Dorandene - Care Home Learning Disabilities is a residential care service to up to 10 people with learning disabilities. Care is provided across two floors in one adapted house. At the time of this inspection, there were nine people living at the service.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

People were kept safe from harm because staff routinely assessed risks and worked collaboratively to reduce them. Where incidents had occurred, action was taken to keep people safe. Staff knew how to identify and respond to potential abuse and were trained in safeguarding adults procedures. People’s medicines were managed and administered safely by trained staff and the systems were regularly checked. The home environment was clean and safe with regular checks carried out on its safety.

People were prepared food in line with their preferences and dietary requirements. Staff ensured people’s healthcare needs were met. Before coming to live at the service, a thorough assessment of people’s needs was carried out. 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 had the right training and support for their roles.

People were supported by kind and committed staff who knew them well. Staff provided care in a way that encouraged people to develop skills and independence. People’s dignity and privacy was promoted as staff provided care in a respectful manner. Staff involved people in their care and the provider had systems to ensure people could express their culture, religion, gender and sexuality.

Care was planned in a personalised manner, with detailed care planning around people’s needs, preferences and routines. Care was regularly reviewed and where changes in need were identified, care plans were updated. Staff supported people to attend activities that suited their interests and personalities. People’s wishes with regards to end of life care had been recorded.

People, relatives and staff got on well with the registered manager. Systems were in place to seek feedback or suggestions from stakeholders and staff. There were a variety of checks and audits carried out at the service and a continuous plan to improve. The provider engaged with the local community, as well as relatives and professionals in an open and transparent manner.

Further information is in the detailed findings below

This inspection took place on 24 March 2016 and was unannounced. At our previous inspection on 13 November 2013 we found the provider was meeting the regulations we inspected.

Dorandene - Care Home Learning Disabilities is a detached house located in a quiet residential area close to Reigate in Surrey. It provides accommodation, care, and support for up to 10 adults with physical and learning disabilities. It is arranged over 2 floors and has a large lounge, spacious dining room and a sensory room. At the time of the inspection, there were seven people living at the service.

There was a registered manager at the service. 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.

We were unable to hold meaningful conversations with most people who used the service due to their limited verbal communication. However, we observed care workers supporting people and interacting with them during activities and over lunch. Care workers demonstrated empathy and an understanding of people’s needs. They spoke to them in a calm manner and it was clear that people felt comfortable in their presence and enjoyed their company.

Each person was assigned a key worker and an assistant key worker who made sure that their needs were met and records were up to date. They made sure they had everything they needed, and arranged activities and co-ordinated any appointments for them. Relatives told us they were kept informed by key workers.

The provider was meeting the requirements of the Mental Capacity Act 2005. Where restrictions were in place for people and they needed to be deprived of their liberty, this was done in accordance to law. Best interests meetings took place where people did not understand reasons for their care or treatment. Independent Mental Capacity Advocates were used where people did not have family members who spoke on their behalf.

Care workers received induction and ongoing training relevant to the needs of people using the service. This meant they were able to support people in an appropriate manner. They received regular supervision and attended regular staff meetings.

They contacted health and social care professionals if needed, and followed appropriate guidelines in relation to managing behaviour that challenged or with regards to nutrition and hydration. People had appointments with their GP or other health professionals for their ongoing health needs.

The provider had systems in place for monitoring concerns, complaints and any incidents and accidents. Regular checks took place to ensure the environment was fit for purpose.

The people who lived at the home had complex support needs and were not always able to tell us their views using the spoken word. We saw the relationship and interactions between staff and people who used the service were positive and respectful.

We spoke with a relative of one person who used the service, this person told us that they were happy with the service provided and that care was of an excellent standard, with friendly staff that behaved in a professional manner and who communicated with them regularly. This person also told us that they had been made aware of the complaints procedure but that they had never had cause to use it.

We spoke with three care staff who told us that they supported people to be as independent as possible and supported them to work towards and achieving personal leisure or social goals. We looked at four care files that demonstrated the personalised approach in place to support the staff’s comments. We observed that the manager operated a model of good practice by offering staff regular supervision and access to a framework of training.

We observed staff treating people with respect and were able to see that there was a good relationship between staff and people who used the service. We observed staff assessing people’s needs and ensured that care was provided in line with individual care plans. We were able to see that people were comfortable and that there was adequate numbers of staff available to provide the individualised support needed.

We were informed that the people living at the service have little or no communication skills and were unable to provided feed back about the service they receive. We therefore undertook a random selection telephone survey of the next of kin of the people who lived at Dorandene.

The majority of the people who we spoke to told us they felt that relative was safe living at the service and that staff were always available when they needed them. They felt the staff knew what their relatives needed and appeared to knew how they liked things done.

People we spoke with told us they were initially involved in making decisions about the way their relatives lives and the care would be delivered. They felt the staff always respected the privacy and dignity of the people who live there.

The people we spoke to said that they felt the staff knew the people living at the service well and had a good understanding of their care needs.

Most of the people who use the service at Dorandene are not able to use verbal forms of communication. Observation showed that some people living there had their own style of communicating, for example, the use of body language, facial expressions or other forms of behaviour which staff clearly understood and responded to.

We observed that people who use services were given time to express their needs, were involved in making some day to day decisions and supported in a way that was mindful of their rights to respect, dignity and privacy. People using services appeared relaxed, content and at ease in their surroundings.