This inspection took place on 7 February 2018. We requested additional information to be sent to us following the inspection which we received on 21 February 2018.

This inspection was unannounced. The inspection was conducted by an adult social care inspector.

At the last inspection of this service in 2015 the home was rated good. During this inspection breaches of legal requirements were found and home was rated 'Requires Improvement.'

Burton House is a care home for six adults that provides support and short breaks to young adults with autism/ learning disabilities and complex needs. Burton House is run by U&I Care Limited. It also provides day service support for a small number of people, which we do not regulate. The home is located in a residential area of Warrington. People staying at the home are supported by staff on a 24 hour basis. Each person has their own bedroom and shared communal areas. There are large well maintained gardens at the back of the house and parking at the front of the building.

Burton House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of our inspection there were two people living at the home permanently, and four people accessing the short break services.

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.' Registering the Right Support CQC policy.

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.

Staff recruitment checks highlighted that information was missing from a selection of files from staff who worked at Burton House. This did not demonstrate that robust recruitment checks were being undertaken by the provider when staff were starting working at the service. We checked the provider’s policy with regards to the recruitment and selection of staff and found the provider was not always adhering to their own procedures.

Quality assurance systems were in place and reviewed on a regularly basis. We saw support plans contained updates which had been hand written by staff if there was a change in support. The service had regular internal audits on service provisions as a whole which resulted in a red, amber , green (known as RAG) rating. Despite these audits taking place, some further improvements were needed to ensure the quality assurance procedure was effective as some issues we found in relation to best interests and staff recruitment had not been highlighted.

We saw that applications to deprive people of their liberties (DOLs) were being appropriately applied for. However, there was limited information with regards to decision making in general. Additionally, there was conflicting information within support plans with reference to what decisions people could make, and what required best interest involvement. We could not see any documented evidence of best interest involvement within the support plans viewed as the records were unclear. We have made a recommendation about this.

Medications were stored and administered safely by staff who had been trained to do so. Medication was clearly signed in and out by staff and the person’s family member if they were only at the home for a short stay period. There was no plan in for place for how to give medication which is needed as and wh

This inspection took place on 15/13/16 February 2015 and was arranged with short notice to ensure that people being supported were given the opportunity to meet us during this inspection.

Burton House is a care home for six adults that provides support and short breaks to young adults with autism/ learning disabilities and complex needs. Burton House is run by U&I Care Limited. It also provides day service support for a small number of people. The home is located in a residential area of Warrington, close to shops and other local facilities. People staying at the home are supported by staff on a 24 hour basis. Each person has their own bedroom and shared communal areas. There are large well maintained gardens at the back of the house and parking at the front of the building.

The home had a 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.

There were four people staying at the home on the day of our visit. We spoke with people staying at Burton House and relatives who acted on their family member’s behalf. They were happy with the care provided and the staff providing support. We observed relaxed and friendly relationships between the people staying at the home and the staff team members. Everyone staying at the home looked relaxed and comfortable with the staff.

Staff knew the people they were supporting and provided a personalised service during each person’s short break. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. Staff were knowledgeable about risks and how to protect each person in keeping them safe and comfortable during their stay.

Staff were up to date with training necessary for their role and felt well supported with their training needs. They had the skills, knowledge and experience required to support people with their care needs. Staffing levels were provided on a one to one basis to provide individual support for each person and the registered manager regularly reviewed staffing levels to offer flexibility in providing staffing numbers to meet people’s changing needs.

We found the home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and staff followed the Mental Capacity Act 2005 for people who lacked capacity to make decisions for themselves.

Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs during their stay.

We saw that people’s medicines were securely stored and safely managed. Staff were aware of the actions to take in the event of an error when giving medicines.

The registered manager was accessible and approachable. Staff, people who used the service and relatives felt able to speak with the registered manager and provide feedback on the service. The registered manager regularly made unannounced visits to the home to review the quality of the service provided.