About the service:

The Care Home for Special Needs is a care home for up to 4 people who have a learning disability or autism spectrum diagnosis. At the time of the inspection 2 people were living at the service.

People’s experience of using this service:

The care people received was safe, although not all environmental checks had been carried out. Risks to people were assessed although not all associated risks were identified. Staff training was not always updated to ensure their knowledge was current.

There were limited staff resources in place at the service which had impacted when not all of the staff team were available. During this time people had received the care and support they needed, however during this time there had been limited oversight of the service. This meant environmental checks had not been completed and care records had not been updated.

People’s experience of using the service was positive. People told us, “I like living here. The staff are nice and kind to me.” People were protected against avoidable harm, abuse, neglect and discrimination. Staff received supervision and support.

Care was person-centred and focused on people being as independent as they could be. The ethos of the service was a Family and this was promoted. The care was planned and delivered based on people’s needs and preferences. The management team embraced new ways of working. Staff felt valued and the culture was open and honest. Staff we spoke with provided positive feedback about the service and the provider. The staff were committed to ensuring improvements continued to ensure the best care for people who lived at the Care Home for Special Needs.

Rating at last inspection: At the last inspection the service was rated Good. (The last inspection report was published on 11 March 2016.) At this inspection the safe and well-led area requires improvement making the service requires improvement overall.

Why we inspected:

This was a planned comprehensive inspection scheduled to take place in line with the Care Quality Commission (CQC) scheduling guidelines for adult social care services.

Follow up:

We will review the service in line with our methodology for services which are rated 'Requires Improvement'.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Our inspection was unannounced and took place on 04 February 2016. The inspection was carried out by one inspector.

The provider is registered to accommodate and deliver personal care to a maximum of four adults who lived with a learning disability. At the time of our inspection three people lived at the home and one person visited the home for day care.

At our last planned inspection of November 2013 the provider was meeting all of the regulations that we assessed.

The registered provider is also the manager. 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 and their relatives told us they felt safe and that staff treated them well. The manager and staff understood how to protect people they supported from abuse, and knew what procedures to follow to report any concerns.

Staff had a good understanding of risks associated with people’s care needs and knew how to support them. There were enough staff to support people safely and provide people with support in the home and whilst outside of the home. Recruitment procedures made sure that only staff of a suitable character to care for people were employed.

Medicines were stored and administered safely, and people received their medicines as prescribed. People were supported to attend health care appointments when they needed to and received healthcare that supported them to maintain their wellbeing.

The manager and staff understood the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), and supported people in line with these principles. People were supported to make everyday decisions themselves, which helped them to maintain their independence. When they were not able to make these decisions relatives and healthcare professionals were consulted for their advice and input.

People were supported to eat and drink food that met their dietary requirements and that they enjoyed eating. People were supported to pursue their hobbies and interests both within and outside of the home. Activities were arranged according to people’s individual preferences, needs and abilities.

Staff felt that they had received adequate training to ensure that they had the skills and knowledge they needed to provide safe and appropriate support to the people who lived at the home.

Complaints systems were available for people to use if needed. Arrangements were in place to monitor the service and ensure that people received a caring and personalised service.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People's capacity to make decisions was reviewed against each plan of care and people's relatives were involved in planning people's care where this was appropriate.

We found that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People told us that they were well looked after at the home and we noted that people looked comfortable with staff that supported them. Risks presented by people's needs and conditions had been assessed and plans were in place to manage risks in a way that balanced safety with independence. People had access to health services and the home worked with local health care specialists to meet people's needs.

The design and layout of the premises was a traditional Victorian town house, close to a local park and we noted that people made use of this with staff support. The home was well decorated, kept in good repair, homely, warm, clean and well lit. We found that people were protected against the risks associated with unsafe or unsuitable premises because installations were regularly serviced.

People had the specialist equipment that they needed to promote their health and independence and it was kept in good order. Equipment including fire safety equipment and electrical appliances were maintained in a safe condition.

When we visited the service on 24 August 2012 we met the two people who were living in the home at that time. People did not talk to us at length because of their complex needs and conditions or because they did not want to on that day. They did tell us that they liked living at the home. They said they had their own room and that people were nice to them. They told us that care workers looked after their medication for them and helped them to wash and dress. They said that the food was good and that they went away to the caravan owned by the provider. People talked about regular contact with their families.

We used other methods to understand people's experience of the service including

reviewing records and talking to workers. We spent three hours in the communal areas of the home observing how workers cared for and supported people. We saw that care workers and the manager treated people with respect and spoke to them with warmth, friendliness and good humour. Workers were able to communicate with people because they knew them well and people looked well cared for and at ease with their care workers.