This inspection took place on the 14 December 2016 and was unannounced.

Russell Villa is a care home that provides accommodation and personal care for up to 10 adults with learning disabilities and autism. Accommodation is divided into three separate units that includes the main house, where up to eight people reside, and two self-contained flats, which are both single occupancy. There were seven men using the service at the time of our inspection.

At the last inspection in January 2015, the service was rated Good. At this inspection we found the service remained Good.

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 and associated Regulations about how the service is run.

Improvements had been made to the effective question and we have revised this rating to good. Russell Villa had undergone refurbishment and redecoration since our last inspection. People lived in a safe environment that was furnished according to their needs and choices. Arrangements for staff supervision had been strengthened in order to monitor their practice and performance more effectively.

The provider’s training programme was designed to meet the needs of people using the service. Staff had the knowledge and skills they required to support people with autism. Training included supporting people who presented behaviours that could result in harming themselves or other people. This helped staff to manage situations in a consistent and positive way, and protect people's dignity and rights.

Detailed assessments were carried out before people moved into the service. People had personalised support plans that were accurate and up to date, reflecting the care and support they needed. Plans identified any associated risks to their health and welfare. Where risks were identified, there was comprehensive guidance on the ways to keep people safe in their home and in the community.

People's care records recognised their rights and were person centred. People were 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 supported this practice.

People were treated with respect and dignity and staff were knowledgeable about their needs, preferences and interests. Staff knew how to recognise and report any concerns they had about the care and welfare of people and how to protect them from abuse. People were supported by adequate numbers of staff who had been safely recruited. Staffing was managed flexibly so that people received their care and support when they needed it.

People were involved in planning and preparing their meals according to their choices. Healthcare needs were monitored and people had access to the services they needed. Referrals were made to other professionals as necessary to help keep them safe and well. Medicines were managed safely and people had their medicines at the times they needed them.

People took part in activities they liked or had an interest in and maintained relationships with people that mattered to them. People decided how they spent their time and staff supported their choices and independence. Pictorial aids were available for those who needed support with communication.

The manager and provider encouraged feedback from people who used the service, relatives, and staff and this was used to improve their experience at Russell Villa. People knew how to complain and told us they would do so if required. Procedures were in place to monitor, investigate and respond to complaints.

There was a thorough and wide ranging system of checks and audits to monitor and assess the quality of the service. Actions arising from these checks were followed up. The s

This visit was an unannounced follow up to an inspection we made on the 29th October 2013. At that time we made two compliance actions; one related to the lack of individualised and appropriate opportunities for social activities for people who used the service. The second related to the access that people had to parts of the building because of the locked doors; in addition the building was not adequately maintained.

A compliance action meant the provider was non-compliant with the law. We required the provider to produce a report setting out how and when they would become compliant, which they did, and we visited again on the 11th February 2014. Following our visit to the service we considered they had done enough to comply with the law and have therefore removed both compliance actions made previously.

We did on this inspection check aspects which related to medication. We considered the administration of medication met all requirements. However, staff authorised to administer medication had not completed refresher training within the timescale required. This was despite the provider being reminded at the last inspection this was an issue. Therefore we have made a compliance action that the provider had not taken sufficient steps to ensure the safety of people who used the service from the risks associated with the management of medication.

Russell Villas provided accommodation for up to eleven young men who required accommodation and personal care, and had learning difficulties and/or were on the Autistic spectrum. Some of the behaviours the young men exhibit can be challenging and therefore some required one to one support from staff.

We were not able to talk in a meaningful way to many of the people who used the service as they had limited verbal communication. Instead we used our SOFI tool to observe interactions between people who used the service and staff. In general, staff were aware of people’s needs and responded accordingly.

We did have concerns about the home and have made two compliance actions. The first related to the activities offered to people who used the service. The second related to the general standards of the environment and the use of locked doors as a way of managing behaviours. We have asked the provider to supply us with an action plan of how they are going to address these issues. We will also visit the service to make sure that the actions they plan to take are implemented.

The previous manager of the service left in the summer months. The provider had appointed a new manager although they were not yet registered with the Care Quality Commission. The previous manager's name therefore still appears on this report. However, in referring to the manager in this report we are referencing the person who was in day to day charge of the home.

We spoke with five out of the ten people who currently use the service and one of their relatives who was visiting the home at the time of our inspection. Most people told us they were happy with the care and support provided at the home and that they felt safe living at Russell Villa. People also told us that staff were kind and caring and that they were supported to develop their independent living skills. During our inspection we saw staff treated the people who use the service with respect and kindness, and encouraged people to do as much for themselves as they were willing and capable of doing safely. Typical feedback we received from people who use the service and a visiting relative included: “I am happy living here”, “things have improved a lot at the home, which I put down to the manager; who is excellent” and “there's a good stable staff team here who do a great job looking after my son”.

We also saw work to improve the physical environment of the home was well underway. We saw evidence that people received effective and safe care from suitably trained and experienced staff that were clearly familiar with individual’s needs and preferences of the people they supported. It was also evident that the provider had effective systems in place to routinely assess and monitor the quality of service that people received.

The feedback we received from people we spoke with during our visit was on balance relatively positive about what it was like to live at Russell Villa. Typical comments people made, included: “Its okay here” and “Although I want to move out now I did enjoy my time here”.

