About the service: Ferndale Crescent is a residential home which provides support to people who have learning disabilities. The service is registered with the Commission to provide personal care for up to eight people and at the time of our inspection there were six people using the service.

People’s experience of using this service:

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service was registered before CQC's 'Registering the right support" policy was published. However, the registered manager demonstrated they promoted the principles of this guidance. People were treated as individuals, encouraged to lead active lifestyles and were part of their local community.

People received personalised care, which met their needs. Guidance was in place to support people consistently and in the way, they wanted. Care plans were informative. People had access to other health care professionals. People were supported to pursue their interests and hobbies, and social activities were offered

Staff knew people well. They were caring in their approach. People told us they liked the staff that supported them and were at ease with the staff that were on duty. People's relatives spoke positively about the service and the support that was in place.

Risks to people's health, safety and wellbeing were assessed. Support plans were put in place to ensure these were reduced as much as possible. People were protected from potential abuse by staff who had received training and were confident in raising concerns.

There was a thorough recruitment process in place that checked potential staff were safe to work

with people living at Ferndale Crescent. People were involved in the recruitment of staff. Staff were provided with the training, supervision and support they needed to care for people.

The service was well led. There was a positive culture at the service where staff and people felt listened to and supported. There were suitable quality assurance systems in place to assess, monitor and improve the quality and safety of the service provided.

Rating at last inspection: Rating at last inspection: Good (report published June 2017)

Why we inspected: This was a planned inspection based on the rating at the last inspection. We found the service continues to meet the characteristics of good with improvements made to how the service supported people with meaningful activities.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We carried out an unannounced comprehensive inspection of this service on 27 September 2016. During that inspection we found that although the provider was not breaching any regulations the service required improvement. This was because we had concerns that care records were not up to date, care reviews were not person centred and plans to improve the quality of the service were not reviewed. As a result we undertook a focused inspection to check whether the provider had made those improvements. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection in September 2016, by selecting the 'all reports' link for Ferndale Crescent on our website at www.cqc.org.uk.

This focused inspection took place on 23 May 2017 and was unannounced.

Ferndale Crescent is a residential home which provides support to people who have learning disabilities. The service is registered with the Commission to provide personal care for up to eight people and at the time of our inspection there were six people using the service.

People told us the home was well run. The registered manager had taken action to address the concerns we identified at our last inspection. They were aware of their responsibilities to the Commission and they were knowledgeable of the type of events they were required to notify us of. Staff told us the registered manager and deputy mangers were supportive and led the staff team well. Staff had a clear understanding of the provider’s philosophy and how to meet people’s specific needs. People had the opportunity to influence and develop the service they received. The registered provider and registered manager made checks to ensure the standard of care was maintained and improved upon when possible.

This inspection took place on 26 and 27 October 2016 and was unannounced. When we last inspected this service in January 2016 where we found improvements were needed in how the service was led and there were two breaches in regulations. The provider had not informed us of the absence of the registered manager and quality monitoring systems were not always effective. We had received an action plan from the provider and this inspection found that improvements had been made and there was no breaches of regulation.

Ferndale Crescent is a residential home which provides support to people who have learning disabilities. The service is registered with the Commission to provide personal care for up to eight people and at the time of our inspection there were six people using the service.

Since our last inspection a new manager had been registered. They were not available on the first day of our inspection visit. 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.

People we spoke with told us they felt safe. Some people we met found verbal communication difficult. We observed people looking relaxed and showing happiness with their facial expressions and body language. Staff knew how to protect people from avoidable harm and abuse. Staff knew how to keep people safe and reduce risks but this information was not always reflected in people’s care records. There was enough staff to support people in a timely manner. The registered manager had access to a resource of agency and bank staff when necessary to ensure people were supported in accordance with their care needs. We saw that the registered manager and staff had a clear understanding of people’s needs.

People received their medicines safely and staff had access to thorough guidance about supporting people to take their medicines.

Staff were appropriately trained and skilled to provide care and support to people. Senior staff were always available for them to seek advice and guidance. The registered manager and staff we spoke with understood the principles of protecting the legal and civil rights of people. Staff were observed seeking people's consent before providing any care and support.

People's changing health and wellbeing needs were responded to and people had regular access to health care professionals to maintain their health. People were given a choice of foods and staff knew what people liked to eat. Meals were prepared according to people’s specific dietary needs.

People and staff enjoyed caring and positive interactions with one another. We saw that people were treated as individuals and they visibly looked at home. People were supported to maintain relationships with people that were important to them.

Staff recognised the individuality of each person, and had planned and delivered support that reflected their individual needs and preferences. Staff were in the process of introducing a new care planning format to ensure that people’s care plans reflected what was important to them, which included the way they received their care and expressed their needs. Staff spoke affectionately about the people they supported. We saw people had access to activities and interests that they enjoyed.

