People were supported by safely recruited staff who had the skills and knowledge to provide effective support. People were supported safely to manage risks to their health and wellbeing and risks associated with medicines. Effective care planning was in place which guided staff to provide support that met people’s diverse needs and in line with their preferences.

People who used the service were supported safely whilst staff promoted their independence. People were supported by caring and kind staff who promoted choices in a way that people understood. People’s right to privacy was upheld.

People were supported to be involved in hobbies and interests that were important to them. Complaints systems were in place, which people and relatives knew how to use. Advance planning was in place to ensure people’s end of life wishes were gained.

Systems were in place to monitor the service, which ensured that people’s risks were mitigated and lessons were learnt when things went wrong. There was an open culture within the service, where people and staff could approach the manager who acted on concerns raised to make improvements to people’s care.

The service met the characteristics of Good in all areas; more information is available in the full report below.

Rating at last inspection: Good (report published 9 February 2016)

About the service:

63 Hoveringham Drive is a residential care home that accommodates up to six people living with learning disabilities or autistic spectrum disorder. At the time of our inspection there were six people living at the home. 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.

Why we inspected:

This was a planned inspection based on the rating of Good at the last inspection. We found the service continued to meet the characteristics of Good in all areas.

Follow up:

We will continue to monitor the service through the information we receive.

We inspected this service on 16 December 2015. This was an unannounced inspection. Our last inspection took place in July 2014 and at that time we found the home was meeting the regulations that we checked them against.

Choices Housing Association Limited - 63 Hoveringham Drive is registered to provide accommodation and personal care for up to six people. People who use the service have a learning disability and/or a mental health condition. At the time of our inspection six people were using the service.

The service 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 and associated Regulations about how the service is run.

People’s safety was maintained because risks were assessed and planned for and the staff understood how to keep people safe. People’s medicines were managed safely, which meant people received the medicines they needed when they needed them.

There were sufficient numbers of suitable staff to meet people’s needs and promote people’s safety. Staff received regular training that provided them with the knowledge and skills to meet people’s needs.

People’s health and wellbeing needs were met and people were supported to attend health appointments as required. People could access suitable amounts of food and drink that met their individual preferences.

Staff showed they understood and applied the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This ensured decisions would be made in people’s best interests if they were unable to make decisions for themselves.

People were treated with kindness, compassion and respect and staff promoted people’s independence and right to privacy.

People were involved in the assessment and review of their care and staff supported and encouraged people to access the community and participate in activities that were important to them.

People’s feedback was sought and used to improve the care. People knew how to make a complaint and complaints were managed in accordance with the provider’s complaints policy.

There was a positive atmosphere at the home and people and staff were supported by the registered manager.

The registered manager and provider regularly assessed and monitored the quality of care to ensure standards were met and maintained. The registered manager understood the requirements of their registration with us.

This inspection was carried out by a CQC inspector. We spoke with four people who used the service, two relatives, two staff members, the registered manager and a health care professional. We also reviewed records relating to the management of the home which included two care records, daily care records, medication records, staff files and training records and minutes of meetings. We used the information to answer the five questions we always ask:

Is the service safe?

A robust safeguarding procedure was in place. The provider used imaginative ways of involving people in awareness of safeguarding to ensure they were safe

Recruitment practice is safe and thorough. Staff had appropriate induction and training prior to working with people who used the service. No staff had been subject to disciplinary action. Policies and procedures were in place and available to staff. This ensured good practice and also that people were safe.

Risk assessments were in place for each person for aspects of daily living. Assessments had been reviewed regularly to ensure that staff were aware of any changes in relation to risk and to provide information for staff to be aware of the current risk profile for each person using the service.

We saw people received effective and safe support to take medicines they had been prescribed, because detailed and accurate records were kept and monitored closely by senior staff. Staff received regular competency tests to ensure they continued their level of knowledge and competency to administer medicines.

We monitor the operation of the Deprivation of Liberty Safeguards (DoLS) that apply to hospitals and care homes. The service had procedures in place and the manager knew how to apply for this authorisation. We found that applications had been made under DoLS procedures for each of the six people who used the service. The service was waiting for replies from the best interests team of the local authority in relation to their applications.

Is the service effective?

