This was an unannounced inspection over two days and took place on 25 and 28 April 2017.

The home provides care and accommodation for up to eight people with learning disabilities. It is located in the Whitton area.

The home 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.

In December 2014, our inspection identified that the service was good in each area with an overall rating of good.

Due to people using the service having limited verbal communication relatives generally spoke on their behalf. Relatives told us that people really enjoyed living at Lichfield Lane and the way that staff treated and supported them. This was confirmed by the positive body language and displays of affection by people using the service towards staff throughout our visit.

People using the service were younger adults who had moved from residential schools, other care home placements or parental homes where their needs could no longer be fully met. Their move to Lichfield Lane had a hugely positive impact on their lives with progress being demonstrated by their personal achievements and opportunities to try new experiences. They were provided with choices from a lot of activities tailored to their individual interests and likes. Although people did not comment on their activities they enjoyed them very much with lots of smiling and laughter. The impact of this was that people enjoyed their activities and developed bonds and friendships.

The positive impact the home had on young people, since moving in was also demonstrated by a substantial reduction of incidents where people displayed anxiety or anger through aggressive behaviour. When aggressive behaviour did occur staff understood that this was an expression of people’s emotions, feelings and turned them into positives by calming the situation, finding out what was wrong and addressing it. They achieved this by having a thorough knowledge of each person living at the home and their likes and dislikes based on trial and error and growing positive bonds and relationships with them.

Relatives said that staff treated people’s safety as of great importance, whilst still recognising that people using the service must be enabled to try new experiences and take opportunities by taking acceptable risks. This was after having considered the benefit to people in relation to the risks involved and was reflected in the number of new experiences people had whilst maintaining those that they previously enjoyed. It meant people received a service that was individual to them and changed with them as their needs changed and skills and confidence developed, resulting in more fulfilling and enjoyable lives.

Staff enabled people to progress by adopting a very person centred approach that encouraged people to recognise and celebrate their achievements. This was by having a thorough knowledge of people’s individual communication and sensory needs and meeting them in a patient and measured way that enabled people to get their feelings and wishes across.

Each person had a comprehensive and individualised support plan that encompassed all aspects of their lives and included their social, leisure, educational and if appropriate, future work aspirational needs. This was reflected in the structured and spontaneous activities that people chose and enabled them to live their lives the way they wished. Great attention was also paid to people’s health and emotional needs with staff working in tandem with health care professionals in the community. People were protected from nutrition and hydration associated risks with balanced diets that also met their likes, dislikes and preferences. Relatives spoke positively a

This was an unannounced inspection over two days and took place on 16 and 17 December 2014.

The home provides care and accommodation for up to seven people with learning disabilities. It is located in the Whitton area.

The home 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.

In September 2013, our inspection found that the service met the regulations we inspected against. At this inspection the home met and exceeded with these regulations.

People and their relatives told us they were extremely happy living at the home and with the service provided. There were lots of activities to choose from, they felt safe and the staff team and organisation really cared.

The home was well maintained, furnished, clean and enabled people to do as they pleased. It provided a safe environment for people to live and work in.

The staff we spoke with where very knowledgeable about the field they worked in, had appropriate skills and training, knew people and their relatives well and understood people’s needs. This knowledge was used to provide care and support in a professional, friendly and supportive way, focussed on the individual.

There were numerous individual and group activities that took place during the inspection, at home and in the community. People did not comment on the activities but were very much enjoying them with lots of smiling and laughter.

We looked at care plans that contained clearly recorded, fully completed, and regularly reviewed information that enabled staff to perform their duties to a high standard. The records we looked at were comprehensive and kept up to date.

People and their relatives were encouraged to discuss their health needs with staff and had access to the GP practice and other community based health professionals, when needed.

People were protected from nutrition and hydration associated risks with balanced diets that also met the likes, dislikes and preferences of people. Relatives spoke positively about the choice and quality of food available.

The staff at all levels of seniority within the organisation and home were well trained, knowledgeable, professional and accessible to people using the service and their relatives. Staff said they had access to good training, support and career advancement.

Relatives said the management team and organisation were approachable, responsive, encouraged feedback from people and consistently monitored and assessed the quality of the service provided.

When we visited the conversations we had with people using the service were not related directly to the inspection outcomes due to communication difficulties. Therefore our findings were based upon the care and support we saw being given, peoples' reactions to it and records and procedures in place. We also spoke to a relative who was visiting. They said "My son is very happy and has settled in well".

We saw staff treated people with dignity, respect and involved them in decision making about what they would like to do. They were supported and encouraged to make their own decisions and choices, choosing activities they liked and ones that helped improve their life skills. Frequently these were one and the same as tasks were made fun.

The staff were friendly, skilled and supported by the organisation and management structure to meet peoples needs well. People were comfortable interacting with staff and spent a lot of time laughing and smiling.

The building was fit for purpose, well-maintained and equipped to meet the needs of people who use the service to a high level.

There was a robust complaints policy and procedure that was available in a part pictorial version to make it more accessible to people using the service.

The records, policies and procedures we saw were well kept easily accessible and up to date.

During our visit the comments from people using the service did not directly

relate to the outcomes we were inspecting. We therefore gathered evidence of people's experience of the service by observing the care being provided and peoples' reactions to it. We used the Short Observational Framework for Inspection (SOFI). SOFI is

a specific way of observing care to help us understand the experience of people who could

not talk to us. Our observations showed that staff treated people with respect and

dignity. They were enabled and encouraged to make their own decisions and choices, including choosing activities they wished to pursue and that helped improve their life skills if they wished. People felt safe and protected by a competent and professional staff and management team.

The staff were friendly, supportive and there were enough of them to meet peoples needs comfortably. People also received any required medication on time. They were comfortable interacting with staff and people spent most of the time laughing and smiling.