This inspection of Abingdon took place on 17 August 2017 and was unannounced.

Situated in a residential part of Southport, Abingdon is a care home offering a service for up to nine people who have a learning disability. At the time of the inspection, there were seven people using the service. The home is situated over three floors. The home has two large lounges, a dining room and a garden at the rear.

At the last inspection, in April 2015 the service was rated ‘Good’. We found during this inspection that the service remained ‘Good’.

We found that risk was well assessed and information was updated regularly. Staff used restraint as a last resort in line with good practice guidance. Staff were able to describe the course of action they would take if they felt anyone was at risk of harm or abuse, this included 'whistleblowing' to external organisations. Medication was stored securely and administered safely by staff that had been appropriately trained. Our observations and discussions with staff confirmed that the staffing levels were sufficient for the support which needed to be provided. The registered manager had systems and processes in place to ensure that staff who worked at the service were recruited safely.

The registered manager provided us with a staff training plan and this showed staff received training to ensure they had the skills and knowledge to support people living at Abingdon. This included autism training to help staff understand and support people with autism and positive behaviour support training. All newly appointed staff were enrolled on the Care Certificate. Records showed that all staff training was in date.

The service operated within the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Records demonstrated that processes were in place to assess people’s capacity and make decisions in their best interests.

People we spoke with were complimentary about the staff, the registered manager and the service in general. People told us they liked the staff who supported them. The provider adopted a caring approach throughout the service towards staff and people living at Abingdon. This was evident through initiatives such as ‘Above and Beyond’ awards for staff, an employee recognition scheme and through the creation of a ‘Dignity Tree’, a visual aid to promote dignity within the service.

People were supported to raise complaints or concerns about the service through the use of comment cards and easy-read policies. Complaints were well managed and documented in accordance with the provider's complaints policy.

Staff we spoke with demonstrated that they knew the people they supported well, and enjoyed the relationships they had built with people. Care plans were person centred and contained relevant information in relation to a person’s wishes, choices and preferences. Positive behaviour support plans were in place for those people who displayed challenging behaviour and assessments were regularly reviewed and updated.

The registered manager had a number of different systems in place to assess and monitor the quality of the home, ensuring that people were receiving safe, compassionate and effective care. Such systems included regular audits, staff and ‘resident meetings’ as well as ‘resident comment cards,’ annual surveys and relevant health and safety and infection control checks.

Further information is in the detailed findings below.

This inspection was to follow up on a previous inspection in June 2013. At that time the home had failed to meet requirements with respect to maintaining a safe environment for people to live in. This inspection was to check on progress and improvements made.

We found at this inspection people lived in accommodation that was suitable for their needs. Improvements had been made regarding maintenance, decoration and safety checks. This included making sure hot water was delivered at a safe temperature and the provision of new flooring, carpets, shower rooms and windows. A person who lived at the home told us the home was " A nice place to live now."

We spoke with nine people who resided at Abingdon and three relatives to find out what it was like to live at the home and how the staff provided the care and support people needed. A person said, "I am fine, its good and I can go out which I like."

We looked at different parts of the home and found a lack of maintenance. The hot water supply to the home was also not subject to safety checks to minimise the risk of scalds when bathing.

During the inspection we found people received effective, safe and appropriate care and support to meet their individual needs. People had a plan of care and a number of documents were in an easy read format. Care documents had pictures and signs to help people's understanding. The care documents provided the staff with the information they needed to support people with their individual needs. External health care professionals had been contacted, where needed, to ensure people's health and welfare.

At the time of the inspection we saw there were sufficient numbers of staff on duty to support people with their individual needs. Staff interviewed had a good knowledge of the care and support people needed. We saw staff accompanying people out from the home during the inspection to take part in their chosen activity.

Systems were in place to monitor and improve the service provision. People and their relatives had access to a complaints procedure, should they wish to raise a concern or comment about the service.

We spoke with people living at Abingdon and they were able to tell us about what it was like to live at the home and how staff provided care and support.

