Cavendish House provides accommodation, personal care and support for up to six adults who have a learning disability which may include epilepsy or autism.

We carried out this unannounced inspection on 23 August 2017. On the day of our inspection there were six people living at the home, although not everyone was receiving the regulated activity.

There was a registered manager in place. 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 assisted us with our inspection.

People were supported to see healthcare professionals regularly and they received the medicines they required. Medicines management systems were good. Staff maintained a safe environment, including appropriate standards of fire safety. There was a plan in place to help ensure people would continue to receive care in the event of an emergency.

People were encouraged to fully participate in the running of their home. Staff supported people to make their own decisions, be independent and live as normal a life as possible. People were involved in choosing what they wished to eat and were encouraged to participate in the planning, shopping and preparation of meals.

There was good management oversight of the home. Records were well organised, up to date and stored confidentially where necessary. People’s support plans were detailed and included guidelines to staff on how to provide the care and support people needed. This included addressing any potential risks to people. Accidents and incidents were recorded and action taken to help prevent reoccurrence.

People were cared for by a sufficient number of staff to meet their needs. Staff understood their roles in keeping people safe and protecting them from abuse. The provider carried out good pre-employment checks before staff started work.

People were supported by staff knew them extremely well and were competent in their roles. Staff had access to training and on-going support from their line managers. Staff acted within the principals of the Mental Capacity Act to ensure that the correct processes were followed with regards to decisions for people.

People were supported by caring staff who demonstrated their understanding in ensuring people were treated with respect. People’s privacy and dignity was maintained. People had access to activities both within and outside of the home. People maintained relationships with those close to them and the atmosphere in the house was very relaxed and family orientated.

There was an appropriate complaints procedure in place, written in a way people would understand. People told us they could speak to staff if they felt worried about anything.

Staff worked well together and told us there was a good culture within the home. Team meetings were used for staff to discuss all aspects of the home and resident’s meeting demonstrated people were included in decisions.

Staff made regular in-house checks on the service provided and the environment in which people lived. The Trust carried out their own regular audits to check people were receiving the service they should expect. Any actions identified were addressed.

Cavendish House is a Christian care home which provides care and support for up to five people who have a learning disability, such as autism. At the time of our visit there were five people living at the home.

There was not a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. There was a new manager who had begun the application process to become the registered manager. They were present during our inspection.

Staff treated people in a kind and caring manner and we observed people were given the dignity and respect they should expect.

People were safe living at Cavendish House as staff carried out appropriate checks to make sure that any risks of harm were identified and managed. For example, if someone wished to go out of the home. People’s care would not be interrupted in the event of an emergency and people needed to be evacuated from the home as staff had guidance to follow.

Staff understood the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) to ensure decisions were made for people in the least restrictive way to protect their human rights.

Staff were aware of their responsibilities to safeguard people from abuse and were able to tell us what they would do in such an event.

Staff were provided with training which allowed them to carry out their role in an effective way. It was evident staff had a good understanding of the individual needs and characteristics of people. This was confirmed by relatives and our observations on the day.

There were enough staff deployed in the home. This meant people were able to undertake their individualised activities each day.

People received their medicines in a safe way and were supported to self-medicate if they were able to. People were encouraged to eat a healthy and varied diet and were involved in choosing and buying the food they ate.

Appropriate checks were carried out to help ensure only suitable staff worked in the home.

People were supported to keep healthy and had access to external health services. Professional involvement was sought by staff when appropriate. However, we found not all records of appointments were recorded in a way it was easy for staff to see.

Staff encouraged people to be independent and to do things for themselves, such as help around the home, cook or shop.

Staff supported people in an individualised way. Activities were planned that meant something to people. For example, some people wanted to lose weight so they were helped to enrol at a gym. People were involved in developing their own care and support needs.

A complaints procedure was available for any concerns and relatives and people were encouraged to feedback their views and ideas into the running of the home.

Staff carried out a number of checks to make sure people received a good quality of care.

Staff felt supported by the manager and had the opportunity to meet regularly with each other as a team as well as on an individual basis.

At our inspection in June 2014, we found the provider had not met the regulations that related to recruitment and records.

We carried out this follow up inspection to check that the provider had taken the necessary action which ensured that their recruitment processes were robust and the records they kept that related to people were up to date.

We looked at two staff files and saw they both contained all the necessary information for safe recruitment. This included references, a health declaration and photographic evidence.

The records held that related to people who used the service had been updated and we read in two support plans that risk assessments had been reviewed.

We carried out an inspection at Cavendish House to look at the care and treatment that people who used the service received.

As part of our inspection we spoke with two staff and one relative. We were able to speak to all of the five people who lived in the house; however at the time of our inspection only two were receiving personal care.

The inspector considered our inspection findings to answer questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

Is the service safe?

We saw that people lived in a safe environment. The service was clean and hygienic and people were able to move around the home and garden freely without any risk of harm.

We found that the provider had not obtained all the necessary information on staff to ensure that they were suitable to work with vulnerable people.

Is the service effective?

Our observations told us that staff had a good understanding of people's needs. However, we found that people’s care plans were not up to date or written in a person centred way.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people.

People's preferences, interests, and diverse needs were provided. We saw how one person liked to spend their time in the garden, whilst another preferred to watch television or take part in some baking.

Is the service responsive?

Staff were attentive and supported people when they needed assistance.

Is the service well-led?

We saw that there were weekly meetings for the people who lived in the house. The provider did not send out formal questionnaires to relatives, but we were told that relatives were very involved and they (staff) spoke to them on a regular basis.

Checks were completed in the home. These included health and safety, fire and maintenance to ensure the environment that people lived in was safe and appropriately maintained.

People's needs were assessed and care and treatment was delivered according to people's needs and expectations.

People who used the service had been living there between ten and seventeen years. They told us they were well settled and enjoyed living in the village and being part of the community.

People told us they felt safe living in the home and said they would feel confident to discuss any problems or issues with the manager and staff team.

We saw the home was well maintained and presents a homely environment. Individual accommodation was personalised and reflected peoples hobbies and interests.

There were enough qualified, skilled and experienced staff employed to meet people's needs. Staff told us they enjoyed working in the home and felt they had the necessary training to undertake their roles.

People told us that they had been living in the home for many years and that they liked it very much. They told us that they were able to access all the community amenities and that they had recently produced a pantomime for local people in the community hall.

People told us that they had a good staff team to support them with their daily living skills.

One person told us that staff supported them to attend Crawley College, and that this was very important to them.

One person told us that the people living in the home were their friends and that they liked going to the caravan on holiday.

People told us that they were good at planning their meals and doing the home's shopping. They told us that they followed a healthy eating plan and knew what food was a good choice.

We were told that some people enjoyed doing voluntary work in the community including helping teach sign language and preparing meals on wheels.

People told us that there were always sufficient staff available to take them to their planned activities and to help them maintain contact with their family and friends.

Staff told us they enjoyed working in the home.

There were five people living in the home during our visit. On the first day the manager was alone in the home and we were told that all the people living there were out attending various day activities. We spent some time talking to him and gaining an overview of the service and the facilities offered.

We arranged to return to the home the following day to meet and talk with people who were engaging in home based activities.

People told us that they had been living in the home for several years and consider it their home from home. They told us that they have full involvement in the home’s routine and are consulted regarding all activities and events.

People told us that they help with shopping and help cook meals. They told us that they use public transport independently and work in the local charity shop.

We saw people interacting with each other and staff in a relaxed and confident way.