Fearnley House is a care home without nursing for four people with learning disabilities or autism. At the time of the inspection, three people lived at the service. The service is situated in a busy residential area of Old Windsor, Berkshire. The service is a single storey bungalow house with four bedrooms and a communal bathroom, lounge, kitchen and dining room. The service is located adjacent to another of the provider’s service.

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 was safe deployment of staff 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 very kind and loved their roles. We saw that staff listened to what people had to say and held meaningful conversations with them. This included using alternate means of communication. People’s right to privacy was respected and staff demonstrated dignity in the care they provided.

We found care plans were very 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. We made a recommendation about the provision of sensory equipment for people.

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.

The inspection took place on 16 December 2014 and was unannounced.

Fearnley House is a care home without nursing for up to four people with a learning disability or autistic spectrum disorder. At the time of the inspection four people lived at Fearnley House. The people living at Fearnley House had a range of support needs. All of the people living at Fearnley House required support of staff when they were away from the home.

The home is required to have a registered manager. 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. At the time of the inspection the manager was not registered with CQC. They had recently been appointed and were in the process of submitting their application to become a registered manager.

People using the service were happy; they were seen to be smiling and relaxed during the inspection. Two of the three relatives we spoke with told us they were very happy with the support and care provided at the home. However, there had been several changes in manager at Fearnley House over the last year and relatives told us this had had a negative impact on their family members. Two relatives said they were involved fully in the care of their family members and that communication was good.

Relatives told us and we observed that staff treated people with kindness and respect. Support was focussed on individuals and designed to meet the specific needs and preferences of people living in the home. There were systems in place to manage risks to people and staff were aware of how to keep people safe by reporting concerns promptly through procedures they understood well. The provider had robust recruitment procedures in place to ensure only staff of suitable character were employed.

People who could not make specific decisions for themselves had their legal rights protected.

People’s support plans showed that when decisions had been made about their care, where they lacked capacity, these had been made in the person’s best interests. Staff understood their responsibilities and knew how each person indicated their consent.

Staff were trained appropriately to meet people’s needs. New staff received induction, training and support from experienced members of staff. Staff felt well supported by the manager and said they were listened to if they raised concerns. Staff spoke with conviction about the values and ethos of the service and understood their responsibilities. People’s medicines were managed safely and staff had received appropriate training in the safety of medicines. Their knowledge and skill was assessed regularly.

People and their relatives were involved in planning and reviewing the support they required. People were encouraged to be as independent as possible and they worked toward agreed goals to achieve this. There was a programme of activities planned to meet the individual needs and preferences of people living at Fearnley House. Links with the community were maintained and people were encouraged to use community facilities such as public transport, leisure centres, town centre shops and cafes, social clubs and colleges.

The quality of the service was monitored regularly by the manager and provider. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service. Complaints were recorded, investigated and responded to in line with the provider’s policy.

We met with all four people who use the service at the time of our inspection. They were unable to verbally communicate with us, but indicated their responses to questions through signs, vocalisations and facial and body gestures.

We saw staff interacted respectfully with people. They checked that they supported people with their consent. Staff understood when it was appropriate to take a best interest decision and the process to follow when this was required.

We spoke with three relatives of people who use the service. They were highly satisfied with the level of care their loved ones received. One person told us “I can’t praise the staff highly enough.” Another stated “The care is exemplary. Staff are marvellous.”

Staff were aware of the support and care needs of each person. They referred to care plans and discussed people’s preferences with them. They were aware of risks that could potentially harm people and took appropriate actions to reduce identified risks.

The home was clean and clutter-free. People were assisted to access all areas of the home by use of ramps where necessary. A maintenance and servicing programme ensured the home was kept in a good state of repair.

Staffing levels were sufficient to meet the care needs and activity programme of people who use the service. One relative we spoke with told us “There are always staff available to supervise people.”

The service had a complaints policy that ensured complaints were investigated and resolved appropriately. Relatives of people who use the service told us they were satisfied concerns were dealt with satisfactorily.

We saw people living in the home were involved in planning their day. Staff used picture boards to help them indicate their preferences for activities. We observed staff being respectful to people living in the home. For example, staff knocked on people's bedroom doors and waited to be invited in.

We saw information appropriate to the needs of people living in the home was provided in easy to read format. We observed staff using communication books to ensure people were able to communicate their wishes. We found personal risk assessments were undertaken to ensure people remained safe. One relative told us “overall the care is fantastic.”

Staff told us of the safeguarding training they received, and explained the safeguarding procedure to us. We observed appropriate actions were taken as directed by care plans, implementing changes required following a safeguarding incident.

One member of staff told us “the home is brilliant to work in.” Staff told us they felt well supported through training opportunities, supervisions and appraisals.

We saw evidence the provider undertook regular unannounced checks on the home, and staff acted on feedback provided to improve the service.