People's health and care needs had been assessed and care records reflected the correct level of support people needed. Referrals to a range of health care professionals had been made. A visiting professional told us the service worked closely with them in providing a coordinated plan of care and treatment.

We saw that the views and comments of people and their relatives were expressed in written reviews and their plans of care had been updated.

We saw the service considered the needs of people with physical, sensory and memory impairments and offered support to improve the quality of the service they received.

Is the service caring?

A relative spoke with us about the level of service saying, "X has been here for several years. It is the best thing that ever happened to them. The staff are marvellous and they really care."

People were supported by kind and attentive staff. We saw examples of staff protecting people's privacy and dignity. Some people needed support to express their views and wishes due to limited verbal skills. Staff told us people expressed their views with body language, facial expressions, sounds and movements. Staff were able to demonstrate positive communication with people. We saw that all people were included in conversations and activities that took place, regardless of their communication needs.

People using the service, their relatives and friends completed an annual satisfaction survey. They all expressed high levels of satisfaction across the service, including relationships with staff. All people using the service and six relatives had returned the questionnaires sent to them.

Is the service responsive?

A person's needs had changed significantly and continuously in the short time they had lived at the home. We saw from records and speaking with staff that the service had responded to the changing needs and complex health care needs of the person. The service had worked well with other agencies to provide a care and treatment regime to continue to meet the person's health and social care needs. This was confirmed by a health care professional we spoke with. Additional specific training had been provided for staff.

The service sought people's views through questionnaires, monthly meetings and individual reviews. We saw from meeting minutes and audits that proposals and suggestions raised by people were listened to and implemented.

Records confirmed that people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes. People were supported to maintain relationships that were important to them. We saw that this included family contacts and relationships with people in other locations they had close relationships with.

Is the service well-led?

The service worked well with other agencies to ensure that people received their care in a seamless way.

Staff worked alongside the registered manager. They had an open dialogue and told us they could raise areas of concern at any time. Staff told us they could raise any areas of concern at regular team meetings, supervision and appraisals. Staff understood their role and responsibilities. They told us they were listened to and were well-supported by the manager and colleagues.

The service had a quality assurance system in place. Quality managers had carried out reviews of the service each month. Suggestions for improvement or change had been fed back to the service. Action plans had been completed where there had been shortfalls. The views of people who used the service, relatives and staff had been sought by the provider and opportunities to change things for the better addressed promptly. We saw and were given examples of this. As a result the quality of the service was continuously improving.

We found that the provider had systems in place to gain consent for care and treatment from people who used the service. We spoke with staff who told us that they respected people’s decisions and understood their responsibilities with regards to the Mental Capacity Act 2005.

People told us that they were happy with the care they received. One person told us. “I like everything here, the staff, the food and the things I do”. One relative told us, “Although my relative has difficulty communicating the staff understand what she wants. It’s a very good service”. We observed staff treating people in a caring and respectful manner and were responsive to people’s needs.

The provider needed to make some improvements to their systems to ensure that medicines were administered and recorded safely and people who used the service were protected from the risk of harm.

Staff we spoke with told us that they had an induction before they provided support to people who used the service. Staff told us they received regular appraisals and training to carry out their role and felt supported by the registered manager.

The provider had an effective complaints system in place which was accessible to people who used the service. People we spoke with told us they knew how to complain if they needed to.

During the inspection we met with all six people who lived at the home, we spoke with three of them who were able to tell us about what they had experienced living at the home. They told us that they liked living at 63 Hoverington Drive.

We also observed and spoke with care staff who worked at the home. There were six staff on duty at the time of the inspection. We spoke with the manager of the home and three other staff. They told us that they had been trained to care for the people in the home and that they enjoyed the work that they did.

We checked staff training records and asked staff about the training and supervision that they had received they told us that they had a training plan and they were released to attend training. Staff said they were supported and enabled to carry out their work.

We inspected three care plans and looked at several more risk assessments as well as the health plans of people who lived at the home. We found that health records were completed and reviewed and that the different and complex needs of people living at the service had been met.

One person living at the home told us they had, "A good Christmas and the staff are really nice here". Two of the people at the home said that they had been to good meetings and they could say whatever they wanted to, and that staff had listened to them.