Disabilities Trust - 25 Welby Close is a care home without nursing for three people with learning disabilities or autism. The service is situated in a quiet residential area of Maidenhead, Berkshire. The house has two floors.

At the last inspection, the service was rated good.

At this inspection we found the service remained good.

Why the service is rated good:

People were protected from abuse and neglect. The service had good assessment, mitigation and documentation about risks to people. This helped prevent people from any harm. There were enough staff deployed to ensure people’s care was safe.

Staff received appropriate support to perform their roles. The service was compliant with the Mental Capacity Act 2005. 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.

We found the staff were kind. We saw that staff listened to what people had to say and held meaningful conversations with them. People’s right to privacy was respected and staff demonstrated dignity in the care they provided.

We found care plans were person-centred and contained appropriate details. People’s preferences, wishes and aspirations were identified and documented. Staff helped people to have an active life in the community.

The service had a positive workplace culture. There was good oversight of the service’s care from the registered manager and the provider’s representatives. The provider ensured that the quality of the care was regularly assessed. Where care to people could be improved in any way, the provider made appropriate changes to enable this.

Further information is in the detailed findings below.

We undertook an unannounced inspection on 4th November 2014. 25 Welby Close is a care home which is registered to provide care for up to three people. The home specialises in the care of adults with autism or a learning disability. The service is provided in a domestic sized house which was located within a housing estate. People have their own bedrooms and shared communal areas are provided. At the time of the inspection there were two people living in the home.

The home was managed by a team senior who was supported by the registered manager. The registered manager also had oversight of three other care homes which were situated some distance from Welby Close. 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 home had a range of methods to ensure that people were kept as safe as possible. Care workers were trained in and understood how to protect people in their care from harm or abuse. People told us they felt safe and could talk to staff and the manager about any concerns they had.

Individual and general risks to people were identified and managed appropriately. The home had a robust recruitment process to ensure that the staff they employed were suitable and safe to work there. The service had a stable staff group who communicated well with each other and had built strong relationships with the people living in the home. The staff team had an in-depth knowledge of people and their needs. However, records relating to the support of people did not always reflect the good care provided as they were not always accurate or up to date.

The service understood the relevance of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Appropriate actions are taken in relation to people’s capacity to consent to a range of decisions relevant to the particular individual. Care staff were skilled in communicating with people and in helping them to make as many decisions for themselves as they could.

There were systems in place to ensure that people were supported and encouraged to look after their health. People were encouraged to be as independent as they could be whilst risks to them or others was supported within a risk management framework.

People were given the opportunity to participate in a variety of activities both individual and with others. People were treated with dignity and respect at all times. They were involved in all aspects of daily life and assisted to meet any spiritual, behavioural or emotional needs.

The house was well kept, clean and comfortable. People’s rooms reflected their individual preferences and tastes and this was also evident throughout the communal areas of the home.

Staff told us the home was well managed with an open and positive culture. People and staff told us the registered manager was very approachable and could be relied upon to respond appropriately to requests or concerns. However, we found that despite a range of quality audits being in place discrepancies and omissions within support documentation had not been identified.

At the time of our visit there was one person living at the home. Another person was moving in on the day of our visit. We saw that people were involved in planning their care and making choices about the support they received. The person living at the home told us they were happy with the support they received. They told us "I say what I'd like to do and they (the staff) put it in my plan".

Care was individually planned and specific to the person using the service. People's consent was sought before care or treatment was given. However, the provider may wish to note that the staff had not received any training in the Mental Capacity Act as this was not part of the mandatory training programme.

The premises were clean and tidy and there were arrangements in place to ensure that regular safety and maintenance checks were carried out.

Staff received regular supervision sessions and annual appraisals from their manager which allowed them to identify training and support requirements. We found care workers received training which the provider considered mandatory and training records were up to date.

The provider may wish to note that at the time of our visit there was no registered manager for the service. We were told the provider was making arrangements for a manger to register with the Commission.

People who lived at the home had complex needs. Wherever possible, we used observation to help us understand people’s experience of the care provided. We spoke with one person who lived at the home. The person told us, “I like living here. I get to do the things I want and the staff are good to me”.

The provider promoted people gaining skills for independent living. We saw one person had completed courses in cooking, gardening and living skills. Staff told us they encouraged people to then use the skills they learned in supporting themselves in the home.

We observed an individualised activities plan for one person. The plan contained a variety of activities the person liked to do including evening drama classes, visiting the day centre and shopping. One person was out on a walk to the local nature reserve when we visited.

At our previous inspection, we found the provider did not have adequate records regarding agency staff, which placed people using the service at risk. We found the provider had made improvements to ensure they had the right information on file about all staff who worked at the home.

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.

During the visit we spoke to people living in the home who told us that they were happy with the care and support they received from staff. They said there were enough staff to meet their needs.

People confirmed that they were involved in decisions about their care and the care planning process.

People were confident in raising any concerns that they had. They said they attended monthly house meetings where they could raise any suggestions and discussed any issues that they had about the service.

People told us that they were able to make decisions about their day to day life at 25 Welby Close.