High Barn is situated in Rochdale and is based in a large house that can accommodate up to four adults with a learning disability. The organisation specialises in the care of young adults with autism. Facilities include a communal lounge, separate dining room and kitchen. All the bedrooms are single and one is situated on the ground floor in order that people with physical disabilities may also be accommodated. Four people were accommodated at the home on the day of the inspection.

A registered manager was 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. The manager had been in post since September 2016.

The service used the local authority safeguarding procedures to report any safeguarding concerns. Staff had been trained in safeguarding topics and were aware of their responsibilities to report any possible abuse.

Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults.

The administration of medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow.

The home was clean, tidy and homely in character. The environment was maintained at a good level and homely in character.

Electrical and gas appliances were serviced regularly. Each person had a personal emergency evacuation plan (PEEP) and there was a business plan for any unforeseen emergencies.

There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities. This helped to protect the health and welfare of staff and people who used the service.

People were given choices in the food they ate and told us it was good. People were encouraged to eat and drink to ensure they were hydrated and well fed.

Most staff had been trained in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The registered manager was aware of her responsibilities of how to apply for any best interest decisions under the Mental Capacity Act (2005) and followed the correct procedures using independent professionals.

New staff received induction training to provide them with the skills to care for people. Staff files and the training matrix showed staff had undertaken sufficient training to meet the needs of people and they were supervised regularly to check their competence. Supervision sessions also gave staff the opportunity to discuss their work and ask for any training they felt necessary.

We observed there were good interactions between staff and people who used the service. People told us staff were kind and caring.

We saw from our observations of staff and records that people who used the service were given choices in many aspects of their lives and helped to remain independent where possible.

We saw that the quality of care plans gave staff sufficient information to look after people accommodated at the care home and they were regularly reviewed. Plans of care contained people’s personal preferences so they could be treated as individuals.

We saw that people were able to attend activities of their choice and able to visit family members with staff support.

Audits, surveys and key worker sessions helped the service maintain and improve their standards of support.

People thought the registered manager was approachable and supportive.

High Barn is situated in Rochdale and is registered to provide personal care and accommodation for up to four people learning disabilities. The organisation specialises in the care of young adults with autism. The provider was given 48 hours’ notice of this inspection which took place on 20 May 2015. This was to ensure that a manager from within the company would be available to assist us with the inspection. There were four people living in the service at the time of our inspection.

We last inspected this service on 1 April 2014 when we found the service to be in breach of several regulations. We issued compliance actions that required the provider to make the necessary improvements in relation to promoting the rights of people who used the service, improving the premises and assessing and monitoring the quality of the service provided.

The service did not have a registered manager. The area manager was in charge of the home on the day of the inspection and told us that she had submitted an application to become registered with the Care Quality Commission as manager of High Barn. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People who used the service told us that High Barn was a safe place to live. Staffing levels were sufficient to meet the needs of people who used the service.

Safeguarding procedures were robust and members of staff understood their role in safeguarding vulnerable people from harm.

We found that recruitment procedures were thorough and protected people from the employment of unsuitable staff.

We saw that medicines were managed correctly in order to ensure that people received their medicines as prescribed.

The home was clean and appropriate procedures were in place for the prevention and control of infection.

Members of staff told us they were supported by management and received regular training to ensure they had the skills and knowledge to provide effective care for people who used the service. The staff team had also completed training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) so they knew when an application should be made and how to submit one.

People who used the service helped to plan the menus. They told us the meals were good and they had a take away on a Friday. We found that people’s weight and nutrition was monitored so that prompt action could be taken if any problems were identified.

People were registered with a GP and had access to a full range of other health and social care professionals.

We saw that staff were friendly and relaxed and looked after people in a caring manner.

Care plans included information about people’s personal preferences which enabled staff to provide care and support that was person centred and promoted people’s dignity and independence.

People who used the service were supported to pursue hobbies and leisure activities of their choice.

