At our last inspection in February 2016 we rated the service as outstanding. At this inspection we found the evidence continued to support the rating of outstanding in the Caring domain and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. The rating for the Well Led domain has reduced to ‘Good’ because the provider’s quality assurance processes had not promoted continuous improvement within this home, for example to work towards outstanding in other areas or taken the learning from this home to develop their other services.

This inspection took place on 06 November 2018 and was unannounced.

Barnett Wood Lane - Care Home Learning Disabilities is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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.

Barnett Wood Lane is registered to provide accommodation and personal care for up to six adults who have a learning disability. At the time of our inspection three people lived there. The service is delivered from a two-story house in a residential area.

It is a requirement of the provider's registration that they have 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. The registered manager was present during this inspection.

Barnett Wood Lane continues to have a rating of outstanding in the care domains, with an overall good rating across the service.

People continued to be supported by kind and caring staff. Peoples independence was well promoted and supported by the staff team. Staff have worked here for many years, and have built caring relationships with people and enjoy their company. People are provided with the care, support and equipment they need to stay as independent as possible. People were supported to stay safe. Risks to people’s health and safety, including the risk of abuse were identified and well managed. People’s medicines were managed in a safe way, and they received them when needed. The home was kept clean by the staff team, with the help of the people who lived there. Accidents and incidents were reviewed by the registered manager and staff team to minimise the risk of them happening again.

Peoples needs were assessed before they came to the home, to ensure that the staff and environment could meet those needs. There are a sufficient number of staff deployed to meet people’s needs. A robust recruitment and selection process is in place. This ensures prospective new staff have the right skills and are suitable to work with people living in the home.

People have enough to eat and drink. People are involved in menu planning and food shopping, so they have the food they like. People have access to health care professionals when the need arises, as well as for routine check-ups to keep them healthy. Where people lacked the capacity to make specific decisions, the stuff understood and followed the requirements of the Mental Capacity Act 2005. This ensured that decisions made for people in their best interest and any restrictions put into place to keep them safe were done in a lawful way.

Care records were comprehensive and give a detailed description of the person, and their individual needs. Staff provid

Barnett Wood Lane provides accommodation and personal care for up to six people who have a learning disability or autistic spectrum disorder. Three people had a sensory impairment, and one was living with the experience of dementia. The home had been well adapted to meet people’s needs, such as having shower rooms for people to avoid the use of a hoist for having a bath, doorways being clearly marked and signed, and flooring being free from complex patterns, or shiny surfaces that may confuse people. Although adaptations had been made around the home, it still felt homely and individualised to the people that lived here.

There was 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.

The inspection took place on 16 February 2016 and was unannounced. At our previous inspection in September 2013 we had identified no concerns at the home.

There was positive feedback about the home and caring nature of staff from people and relatives. One relative said, “Staff are all fantastic”. An advocate said, “They take into account residents views and make a great effort to make sure they enjoy life. It’s very residents focused.” A comment from a psychologist read, “I can honestly say that the care that (registered manager) and her staff provided to (resident) was the most outstanding I have ever witnessed.”

The registered manager had established a culture in the home that put people at the centre of the home. The registered manager was not present at the time of our inspection. However the staff were aware of, and understood, the high standard of care expected by the registered manager and ensured that they adhered to this despite her absence at the inspection. They were confident and knowledgeable in their ability to support and care for people and their passion for supporting people live a fulfilled life was evident throughout the inspection.

The staff were exceptionally kind and caring and treated people with dignity and respect. Good interactions were seen throughout the day of our inspection, such as staff holding people’s hands and sitting and talking with them. Staff went out of their way to make sure people enjoyed life, or support them through times of illness. People were relaxed and happy with the staff and it was clear that caring relationships had developed between them. People could have visitors from family and friends whenever they wanted.

People were safe at Barnett Wood Lane. Although there was a small staff team there were sufficient staff deployed to meet the needs and preferences of the people that lived there. An advocate said, “They cover the home well.” The staff team had worked at the home for many years and were very positive about their enjoyment of the job and the people they support.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff worked on the premise of how people could be supported to do fun, but risky activities, rather than trying to stop people doing things they liked due to ‘health and safety’. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building, in a format people could understand. Each person had a plan which detailed the support they needed to get safely out of the building in an emergency.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff receive

Barnett Wood Lane had four people living there. On the day of our visit one person was at the home. Staff told us that two of the people were out for lunch, they returned briefly before leaving to collect the other person who was at a day centre. We spoke with two people. Due to the nature of the individual’s learning disability we were able to gather limited comments with the support of staff.

People told us they were “happy” and they were “safe”. We saw that people looked happy and relaxed in the presence of staff. Staff told us that three of the people had lived in the home for 18 years and another person had recently moved into the home.

We looked around the home which was clean, comfortably furnished and free from unpleasant odours. One person was happy for us to look at their room. Their bedroom was personalised with photographs, books, TV’s and pictures.

We also spoke with three staff. We spent time observing how staff interacted and supported people. We saw staff treated people in a sensitive, respectful and professional manner.

Some of the people who used the service had complex learning disabilities therefore they were not able to respond to our questions independently. We spoke with two people who were supported by members of staff during our discussions.

One person told us that they made choices every day. They told us that they chose the activities they wanted to do and how they wanted to spend their days. They told us that they liked football and had recently been to Wembley with their key worker to watch England play. They said that they liked cooking and choosing their bed times. They were able to convey, “I got to bed at 11 o’clock and get up at 10:00.”

One person who used the service told us that they were happy living at the home. They said they “Would tell the manager” if any one had treated them badly. We observed staff interacting with people who used the service in a respectful manner, calling people by their first names and offering choices.

People’s diversity, values and human rights were respected. We saw that the religious needs of people who used the service had been recorded in the two care plans that we reviewed during the inspection.