People were aware of the provider’s complaints process but felt they could talk with staff and that their concerns would be addressed. People were encouraged to express their views about the service and felt involved in directing how care was provided. Staff felt involved in developing the service through staff meetings and supervisions with the registered manager.

The registered manager was aware of her responsibilities and had the skills and experiences required to enable her to effectively lead thi

This inspection took place on 18 January 2016 and was unannounced. When we last inspected this service in September 2013 we found it compliant with all the regulations we looked at.

Ferndale Crescent is a residential home which provides support to people who have learning disabilities. The service is registered with the Commission to provide personal care for up to eight people and at the time of our inspection there were six people using the service. There was a registered manager at this location however they were not present during our visit and we were told they had not been at the service for two 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 and associated Regulations about how the service is run. The provider had not notified us of the registered manager’s absence in line with their legal responsibility. You can see what action we told the provider to take at the back of the full version of the report.

The deputy manager was in the role of acting manager and a manager from another of the provider’s locations was in the process of applying to become the new registered manager for the service.

Processes for reviewing the quality of records were not robust as it had not been identified that several records were not completed or contained insufficient information. There was no analysis and review of incidences to identify any actions which could prevent a similar incident from reoccurring to other people.

People we spoke with told us they felt safe and were kept safe from the risk of harm by staff who could recognise the signs of abuse. Assessments had been conducted to identify if people were at risk of harm and how this could be reduced.

There were enough staff to meet people’s care needs. The deputy manager had access to a resource of agency and bank staff when necessary to ensure people were supported in accordance with their care needs.

Medication was managed safely. Where people were prescribed medicines to be taken on an “as required” basis there were details in their files about when they should be used.

Staff told us and records confirmed that they received regular training and supervisions with senior staff to maintain their skills and knowledge. Due to recent staff turnover, there were several members of new staff who were yet to develop a detailed knowledge of how to support people. Relatives were confident in the abilities of the staff to support people appropriately however one member of staff told us that felt unable to take people out because they were not confident to leave less experienced staff unsupervised in the home.

The service was working within the principles of the MCA and whether any conditions on authorisations to deprive a person of their liberty were being met. A person who used the service told us that staff would always ask their permission before providing personal care.

People were given a choice of foods and staff knew what people liked to eat. Meals were prepared according to people’s specific dietary needs.

People had regular access to other health care professionals to maintain their health. Details from appointments were shared at staff handover however these were not always well documented.

Staff spoke affectionately about the people they supported. Processes were in place which supported people to be involved in developing their care plans and expressing how they wanted their care to be delivered. People felt listened to and had control over the care they received.

There were several notices for people and instructions about how staff were to support people displayed in communal areas and bedrooms. This did not support people’s right to confidentiality or help promote a homely feel.

During our visit people spent most of their time watching television. People appeared to enjoy the activities they were engaged in but staff did not regularly prompt people to engage in other activities they also liked to do. Daily handover notes did not record that people had regularly engaged in their preferred activities and a lack of experienced staff meant that on occasion some people were not supported to engage in activities in the community. However the service was good at responding to people’s requests for trips and visits out.

The deputy manager had taken action when people had voiced their opinions about the service and people were involved in recruiting staff they wanted to be supported by.

People were aware of the provider’s complaints process but felt they could talk openly with staff and that their concerns would be addressed appropriately.

People were encouraged to express their views about the service and felt involved in directing how care was provided. Staff felt involved in developing the service through staff meetings and supervisions with the deputy manager.

The provider’s systems to check and improve the quality of the service were not robust. You can see what action we told the provider to take at the back of the full version of the report.

People's needs were assessed to establish the care that they needed and care was planned and delivered in line with their individual care plan. People appeared comfortable with staff and we noted that staff understood people's non-verbal communication methods. People were protected from inadequate nutrition and supported to eat a healthy and balanced diet. People had access to general and specialist healthcare and staff followed the advice given to support people's health.

The design and layout of the premises were suitable for people who used it. The home was warm and clean and the communal rooms were large with sufficient room for people's wheel chairs to move around. People could access the front and rear gardens. We found that there were good systems in place for staff to carry out regular health and safety checks around the premises including the fire safety equipment and installations. The provider had contracts in place to regularly test, inspect and service installations such as the central heating systems, the fire detection system and lifting equipment. There was a programme of planned maintenance and refurbishment.

Most people who used the service at the time of our inspection required specialist equipment. We found that people had the equipment they needed and it was kept clean and regularly inspected and serviced.

We found the service being delivered to people was consistent with what the provider's statement of purpose offered.

We visited the service on 1 June 2012. We spoke with two people. They told us that they were able to get up and go to bed when they choose and that workers supported and cared for them in the way that they preferred.

One person told us "Yes, it's alright here. We all get along with each other." They told us that they attended a day service twice each week. They said "I don't have to go if I don’t want to." They told us that they were involved sometimes in the recruitment of workers for the provider organisation. They said that the home had just received a grant to develop the gardens and they were involved with the project.