It was evident from other comments we received that people who live at Russell Villa are encouraged to make informed choices about every aspect of their life’s and have opportunities to influence how their home is run. It was positively noted that a person using the service who requested to look at their care plan was immediately provided with a copy. Typical feedback made by the people using the service, included: “Staff do listen to me”, “You can choose what you eat here”, “I am going to have sausages for my lunch today because I have told staff I do not like fish pie”, and “The staff know I do not like broccoli so they never give it to me”.

It was also evident from comments made by people we met and practices observed that care staff who work at Russell Villa treat everyone with respect and courtesy. Typical feedback we received, included: “Staff always knock on my bedroom door before coming in” and “I like my key-worker and the manager”. Throughout the course of our visit it was positively noted that staff were always observed knocking on peoples bedroom doors to seek the occupants permission before entering. If no answer was received the staff would not enter.

The feedback we received from people we spoke with about the opportunities they had to join in meaningful activities and to pursue their social interests was also very positive. Typical comments made by people we met, included: “I go out lots”, “I go food shopping with staff sometimes and today I bought a paper”, and “Sometimes we go to the pub with staff”. During our visit the vast majority of people using the service were seen being actively encouraged and supported by staff to participate in all manner of interesting social activities, both at home and in the wider community.

Furthermore, it was positively noted that staff actively encourage and support people who live at Russell Villa to do as much for themselves as they are willing and able to do safely. For example, during a tour of the premises we observed staff supporting a person using the service vacuum the upstairs landing and another individual being encouraged to help staff prepare lunch for everyone in the kitchen. One person we met told us: “I go food shopping with staff sometimes”.

Everyone we spoke with who lives at Russell Villa told us they felt safe living there and able to talk to staff if they were unhappy about anything.

People told us they had their own bedrooms and liked the way they were decorated and furnished. Typical comments we received, included: “I have everything I need in my bedroom” and “I like my bedroom”.

However, all the positive made above notwithstanding we did receive some negative comments from people we spoke with about the decorative state of the home. There have clearly been delays in addressing some of the homes maintenance issues. In future CareTech must not allow Russell Villa to get into such a poor state of repair before it considers taking action to remedy any structural or environmental defects.

Furthermore, during lunch we also noticed that none of the staff took this opportunity to sit and talk to the people using the service. Staff who were supporting people in the dinning during lunch either remained standing or positioned themselves some distance from the dinning table. On balance we felt this was a missed opportunity for staff to make the mealtime a much more positive and social experience for everyone who lives at Russell Villa.

This inspection took place on the 15 and 19 January 2015 and was unannounced. At our previous inspection in February 2014, we found the provider was not meeting the regulation in relation to the management of medicines. Following this inspection the provider sent us an action plan to tell us the improvements they were going to make. During this inspection we looked to see if these improvements had been made.

Russell Villa is a care home that provides accommodation and personal care for up to ten adults with learning disabilities and autism. Accommodation is divided into three separate units that includes the main house, where up to eight people who use the service reside, and two self-contained flats, which are both single occupancy. There were nine men using the service at the time of our inspection.

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 and associated Regulations about how the service is run.

The provider had improved the way medicines were managed and people received their medicines safely and as prescribed because staff had undergone further training.

Staff had a good understanding of how to keep people safe and felt confident to act on any concerns they should have. The provider’s recruitment and employment processes were robust and protected people from unsafe care.

Russell Villa had been undergoing refurbishment and redecoration for many months and home improvements were still in process at the time of this inspection. Although the environment was safe, some people’s bedrooms were not suitably maintained and lacked personalisation.

Staff received the training they required to meet people’s needs and undertake their roles and responsibilities. However, not all staff had received regular supervision to montior their practice and performance. The provider had begun to address these issues and implemented a new system for supporting staff.

Staff understood people’s rights to make choices about their care and support and their responsibilities where people lacked capacity to consent or make decisions. This was because they had received training on the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). People’s rights were being protected as DoLS applications were in progress where required and had been submitted to the relevant local authorities.

Care plans contained personalised information to ensure staff knew how to support people and meet their needs. People were provided with a range of activities in and outside the service which met their individual needs and interests. They were actively involved in deciding how they spent their time and pictorial aids were available for those who needed support with communication.

People using the service had their care needs kept under review and any changes were responded to and addressed promptly and appropriately. Assessments were undertaken to identify risks to people and plans were in place to manage these risks.

Staff were kind and caring and gave people the time and attention they needed. Staff knew the importance of promoting people’s privacy and dignity and respecting people’s diverse needs.

People were supported to keep healthy. Any changes to their health or wellbeing or accidents and incidents were responded to quickly. A wide range of health and social care professionals were involved in people's care to help keep them safe and well. Others close to them, such as their family members, were also involved.

Systems were in place for people and their relatives to raise their concerns or complaints.

There was an open and inclusive atmosphere in the service. The management structure in the home provided staff with clear lines of responsibility and accountability. People that used the service and staff told us they found the manager to be approachable and supportive. Staff were able to challenge when they felt there could be improvements.

The provider had a number of audits and quality assurance programmes in place. These included action plans so the provider could monitor whether necessary changes were made.