We undertook an unannounced inspection on 24 May 2017 of Franklyn Lodge, 71A District Road. Franklyn Lodge, 71A District Road is registered for a maximum of three adults who have a learning disability. At the time of this inspection, there were three people using the service.

Since the last inspection, the registered manager had left. The home was being managed and supported by a new manager and the provider. The provider told us that an application to register the manager with us would be submitted after completion of a successful probationary period.

At the last inspection on 1 June 2015, the service was rated Good.

At this inspection we found the service remained Good.

Care plans were person-centred, and specific to each person and their needs. Care preferences were documented and staff we spoke with were aware of people's likes and dislikes. Care plans were reviewed and were updated when people's needs changed.

Relatives informed us that they were satisfied with the care and services provided.

Systems and processes were in place to help protect people from the risk of harm. Staff had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

Systems were in place to make sure people received their medicines safely. Arrangements were in place for the recording of medicines received into the home and for their storage, administration and disposal.

We found the premises were clean and tidy. Bedrooms had been personalised with people's belongings to assist people to feel at home.

Staff had been carefully recruited and provided with training to enable them to support people effectively. They had the necessary support, supervision and appraisals from management.

Staff we spoke with had an understanding of the principles of the Mental Capacity Act (MCA 2005). Capacity.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The home had made necessary applications for DoLS as it was recognised that there were areas of people’s care in which the person’s liberties were being deprived. Records showed that the relevant authorisations had been granted and were in place.

There were suitable arrangements for the provision of food to ensure that people's dietary needs were met.

Staff were informed of changes occurring within the home through daily handovers and staff meetings. Staff told us that they received up to date information about people and the service, and had an opportunity to share good practice and any concerns at these meetings.

There were systems in place to monitor and improve the quality of the service.

We undertook an unannounced inspection of Franklyn Lodge at 71A District Road on 1 June 2015.

Franklyn Lodge is a care home registered to provide personal care and accommodation for a maximum of three adults who have a learning disability. At the time of the inspection, three people were using the service. People had learning disabilities and complex needs and could not always communicate with us and tell us what they thought about the service. They used specific key words and gestures which staff were able to understand and recognise.

At our last inspection on 2 May 2014 the service met the regulations inspected. There was a registered manager in post. 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.

Arrangements were in place to protect people from avoidable harm and abuse. Safeguarding and whistleblowing policies and procedures were in place. Staff undertook training in how to safeguard adults.

Risks to people were identified and managed so that people were safe and their freedom supported and protected. Each person had risk assessments however the information they contained was limited. There was limited information about the safe practice of moving and handling and when people went out in the community.

People were not restricted from leaving the home. They went out and enjoyed various activities and community outings. However, one person using the service was not engaged in meaningful activities and experienced a lack of mental stimulation.

People were treated with respect and dignity. Care workers were patient when supporting people and communicated with people in a way that was understood by them. However, we received some feedback from relatives telling us, they were not happy with some of the care workers and their mannerisms towards people using the service were sometimes not caring.

Care workers spoke positively about working at the home and felt supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities.

There were effective recruitment and selection procedures in place to ensure people were safe and not at risk of being supported by people who were unsuitable.

Relatives and care worker spoke positively about the registered manager. There was a clear management structure in place with a team of care workers, registered manager, senior managers and provider.

Systems were in place to monitor and improve the quality of the service.

We have made a recommendation about introducing meaningful activities for people to be positively engaged with.

We spoke with one person who used the service and two relatives of people who used the service. They told us that they were satisfied with the care provided and people who used the service had been well treated. Their views can be summarised by the following comment made by a relative, “The staff are good. They take good care of my relative. I have no complaints”.

Care records indicated that the needs of people who used the service had been carefully monitored and attended to. The care records contained appropriate assessments, care plans and reviews. Details of appointments with healthcare professionals were recorded. There were suitable arrangements in place to manage medicines. People who used the service and relatives informed us that people who used the service had been given their medication.

The premises were clean and tidy. Safety inspections of the portable appliances and gas boiler had been carried out. Fire safety arrangements were in place.

Staff were knowledgeable regarding their roles and responsibilities. People who used the service and their relatives informed us that staff were able to meet the needs of people who used the service. They were aware of the complaints procedure and knew who to speak to if they had concerns.

