This comprehensive inspection took place on 14 February 2018 and was unannounced.

Gowlands is a residential home that provides respite personal care and support for up to nine people with learning disabilities, sensory impairment, physical disability and associated complex needs. People use the service for short term periods to provide respite for them and their families/carers. At the time of our inspection six people were receiving respite care.

At our last inspection in December 2015 the service was rated ‘Good’ in all five domains. At this inspection we found the key question ‘Is the service well-led?’ rating had not been sustained and improvements were required. The service did not have a registered manager which is a requirement of their registration. 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 2008 and associated regulations about how the service is run.

The overall rating of the service remains Good.

Gowlands is a three storey building with lift access to the first and second floors. People using the service had their own bedroom with wash basin and/or shower facilities. Communal bathrooms and toilets were available on each floor. People had access to various communal lounges and a sensory room. The accommodation is located next to the provider’s purpose built hydrotherapy pool.

The service was safe. Staff understood their responsibilities to protect people from the risk of abuse and avoidable harm. Risks to people’s health and wellbeing had been identified and management plans were in place to mitigate these. Appropriate recruitment procedures were in place which ensured staff suitability for their role. There were enough staff to help keep people safe and meet their care and support needs. People received their medicines as prescribed.

The service was effective. People were supported by staff had received training to equip them with the skills and knowledge needed to provide effective care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were supported to eat and drink enough and to access health care services if required. People’s rights were protected because staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA).

The service was caring. Staff were kind and sensitive to people’s needs and were passionate about providing the best possible care and support for people. Staff promoted people’s independence and well-being.

The service was responsive to people’s individual needs. People, including their relatives were involved in the planning and review of their care and support needs prior to their stay at Gowlands. Care plans were regularly reviewed to ensure they continued to accurately reflect people’s care and support needs. Activities were tailored around people’s likes, choices and abilities. There was an effective complaints system in place.

The service was not consistently well-led. The service had been without a registered manager since December 2016. There were systems in place to assess and monitor the quality of the service however some improvements were required to ensure these were robust. Staff were empowered to deliver a positive person centred culture which focussed on ensuring people's experience at the service was of the utmost importance. Staff felt valued and were proud to work at the service. People, relatives and staff had the opportunity to say how they felt about the home and the service it provided.

Further information is in the detailed findings below.

The Inspection took place on the 16 December 2015.

Gowlands provides accommodation and personal care without nursing for up to nine people who have a physical disability or learning disability. The service offers short breaks and respite care. There were six people using the service on the day of our inspection.

The service did have a registered manager. Although at the time of our inspection the registered manager was in the process of de-registering. A manager has been appointed and was being supported into the role by the existing 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 2008 and associated Regulations about how the service is run.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

People were safeguarded from the potential of harm and their freedoms were protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).

People had sufficient amounts to eat and drink to ensure that their dietary and nutritional needs were met. The service worked well with other professionals to ensure that people's health needs were met. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including a doctor and district nurse.

Staff were attentive to people's needs. Staff were able to demonstrate that they knew people well. Staff treated people with dignity and respect.

People were provided with the opportunity to participate in activities which interested them. These activities were diverse to meet people’s social needs. People knew how to make a complaint and complaints had been resolved efficiently.

The service had a number of ways of gathering people’s views including using surveys and by talking with people, staff and relatives. The acting manager carried out a number of quality monitoring audits to help ensure the service was running effectively and to make improvements.

Gowlands specialises in providing regular respite care for people with learning disabilities and any associated needs, who are living with family or carers in the community. Gowlands is run by Hamelin Trust, which is a registered charity. There is a registered manager in the service.

The family carers of people using the service gave positive feedback about the service and we saw that there were systems in place to care for people safely.

Staff had the knowledge and skills to provide effective care and support for people who used the service.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are a code of practice to supplement the main MCA 2005 code of practice. We looked at whether the service was applying DoLS appropriately and found they were meeting the requirements of the code.

Family carers were confident their relatives were treated with dignity and respect and support was provided in a caring manner.

The service was well led by a competent manager who promoted an open culture that encouraged people using the service, their family carers and staff to raise issues and they could be confident concerns would be dealt with appropriately.

Upon entering this service we found the atmosphere to be relaxed and friendly. Throughout the day the numbers of people using the service varied as they either went to day services or were brought in by parents for their stay. We took this opportunity to observe the interaction between staff and people using the service, their parents/carers and other providers (for example transport services). We found these interactions to be informal yet professional with the focus being on the care and welfare of the person using the service.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We spent half an hour in the lounge with five people using the service observing the care and support being given. We spoke to the relatives of three people whose comments included, "Very excellent service, I've never had any reason to complain," and, "It's home from home."

On the day of our inspection we saw there were sufficient numbers of staff to provide support for people. People had their nutritional needs met and the provider had given consideration to what supportive equipment people required to support their independence with eating and drinking. We saw that staff were knowledgeable about people using the service and had sufficient training and information available to meet their needs.

On the day of our visit there was a friendly and relaxed atmosphere. Due to people being out at day services, recently discharged or not yet admitted we were limited in seeing staff interactions with people and in being able to gain the views of people using the service.

We spoke with a person using the service and their relative. We were told that, "[person] comes back and [they are] more confident. [Person] comes back with arts and crafts and things [they've] made....You know if there was a problem they [staff] are approachable." The person we spoke with told us they felt safe and had friends there and that they liked the staff.

We found that staff interacted with people in an easy manner and gave them space to do the activities that they wanted to but provided support when required.

There were no people who use the service present at the time of our visit.

People who use the service were unable to provide a verbal response or tell us their experiences, as a result of their limited verbal communication or poor cognitive ability. We noted their non-verbal cues and these indicated that people were relaxed and comfortable and found their experience at Gowlands to be positive.