About the service:

Harborne House is a residential care home providing personal care and support to four people who were aged under 65 at the time of the inspection.

The care service had not originally been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. The home had been registered before such guidance was produced. The guidance focussed on values include choice, promotion of independence and inclusion so that people with learning disabilities and autism using a service can live as ordinary a life as any citizen. However, it was clear that people living in Harborne House were given such choices in the home that was located in a residential suburb where their independence and participation within the local community had been and was continuing to be encouraged and enabled.

People’s experience of using this service:

People who used the service continued to be supported to remain safe. Staff knew people well and supported them with kindness and consideration.

People received medications safely and risks to people had been assessed and managed to identify and reduce or address the impact of any known risks. Other aspects of safety, including fire safety and issues of personal safety, were well managed in the home.

People continued to be supported in a well maintained and comfortable home with access to all communal areas and private space as they wished.

Peoples rights were upheld and protected. People were protected from discrimination and supported to make full use of all community based facilities. People were supported to have choice and control over their day to day lives and received kind support and assistance from staff to exercise choice to make everyday decisions.

People continued to be supported by an established team of staff who provided kind and personalised care to people living in the home. Safe recruitment of staff ensured people were supported by staff of good character.

There was a range of monitoring systems in place that checked if the home was well managed and effective in supporting people to have a good quality of life. People were supported by staff who were well trained and focussed on supporting them with their plans.

The registered manager was keen to promote opportunities to support people to engage in community based activities and enjoy a range of experiences in line with their wishes or interests. People’s preferences and experiences were known to the registered manager and staff who provided personalised encouragement and enabled people to do as much as possible for themselves.

The home continued to meet the characteristics of a rating of good in all areas. More information about the inspection is in the full report.

Rating at last inspection:

The home was rated Good at the last inspection (report published in April 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor the service through the information we receive.

This inspection took place on 8 March 2016 and was unannounced. The inspection was undertaken by one inspector. We last inspected the service 15 July 2013, all the regulations we assessed were met.

Harborne House is a residential care home for up to four people with autistic spectrum disorder and learning disabilities.

There was a registered manager in post at the time of our inspection. 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.

People received a safe service, because the provider had clear procedures in place to support staff in reducing the risks of harm to people. Staff were trained and knew the procedures to help to keep people safe.

People were supported by sufficient numbers of staff that were trained, supported and suitably recruited to meet people’s needs.

People received their medicines as prescribed and staff followed the provider’s procedure to ensure medicines were administered and managed safely.

People’s rights, privacy, dignity and independence were promoted and respected at all times.

People received food and drink to ensure they remained healthy and had access to health care professionals to support their health.

People pursued a range of social, work and community interests to enhance their lifestyle and well-being.

People received a service which focused on their individuality and they were involved in assessing and planning their care.

People and their relatives were confident that their concerns and complaints would be listened to and acted upon.

People received a good quality service from staff that were friendly and approachable.The management of the service was stable, with robust processes in place to monitor the quality of the service and to seek the views of people using the service.

On the day of our visit we met all four people who used the service. Because of their complex health needs they were not able to tell us much about their experiences of the home. We therefore used other methods to help us understand people’s experiences. One person told us that it was “Okay” living at the home.

We spoke with three members of care staff and two senior staff (including the registered manager) and looked at documentation that was made available to us. We saw staff interacting in a friendly manner with people and supporting them to be independent. People appeared at ease in their environment and were appropriately dressed for the hot weather. They moved freely around the home and gardens.

People made day to day decisions about their lives such as getting up and what clothes they wore. Where decisions were made on a person’s behalf they were done so in their best interest.

People were supported to receive adequate food and drink that met their individual needs. Staff were knowledgeable about any specific dietary requirements people had and supported them with this.

Processes for the recruitment of staff helped to ensure that people were cared for by suitably skilled and experience staff. Staff were given training to maintain their skills.

Systems were also in place to monitor how the service was run and ensure people received a quality service.

On the day of our visit we met all three people who lived at the home. We used a number of different methods to help us understand the experiences of people using the service, because the people who used the service had complex needs and were either unable or unwilling to share with us their experiences of using the service. Methods used included speaking with staff, a visiting health professional, observing care and reviewing relevant information available to us.

Following our visit we also contacted three relatives of people who used the service by telephone. The relatives we spoke with told us that they were satisfied with the care that was currently provided. One person told us, “The home is very nice…they look after them well.” Another person said, “My relative is fine at the moment, they are very happy.”

We spent time observing staff as they provided support to people who lived in the home. The people who used the service looked relaxed in the company of staff. The staff spoke politely with people and assisted them with their needs. We saw people being encouraged to remain independent and making choices about what they wanted to do.