People told us the staff were "Kind and nice to be around” and they were pleased with the support they received at the home and that it was at the right level for them.

People told us the food was good and that there was plenty of choice. They also said they enjoyed getting involved with planning the menus and helping with the cooking and domstic tasks.

People said that they enjoyed the activities they took part in and that they had plenty of opportunities to go out with their friends, family and the staff. One person said, "I can make my own decisions about where I am going as long as I tell the staff what I want to do." People informed us that they did not get bored and that there was always something to do or some one to talk to. They felt this was an important part of their social care.

People said that the staff explained everything well to them. For example, asking people about what they wanted to do each day and the staff asking for consent on a daily basis when they gave personal care. A person said, “The carers ask me how I am each day and when I want help with a bath.” Likewise, another person stated, “I know why I need to have some one with me, it is to make sure I am OK and this has been explained to me.”

People said they liked living at the home and that they felt safe and comfortable with the staff. They told us that the staff were good and made sure they were “OK with what was going on each day.”

People told us they could speak up if worried about anything and that there was always someone to go to and to get things sorted.

In respect of medicine administration, people confirmed that their medicines were given on time and they could see a doctor when they wanted.

We asked people if staff asked them what they thought about the home. We were told, “Yes the staff listen to me”, “If I want something I ask”, “I am told everything” and “I can give my opinion and they listen.”

This announced inspection of Abingdon took place on 22 & 23 April 2015.

Abingdon is a care home offering a service to nine people who have a learning disability. The home is owned by Raglin Care Limited. The home is situated in a residential part of Southport with access to the town centre. The home is situated over three floors. The home has two large lounges, a dining room, computer/activities room and a large garden at the rear.

A registered manager was 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’.

People we spoke with told us they felt safe when staff supported them in and outside of the home. One person when asked if they felt safe said, “Of course, they (the staff) are my friends.”

The staff we spoke with told us they had received safeguarding adults training and were aware of what constituted abuse and how to report an alleged incident.

Our observations showed people were supported by sufficient numbers of staff. This was confirmed by people we spoke with.

We saw the necessary recruitment checks had been undertaken to ensure staff employed were suitable to work with vulnerable people.

We found medicines were administered safely to people. Staff had received medicine training and had their practice checked to ensure they had the skills and knowledge to safely administer medicines.

Care files showed staff had completed risk assessments to assess and monitor people’s health and safety.

Relevant health and safety checks for the building and equipment had been undertaken.

People at the home were supported by the staff and external health care professionals to maintain their health and wellbeing. A person said, “I see my dentist and if I feel unwell I see my doctor.”

The manager provided us with a staff training plan and this showed staff received training to ensure they had the skills and knowledge to support people. This included autism training to help understand and support people with autism. Supervision meetings and staff appraisals were on-going.

The manager informed us people who lived at Abingdon were supported to make key decisions regarding their care. We found the manager and staff knowledgeable regarding acting in people’s best interests. We saw this followed good practice in line with the Mental Capacity Act (MCA) (2005) Code of Practice.

People we spoke with were happy with the food and were involved in choosing the menus. People’s nutritional needs were monitored by the staff.

People at the home articulated their needs and wishes in different ways and our observations showed staff understood and responded accordingly. Communication aids and strategies were in place to support people.

Staff had a good knowledge of people’s care needs and support was provided in accordance with their support plan.

Staff were polite, patient, attentive and caring in their approach; they took time to listen and to respond in a way that the person they engaged with understood.

People told us they took part in a range of activities, some of which were organised social events in the community.

A process was in place for managing complaints. People who lived at the home and relatives told us they had confidence in the manager to investigate any concerns they had.

We received positive feedback about the manager from staff, people who lived at the home and relatives. Staff told us the manager was ‘approachable’ and ensured the home ran well.

Arrangements were in place to seek the opinions of people who lived at the home and their relatives, so they could provide feedback about the home.

Quality assurance systems were in place to monitor the quality of the service and improve practice.