About the service: Dove Lane is registered to provide accommodation and personal care for up to six people with learning disabilities. At the time of inspection, four people were using the service.

People’s experience of using this service: People continued to receive safe care. Staff understood safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place to manage risks within people’s lives, whilst also promoting their independence.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out. Staffing support matched the level of assessed needs within the service during our inspection.

Staff training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Specialist training was provided to make sure that people’s needs were met and they were supported effectively.

Staff were well supported by the manager, and had one to one supervisions. The staff we spoke with were all positive about the senior staff and management in place.

People's consent was gained before any care was provided. 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

Staff continued to treat people with kindness, dignity and respect and spent time getting to know them. Care plans reflected people’s likes and dislikes, and staff spoke with people in a friendly manner.

People were involved in their own care planning and were able to contribute to the way in which they were supported. People and their family were involved in reviewing their care and making any necessary changes.

A process was in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly and lessons were learned through positive communication.

The service continued to be well managed. The provider had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required.

Rating at last inspection: Good (report published 24/02/2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Dove Lane provides accommodation and personal care for up to six adults who may have a range of care needs, including learning disabilities, physical disabilities and dementia. It is situated in a rural area, just outside of Bedford. On the day of our visit, there were five people living in the service.

Our inspection took place on 5 February 2016. At the last inspection in June 2014, the provider was meeting the regulations we looked at.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff worked hard to ensure people were kept safe and secure. Staff had been trained in safeguarding people and understood how to protect them from harm and abuse. They were aware of the actions to take to report suspected abuse. Individual risks to people had been identified and were managed appropriately with detailed control measures in place to minimise the potential for future risk to occur.

There were sufficient numbers of consistent staff on duty to meet people’s needs. The service had a robust recruitment process which ensured that the staff employed were suitable to work with people. There were safe systems in place for the administration, disposal, storage and recording of medicines.

Staff received an induction which was based upon the fundamental standards of care and which determined their competency in a variety of subjects. They also had on-going training and formal supervision, to help them to deliver safe and appropriate care to people.

Staff ensured they worked in a way which recognised and respected people’s rights. They understood and complied with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS.)

People had appropriate amounts of nutritious food which was based upon their specific dietary requirements. They were supported by staff to access a range of healthcare professionals so as to maintain their health and general well-being.

People were encouraged to be as independent as possible and were supported by staff that were knowledgeable about how to meet their needs. Staff understood how people preferred to be supported on a daily basis and were skilled in communicating with people in order that they could make as many decisions for themselves as possible.

People were treated with dignity and respect by staff who understood how to promote and protect people’s rights and maintain their privacy. People had access to advocacy services when required. Relationships with family members were valued and people were supported by staff to maintain these.

People received person-centred care, based on their likes, dislikes and individual preferences. They were involved in their daily care and were helped to maintain any spiritual and emotional needs they had. People were given the opportunity to participate in a variety of activities, both individually and on a group basis.

People and their relatives were aware of how to complain if they needed to and were encouraged to contribute to the development of the service by raising any issues or concerns. This feedback was used to help identify areas for development in the future.

The service had a registered manager in place, who led a stable and consistent group of staff. The service had an open and transparent culture with staff who shared a common vision and values. Staff were constantly looking at ways they could improve the delivery of service and were encouraged to contribute to its development. The provider had robust audit systems in place, to monitor quality assurance and safety and to drive future improvements.

During this inspection, we gathered evidence against the outcomes we inspected to help answer our five key questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with staff and looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

We found that people’s care and support was planned and delivered in line with their individual needs.

People living in the home were also protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

At our last inspection of Dove Lane on 25 June 2013, we found that people living in the home, staff and visitors were not always protected against the risks of unsafe or unsuitable premises. This was because some people’s needs had changed over the years and the environment no longer met their physical needs in respect of easy access, adequate space and facilities. The manager told us then that the provider recognised the environmental deficits and a planning application to rebuild the home on the same site had been submitted and approved. However, no timescales were known at that time for the work to take place. We therefore gave the provider a compliance action, and asked them to tell us what they were going to do to improve the environment to ensure people’s safety and wellbeing.

