relatives of the people living in the home told us they felt the home was safe. Staffing levels were organised to cover 24 hour care. The highest number of staff were found during the day, this enabled people to access the community with appropriate support.

We looked at the recruitment of staff to ensure appropriate checks were completed. Whilst most checks had been completed we found gaps in candidate’s employment histories had not been checked. We were advised by a senior manager after the inspection that this had been addressed and additional checks were now being made to ensure full histories were investigated.

Medicines were stored securely and administered appropriately. Risks to the care being provided had been assessed and strategies had been put in place to manage the risks. Care plans detailed how care should be provided in line with people’s preferences and wishes. Where people required additional support with maintaining their health, health professionals such as dietitians and GPs were referred to.

Staff knew how to identify and report concerns of abuse. Safety checks were carried out on the building and equipment to ensure the home was safe for people to live and work in.

Training was provided to staff so they had the skills and knowledge to meet people’s needs. Staff were described as caring by relatives and we observed good positive interactions with people living in the home. Staff showed people respect by referring to them by their names and by appreciating and respecting when they wanted time alone or required attention. They were courteous to people when asking people’s permission before carrying out a task and telling people what they were doing before carrying out care. Staff knew how to protect people’s dignity and during our observations we saw them put this into practice, by knocking on people’s doors and asking permission before entering.

People’s care was reviewed regularly, and their relatives were invited to participate in the care review. Where people lacked the capacity to make decisions for themselves, a decision making process was followed to ensure any decisions made were in their best interest by people who knew them well. Where appropriate Deprivation of Liberty (DoLS) had been authorised by the local authority.

Activities were provided both in the home and in the local community, this protected people from social isolation.

Staff and relatives spoke positively about the management of the home. Staff praised their supportive management style. Relatives told us how they felt supported by the management and the staff, and how they felt listened to. They were kept informed of any incidents or events that occurred in the home.

The atmosphere in the home was friendly and relaxed. The assistant manager was viewed by staff as a role model. We found all the staff and management in the home to be considerate, professional and sensitive to the needs of the people living there.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

We looked at the personal care or treatment records of people who use services, carried out on a visit on 13th January 2014, observed how people were cared for and talked to staff and relatives. It was only possible to talk with one person who use services on this occasion.

People’s needs were assessed and care plans were clear and individualised, reflecting the needs of people who use services. Staff plan activities and people were taken out regularly and involved in the local community, this was confirmed by a person who told us “I like it here, I get to go out a lot.”

Staff provide a healthy balance and choice of food and use the opportunity to make meal times an occasion for people who use services. Dietary needs were met and staff were properly trained in food hygiene. Specialist dietary advice was followed in the management of a person’s medical needs.

Clear systems were in place for the management of medicines and staff were trained to ensure medicines were handled safely, securely and appropriately.

Staff were trained to care for people who used the service and staff demonstrated a good understanding of the needs of those people. Planning of staff rostas and strategies for coping with shortfalls in staffing were in place.

The home had assurances in place to assess and monitor the quality of services.

We spoke to a relative of one person using the service. They told us the people at 4 Old Barn Close were some of the most vulnerable people in care. They said the regular staff working in the service did “..a fantastic job”. They said their relative was well supported and they had confidence in the staff.

We saw that staff treated people with respect and had a good relationship with them. We found people’s needs were assessed and their care was provided in line with their care plan. People were protected against the risk of abuse. Staff were supported in providing care and support to people. The organisation had arrangements for monitoring the quality of the service.