Darley Cottage is a care home registered for six adults with a learning disability. Located in a residential area in Chester, the home is close to shops, pubs and other local facilities. It is also on the bus route to the city centre. Access between the ground and first floors of the two-storey building is via the stairway. Two of the bedrooms have en-suite facilities. Staff are on duty twenty-four hours a day to support the people living in the home. At the time of our visit, five people were living at Darley Cottage.

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

The registered provider had systems in place to ensure the safety of the people who used the service. This included arrangements for identifying, reporting and taking action on any allegations of abuse. This was reinforced through training for staff, staff knowledge and reporting processes. People’s safety was further enhanced through assessments for individuals identifying risks they faced from the environment or from risks associated with their own health and social needs. The registered provider ensured that a system for the safe management of medication was in place and that the premises were well maintained and hygienic.

The registered provider took the requirement of the Mental Capacity Act 2005 (MCA) and associated safeguards into account. This meant they were working within the law to support and assist people who may lack capacity to make their own decisions. 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 support this practice.

People who used the service were supported by a staff team who had received the training and had the knowledge to best support them. The nutritional needs of people were met. Consideration was made to the dietary needs of people and their personal preferences. People who used the service were involved in shopping for food and occasionally assisted in preparing it.

Staff interactions were friendly, caring and supportive. People were supported in a patient and respectful manner. Staff ensured that people were treated as individuals and had their privacy and dignity taken into account through care practice. People were given information about their care and the support they could be provided with. People were encouraged to make choices concerning their daily lives and the support provided by staff was directed by these choices and preferences.

Care plans provided staff with the information they needed to successfully support people in all aspects of their daily lives. These were person centred and detailed with evidence outlining that people were actively involved in them. Care plans were reviewed and updated when required.

People undertook activities which were linked to their personal preferences. Some people were involved in voluntary work in the local community and this was fully supported by the staff team.

Information was in place in respect of how people could make a complaint. This was presented in a format appropriate to the communication needs of people. Complaints records were maintained and concerns responded to in a timely manner.

The registered manager used a variety of methods to assess and monitor the quality of the support provided at Darley Cottage. These included regular audits of the service and staff and resident meetings to seek the views of people about the quality of care being provided. The registered manager had provided feedback to people about the rating that we had applied at our last visit. The registered manager always notified us of significant incidents within the service as required. A robust system of audits enabled the registered manager to identify those areas of support that required either improvement or development.

Further information is in the detailed findings below.

We spoke with five people who lived at Darley Cottage. They said:

"We like the staff"

"They take notice of what we say"

"I am well but if I was not, they would get me to see a Doctor"

"I feel safe living here and have no worries"

"They look after me and they will help me"

"I get my tablets when I need them and the staff never miss me out"

"If I was not happy with something I would talk to the staff and they would sort it out"

This visit found that records relating to the care of individuals were accurate and up to date and this in turn enabled the care and welfare of people to be promoted. We found that the social and health needs of people were maintained and that action was taken to ensure that people had access to the medical services they required. We found that individuals were protected from abuse and as a result felt safe with the staff team. We found that people's health was maintained by the safe management of medication. The complaints procedure gave individuals the opportunity to voice concerns and was presented in a format appropriate for their needs. Care plans were presented in a pictorial form and were accurate. Their format and evidence of people being involved in reviews of care plans provided evidence that support was inclusive.

We observed staff interactions with people. These were positive and friendly. Staff provided a focus for individuals to refer to and people appeared relaxed and at ease with the staff team.

We found that people’s privacy, dignity and independence were respected. People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care. One person who used the service said, "We have meetings. They are great."

People experienced care, treatment and support that met their needs and protected their rights through good care planning and risk assessments. One person who used the service said, "I have seizures and the worker that is with me looks after me. We have birthdays with a cake. The food is nice."

We found that people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. The staff members we spoke with said that they felt supported. Two members of staff said, "I love working here."

The provider had an effective system to regularly assess and monitor the quality of service that people receive. One family member said, "We think it is very, very good. We have no complaints. We are always welcomed." The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. One person who used the service said, "I like living here."

When we visited Darley Cottage we had the opportunity to observe the support that was being given to people living there. We saw many examples of good communication and patience by staff and staff interacted with the people they supported in a positive manner. Staff were friendly and respectful to the people they were supporting.

People we met at Darley cottage confirmed that they were treated with respect and their dignity was maintained. We met everyone living at Darley Cottage when they arrived home throughout the day.

Comments received included:

“I have everything I need I do not have any problems.”

”love my room and have lots of things I like in it”.

“We go shopping and get what ever we want for meals”.

“I like to go out when ever I want”.

People told us they liked the staff. They knew the staff’s names and who was their key worker.

We had also contacted the local authority contracts and monitoring team for Cheshire West and Chester before we visited the service. They had no issues of concern to report.

The inspection took place on 23rd of January 2015. We gave the provider a day's notice.  This was to ensure that people using the service could be given the opportunity to speak with us. Darley Cottage is registered to provide accommodation and personal care for up to six people with a learning disability. Located in a residential area in Chester, the home is close to shops, pubs and other local facilities. It is also on the bus route to the city centre. Staff are on duty twenty-four hours a day to support the people living in the home. At the time of our visit, six people were living at the service. The service has a registered manager who has been in post for a number of years. 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 manager continues to update her training and had demonstrated to us her understanding of requirements under her registration. As well as providing supervision and appraisals to the staff team, the registered manager was involved in the provider’s quality assurance processes. People told us that they felt safe and that felt cared for. We saw that people who used the service would refer to the staff team for information and advice. People lived in an environment that was clean and home-like in appearance. Some attention was needed to brightening up paintwork in halls and landings and plans to address this were made during our visit. People received care that was personalised and met their needs effectively. People had care plans which were person centred and presented in a format which suited the communication skills of people. Care plans went into great detail and people we spoke with felt included in the way care plans were devised. We saw that care was given in a way that promoted independence and was delivered with dignity and respect. Staff sought the consent of someone when they provided care and had an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) to enable them to provide care lawfully where people lacked in capacity. People were being cared for by staff that had received training and were being encouraged to develop further skills. The manager provided the staff with on-going support and sometimes worked alongside them to ensure that they were probing appropriate care.