About the service: Cauldon Place is a residential care home that was registered to provide personal care to 25 people that may have a learning disability. The service was also registered to provide support to people living in the community in their own homes. At the time of the inspection 24 people were living in the home and three people were supported in the community. Not everyone using Cauldon Place received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Cauldon Place was not originally designed with the principles of Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion, so that people with learning disabilities and autism using the service can live as ordinary life as any citizen. The registered manager ensured that care was responsive to people’s needs and people could be assured that they had choice and control over their care.

People’s experience of using this service:

Notifications were not always submitted as required. This is a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

Although plans were in place to monitor people’s safety, we found that the actions from these plans weren’t always documented. We have made a recommendation that the provider strengthen their systems around recording of these checks.

Where people did lack capacity under the Mental Capacity Act 2005, the best interest process was not clearly evidenced. We recommend that the MCA documentation is strengthened to ensure all areas of the process is evidenced.

People told us that they felt safe.

People could be assured they received their medicines as prescribed and there were enough safely recruited staff to meet people’s needs.

People’s needs were assessed to identify the support they required and people told us that they liked the food.

People were supported to access healthcare services and staff worked with other agencies to provide effective care.

People were able to personalise their rooms as they wished.

People were treated with kindness by staff and were supported to make decisions about the care they received.

People had their privacy protected and independence promoted.

People received personalised care responsive to their needs and knew how to make a complaint if necessary.

The registered manager was approachable.

More information is in the full report.

Rating at last inspection: Requires improvement, report published 12 July 2017

Why we inspected: This was a planned inspection based on previous rating.

Enforcement: We found there was a breach in Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the end of the full version of this report.

Follow up: We will continue to monitor the service through the information we receive and schedule our next inspection as appropriate.

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

This inspection was unannounced and took place on 17 and 19 May 2017.

Cauldon Place provides accommodation and personal care for up to 25 people who have a learning disability. These numbers included personal care for three people living in their own home. On the days of the inspection 24 people were using the service.

The home had a registered manager who was present on the second day of the inspection. 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 were not always supported appropriately to take their prescribed medicines and this placed their health at risk. People felt safe living at the home and staff knew how to protect them from potential abuse. The risk of harm to people was reduced due to the support they received from staff. People were supported by sufficient numbers of staff who were recruited safely.

The provider had systems in place to monitor the quality of service provided to people but they were ineffective in identifying discrepancies with the management of medicines. People were given the opportunity to tell the provider about their experiences of using the service. Staff felt supported by the registered manager to carry out their role.

People were cared for and supported by staff who had access to training and who were supported in their role by the registered manager to provide an effective service. People were supported to make their own decisions and their consent for care and support was obtained by staff. People had access to a choice of meals and had access to drinks at all times. People were supported to obtain the necessary healthcare services when needed to promote their health and wellbeing.

People were supported by staff who were caring and attentive to their needs. People were encouraged to be involved in decisions about their care so their care and support preferences were met. People’s right to privacy and dignity was respected by staff.

People’s involvement in their care assessment and reviews ensured they received a service the way they liked. People were supported by staff to pursue their interests and staff respected their diverse needs. People were aware of how to share their concerns, which were listened to and acted on.

We inspected Cauldon Place on 23 March 2015 which was unannounced.

Cauldon Place provides accommodation and support for up to 25 people who predominately have a learning disability. The service supports people within ten flats, three that are shared and seven flats with single occupancy. At the time of our inspection there were 25 people who used the service.

The service had 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.

People’s capacity had been assessed and staff knew how to support people in a way that was in their best interests. Staff had a good knowledge of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). The Mental Capacity Act 2005 sets out the requirements that ensure, where appropriate, decisions are made in people’s best interests when they are unable to do this for themselves. We found improvements were needed to the way the provider reviewed Deprivation of Liberty Safeguards.

People told us that they felt safe and staff understood the procedures to follow to keep people safe.

People’s risks were assessed in a way that kept them safe whilst promoting and maintaining their independence.

People who used the service received their medicines safely. Systems were in place that ensured people were protected from risks associated with medicines management.

We found that there were enough suitably qualified staff available to meet people’s needs in a timely manner.

People were supported to eat and drink sufficient amounts and staff ensured that people’s nutritional needs were assessed and monitored.

People told us that staff were kind and caring. We saw that staff treated people with respect, gave choices and listened to what people wanted.

People told us they were involved in hobbies and interests that were important to them. People were involved with the planning of their care and care was provided in a way that met their preferences.

The provider had a complaints procedure that was available to people in a format that they understood.

Staff told us that the registered manager was approachable and led the team well. The provider had a system in place to recognise and promote good practice within the service.

People were encouraged to be involved in the improvement of the service and provide feedback. The registered manager had systems in place to monitor and assess the quality of the care provided.

Cauldon Place is registered to accommodate up to 25 people. The building is separated into different units each had its own sitting room, kitchen and bathrooms. There were five bedrooms to each unit. Staff usually worked on the same unit, but could be called on to assist other units. In addition the home had a number of single occupancy flats where people have their own facilities and dedicated staff who provided support to enable people to live independently.

People who used the service were able to make choices about their care, treatment and support. Where people’s liberty was restricted legislation had been followed and people’s rights had been protected.

Care and support had been planned in a way which met individual’s needs. Risk assessments and care plans were regularly reviewed. A person who used the service told us, “My staff are nice, they help me”.

We saw that the home was clean and tidy. Staff understood the principles of infection prevention and control.

Staff told us they enjoyed working at Cauldon Place and believed they were supported and valued by their managers and the organisation. A member of staff said, “I really enjoy working here. I feel that I’m making a difference to people’s lives”.

The provider had systems in place to enable them to monitor and assess the quality of service provided.

We carried out this inspection to check on the care and welfare of people using this service. The inspection was unannounced which meant the provider and the staff did not know we were coming.

We spent time observing the care provided and spoke with eight people who lived in three of living accommodations within Cauldon Place. Some people were unable to tell us about their experiences due to their learning disability so we spent time observing the support they received from staff. We also spoke with five members of staff and the registered manager.

We saw people received the care and support that met their individual needs. We saw that people looked relaxed and comfortable in their home and staff interacted with people in a positive and respectful manner.

People had individual care records which informed staff of how people wanted to be supported and they were written in a style that people could understand.

We saw that people using the service were encouraged to be independent and helped with cooking, making drinks, and looking after their home. People told us they enjoyed many social activities including going to college, athletics, football and swimming. This meant people were involved in everyday ordinary activities of their choosing.

Each part of the service was managed independently and people lived in a flat or house. People were able to have a key to their home and told us they were able to choose how to decorate their home and their bedroom.

We carried out this review to check on the care and welfare of people using this service. We visited Cauldon Place in order to up date the information we hold and to establish that the needs of people were being met safely.

There were 23 people living at Cauldon Place when we visited on 2 February 2012. The visit was unannounced which meant the provider and the staff did not know we were coming.

Cauldon Place, a learning disability service, had nine separate flats each accommodating between one and five people. Each flat had its own staff group. Many of the people living at the home were out during our visit. Staff told us that people were at college, voluntary work placements, shopping and one person had gone on a day trip to London. We saw that some of the people who were home were watching TV, knitting, listening to music or sat talking with staff.

Some people were not able to express themselves verbally. Where people were not able to express their views to us we observed interaction between people and staff and we observed that staff were aware of how they made their needs known. We saw that people were relaxed and were able to express themselves in words and gestures. We saw staff reassuring people who appeared anxious or concerned.