During this inspection we asked the manager and service manager for an update. We also looked round the building taking into account the physical needs of the people currently living there, and the facilities available. We were told that there were still no firm timescales for the redevelopment of the service, but that the provider was still committed to making this a reality. We found that some improvements had been made in the interim, and although the environment would not be fit for purpose in the long term, we found on this occasion that the provider had taken reasonable steps to ensure people currently living in the home, were safe and cared for appropriately until such time that the redevelopment of the service can take place.

Is the service effective?

People’s health and care needs had been assessed to establish their needs.

Although some people did not communicate using words, we observed that they were able to demonstrate their consent clearly through other methods such as actions and physical movement. People were encouraged to make their own choices and decisions, as far as possible, throughout our inspection. It was clear that staff understood people’s needs well and knew how best to support them.

Through the course of the day we observed food and drink being regularly provided to people living in the home. The home’s routines were flexible, and showed that people’s individual preferences and needs mattered.

Is the service caring?

Everyone we observed looked well cared for.

We observed some positive interactions between staff and people living in the home. People were treated with dignity at all times.

Although people living in the home at the time of this inspection did not communicate verbally, staff continually included them in conversations and encouraged them to express their views using non-verbal methods of communication. The manager told us that they were committed to improving ways of communicating with people, in a meaningful way.

Care records that we looked at were personalised, and included information about people’s individual preferences in respect of daily routines. We observed that preferences were taken into account and respected.

Is the service responsive?

We saw guidelines that had been written to support staff in managing specific care issues for some people living in the home. The guidelines we read were detailed and had also been reviewed recently. Our observations showed that the care and support provided to people accurately reflected that which was set out in their care records.

Arrangements were in place to support people who were at risk, for example because of limited mobility or poor nutritional intake. There was evidence that people’s health conditions were being regularly monitored. Where needed, support had been sought from external professionals; to ensure people's welfare was protected and all their needs met. We noted in one person’s records that their health condition had stabilised as a result.

Is the service well-led?

A registered manager was in place, who had worked at the home for a number of years.

It was clear from speaking with staff that they felt well supported and were clear about their roles and responsibilities.

We found that appropriate systems were in place to monitor the quality of service provision, and to give people the opportunity to express their views.

We found that the service was responsive to feedback from external agencies and professionals, in respect of improving the service provided to people living at Dove Lane.

People living at Dove Lane had complex needs and did not communicate with spoken words. They expressed themselves by making sounds and displayed facial expressions and body movements individual to their personalities.

We observed positive interactions between staff and people living in the home, and saw that staff understood the needs of the people they were supporting.

We found that there were systems in place to ensure people received their medicines safely and as prescribed by the doctor.

Areas of the home, in particular people’s bedrooms, were not spacious enough to adequately store large pieces of specialist equipment. The manager informed us that the provider was in the process of reviewing the accommodation. A previous planning application was successful on this site for a six bed space care home. Some areas of the home were in need of immediate improvements.

There was an effective complaints system in place to enable people to comment about the service.

People living at Dove Lane had complex needs and did not communicate with spoken words. They expressed themselves by making sounds and displayed facial expressions and body movements individual to their personalities.

Our observations during our visit to Dove Lane on 27 November 2012 concluded that there was a very positive interaction between people living there and the staff team. People living there presented as relaxed and confident to approach staff. There was lots of friendly speech, smiles and appropriate contact from staff toward people who used the service. Staff were attentive to people's needs and discreet and respectful in meeting personal care needs.

We saw people being supported to maintain and improve upon their skills. We observed people being included and involved in meal preparation so that people could see and smell meals being created. Family members and advocates were involved in people's lives and decision making. Dove Lane makes use of local shops and GP services. People living there are included within the local community. We saw that social activities take place.The weekend before our visit people had enjoyed a themed seventies music party with family and friends present.

During our visit we observed that staff at Dove Lane demonstrated a high level commitment to the people living there. We spoke to staff who reported that they enjoyed their work and who we observed delivered care in a dignified, respectful and committed manner.

People living at Dove Lane had complex needs and did not use words to communicate, so we were not able to ask for their views on the quality of the service provided. However, people communicated in various other ways, and by facial expressions, gestures and body language people were able to make their feelings and needs known.

Our observations during our visit to Dove Lane on 18 November 2011 concluded that there was very positive interaction between people living here and the staff team. There was a lot of friendly banter and laughter. Staff were attentive to people’s needs, supported people to maintain or improve on their skills and ensured people were comfortable with whatever was going on.