People who use the service have learning difficulties and communication was limited. Two people we spoke with did not comment on their care. The third person indicated that they were satisfied with their care and they were well treated. One relative who spoke with us by phone indicated that people had been treated with respect and dignity. Their views can be summarised by the following comment, “I am happy here. The staff are nice to me. I can choose the food I like to eat. The staff listen to me. “

Care records indicated that the needs of people had been attended to. The care records contained assessments, care plans and reviews. Details of appointments with healthcare professionals were recorded. Risks assessments had been carried out.

People had been given their medication. However, we noted that there were some deficiencies in the storage and recording arrangements for medication.

Staff had been provided with essential training. Staff informed us that they worked well as a team and felt supported by their manager. They were aware of the safeguarding policy and procedure aimed at protecting people from abuse and understood their role.

We spoke with the small number of people who use the service and their representatives. We were told that people are generally treated respectfully. People felt that they got good support with personal and healthcare matters. One person said that it was like ‘being waited on.’ Staff were referred to as ‘nice people’. The registered manager, and senior managers in the company, were reported to be approachable.

People told us that they could contact and have visits from friends and relatives. People’s representatives told us that they could visit anytime. This meant that people who use the service were not isolated within the service.

We saw that staff asked people their preferences, for instance around meals. One person, who was not able to verbally express choices, was asked to come to where the food was stored, to enable them to point out preferences.

A single Inspector carried out this inspection. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led?

We used a number of different methods to help us understand the experiences of people using the service, because people using the service had complex needs which meant they were not able to tell us their experiences.

We observed the care provided and the interaction between staff and people who used the service. We also spoke with three care staff, the Registered Manager and Director of Services. We also read feedback from relatives.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People who used the service had support plans and risk assessments which helped to ensure their safety and welfare.

We found the home had safeguarding, whistle blowing and Deprivation of Liberty Safeguards (DOLs) policies and guidance in place. Training records showed staff had received training in safeguarding and DOLs. When speaking to them, they were able to provide examples of what constituted abuse and how they could identify abuse. They were aware of action to take and how to report allegations or incidents of abuse to the relevant authorities.

CQC monitors the operation of the DOLs which applies to care homes. While no applications have been submitted, appropriate policies and procedures were in place. When speaking with staff we found they had an understanding of the Mental Capacity Act (MCA) 2005 and the DOLs and how it applied to the people they were providing care and support to on a daily basis.

We found the home ensured people were cared for, or supported by, suitably qualified, skilled and experienced staff. We saw there were recruitment and selection procedures in place and found that the appropriate checks had been undertaken before staff began work. Staff were trained in areas of relevance to their job roles and demonstrated knowledge of people’s individual needs and requirements.

Is the service effective?

We found the home had taken steps to ensure that people were included and involved as much as possible in their care and support. We found they used various methods of communication to engage and involve people who used the service as much as possible such as pictures, facial expressions, sign language, key objects and words and simple Makaton signs.

We looked at three care plans and saw that people's needs had been assessed and care and treatment were planned and delivered in line with their individual care plan. Risk assessments had been carried out. We found these were person-centred, very detailed and specific to each person and their needs.

Is the service caring?

One person who used the service told us “it is nice here. I like it. It’s my home”.

We found good feedback had been received about the home. Feedback from one relative read “All the staff are very helpful and hospitable” and “we are very pleased and satisfied”. Another relative commented “we are very satisfied with [their relatives] care. Thanks to the very helpful staff”.

We saw people being treated with respect and dignity. Staff communicated well with people and explained what they were doing and why. We observed people were given a choice by staff and asked what they wanted to do. During the inspection, we observed people who used the service were relaxed and happy.

Is the service responsive?

We saw the home had a complaints policy and procedure in place and was easily accessible to staff and people who used the service. We found people and staff were aware of how to make a complaint and felt comfortable approaching the manager with any concerns they had.

We also found regular reviews were being held between people who used the service, their family or representatives, the Registered Manager and Director of Services, where all aspects of their care were discussed and any changes actioned if required.

People's health and medical needs were assessed and we viewed records demonstrating that they were supported and provided access to health and medical services when necessary.

Is the service well-led?

We found the home had a system in place to obtain feedback through surveys which showed good feedback had been received.

There were regular consultations and resident meetings with the people who used the service which gave them the opportunity to discuss any issues or concerns they had and if they had any complaints they wished to make.

We also found regular monthly staff meetings took place which ensured staff had the opportunity to communicate their views about the service and to discuss the care and support needs of people using the service.

We found the home had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. Checks had also being conducted on all electrical equipment and maintenance checks and service records were up to date.