We undertook an unannounced inspection on 17 November 2016 of Franklyn Lodge 8 Forty Lane. Franklyn Lodge 8 Forty Lane is registered to provide accommodation and personal care for a maximum of nine adults who have learning disabilities. At the time of this inspection, there were nine people using the service.

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.

People's health and social care needs had been appropriately assessed. 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 monthly and were updated when people's needs changed.

Relatives informed us that they were satisfied with the care and services provided. Relatives also told us that they were confident that people were safe in the home.

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. There was a record of essential maintenance carried out at the home. Bedrooms had been personalised with people's belongings to assist people to feel at home.

Staff had been carefully recruited and provided with induction and 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 to make specific decisions was recorded in people's care plans.

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 the person’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 and had an opportunity to share good practice and any concerns they had at these meetings.

There was a management structure in place with a team of care workers, registered manager and the provider. Staff spoke positively about working at the home. They told us management were approachable and the service had an open and transparent culture. There were systems in place to monitor and improve the quality of the service.

People who use the service had learning difficulties and some were not able to express their views to us. However, two people who use the service and two of their representatives indicated that staff had treated them with respect and they were responsive towards the needs of people who use the service.

We observed that people who use the service appeared well cared for and were dressed appropriately. Staff were noted to be constantly supervising and interacting with people who use the service in a friendly manner. Plans of care had been prepared for people who use the service. These were comprehensive and addressed the needs of people who use the service. The healthcare needs of people who use the service were closely monitored by staff. Details of appointments with healthcare professionals such as the optician and GP had been kept.

Arrangements were in place to ensure that people who use the service were protected from abuse. We observed that staff treated people who use the service sensitively and were attentive towards them. We noted that staff were vigilant in ensuring that people who use the service were protected and not put at risk of harm.

There were arrangements to ensure that staff received regular supervision and support from their manager. There was a record of essential training provided.

Staff were caring and knowledgeable regarding the individual needs of people who use the service. Representatives of people who use the service spoke highly of staff.

The home had consulted with and asked people who use the service and their representatives about their views. Quality monitoring checks including spot checks had been done and a satisfaction survey was completed at the end off last year.

Due to communication difficulties of the people who were using this service during our visit, we interpreted their experiences of the service though our observations. We also spoke to some representatives of people who use services after our visit.

People’s representatives confirmed that they felt the service to be safe and trustworthy. We were told for instance that staff are “very caring” and that the management team listened to and responded to questions and concerns they had. One person told us, “My daughter is very happy here.”

We saw that staff understood and aimed to meet people’s needs. For instance, people were supported where needed to wear appropriate clothing. Staff generally spoke to people in an appropriate and friendly manner. However, we saw staff going into people’s rooms without first knocking or in any way asking permission, usually when the person was in their room. This failed to respect the privacy and dignity of people.

One person’s representatives told us that they had concerns about the person “not always having access” to items brought in for them. We found a number of doors to be kept locked at the service which restricted people’s access. Whilst this may help to keep people safe, we are concerned that this may infringe on some people’s human rights.

We found that suitable arrangements were not in place to ensure that people were safeguarded against the risk of abuse. This was because an allegation of abuse was not initially responded to appropriately, and because there may have been insufficient action to identify the possibility of abuse and prevent it from occurring.

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?

At the time of our inspection, the home was providing care for five people.

We used a number of different methods to help us understand the experiences of people who used the service, because people who used the service had complex needs which meant they were only able to communicate using key words, body language, gestures, facial expressions and objects of reference.

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.

The Care Quality Commission (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.

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 four 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, detailed and specific to each person and their needs.

Although the care plans included information about people’s mental state and cognition, we saw no evidence that mental capacity assessments had been carried out. We raised this with the Registered Manager and they confirmed they would carry out a mental capacity assessment for each person in the home.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Staff received training in areas of relevance to their job roles and demonstrated knowledge of people’s individual needs and requirements.

Is the service caring?

We found good feedback had been received about the home. Feedback from one relative read “Thank you for the inclusion in the family review meeting. I can honestly say that the care and attention given to [relative] is excellent. [Relative] is always happy and attentive when we meet. Thanks to you and their carer for supporting [relative] to lead an enjoyable and fulfilled life”.

We saw people treated with respect and dignity. Staff communicated well with people and explained what they were doing and why. We observed staff supporting people to make choices and staff asked people what they wanted to do. During the inspection we observed that people who used the service were relaxed and happy.

Is the service responsive?

We found that regular reviews of each person’s support and care needs took place. The reviews involved people who used the service, their family or representatives, the Registered Manager and Director of Services. The reviews included discussion of all aspects of each person’s care and any changes were actioned if required.

People's health and medical needs were assessed and we viewed records demonstrating that they were supported and had 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. There were regular consultations and resident meetings with the people who used the service. These gave people the opportunity to relay any issues or concerns they had and to raise any complaints they wished to make.

We also found that 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 who used the service.

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 were also conducted on all electrical equipment and maintenance checks and service records were up to date.