Members of staff told us they liked working at the home and found the area manager approachable and supportive.

We saw that systems were in place for the area manager to monitor the quality and safety of the care provided.

High Barn is a care home that can accommodate up to four people with learning disabilities. The home specialises in the care of younger adults with autism, however we found no specialist support was provided for people with a learning disability or autism.

The home was a large detached property with secure garden space to the side of home. Facilities included a communal lounge, a separate dining room and kitchen. All bedrooms were single occupancy. One bedroom with an en-suite was situated on the ground floor in order that people with physical disabilities may also be accommodated.

High Barn had new manager who was registered with the Care Quality Commission in March 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

We found the location was not meeting the requirements of the Deprivation of Liberty Safeguards. Whilst proper policies and procedures were in place and training had been provided to staff in the Mental Capacity Act (2005) and deprivation of liberty safeguards (DoLS), staff spoken with were not able to demonstrate a good understanding. This did not ensure people’s rights were protected and promoted. This meant there had been a breach of the relevant regulation.

We found the care records did not provide information about the individual needs of people to help guide staff in the delivering of people’s support. This meant there had been a breach of the relevant regulation. We saw the care records were securely stored when not in use ensuring confidentiality was maintained.

For some people communication and decision making was difficult. People expressed themselves through gestures and facial expressions. We saw staff assisted people who used the service in making decisions and choices where possible in a kind and respectful way.

During the course of our inspection we saw people were not offered any meaningful, stimulating activities or variety to their day. In the main, people were left to their own devices either in the garden or watching television. This meant there had been a breach of the relevant regulation.

Suitable arrangements were in place with regards to protecting people from abuse or unlawful practice. Recruitment procedures were in place so that only applicants suitable for employment were offered work at the home.

New staff received mandatory training as part of their induction programme. A programme of on-going training and development was in place. However staff spoken with had not received training in specific areas of support. This meant staff did not always have the necessary skills required to meet people’s needs. This meant there had been a breach of the relevant regulation.

Staffing levels at certain times of the day were insufficient. This meant people’s safety could be compromised and choices of spontaneous activities were limited.

Checks were made to the premises and servicing of equipment ensuring people living at working at the home were safe. However systems to monitor the quality of care and support people received needed improving.  This meant there had been a breach of the relevant regulation.

We found the home was warm and clean. The communal areas and corridors were in need of decorating and refurbishment to ensure people who used the service lived in a comfortable, well maintained environment.

Records showed the Care Quality Commission had been notified of any incidents that could affect the health, safety and welfare of people.

We did not speak with any people using the services as part of this inspection.

We received an action plan with details of how the provider was going to meet the areas of non-compliance. During this inspection we found that the provider had met the areas of non-compliance from the previous inspection in May 2013.

In this report the name of a registered manager appears who was not present and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

Due to the complex needs of people living at High Barn it was difficult for everyone to express their opinions on the service they received. Although the people found it difficult to fully express what they were trying to say, they looked happy and comfortable in their surroundings.

We spoke with one person who told us they enjoyed living at High Barn and liked the way their room was decorated. They told us they went out regularly and enjoyed going out to eat on occasions. The person we spoke with was complimentary about the staff and seemed to have a good relationship with them.

Due to the complex needs of people living at High Barn it was difficult for them to express their opinions on the service they received. Although the people found it difficult to fully express what they were trying to say, they looked happy and comfortable in their surroundings.

People's care records contained detailed information to show how people were to be supported and cared for and how their dignity and privacy were to be respected.

The people living at High Barn have multiple and complex needs therefore we were not able to speak to everyone. However from observing practices we saw people appeared genuinely happy in their home and were relaxed with the staff.

One person was able to chat to us; he told us that he was able to make his own choices and said “I can do what I like”.

He was happy with the care and support he received and told us he was treated well.

He liked the food and could eat what he wanted and said that the home was nice and clean.

He told us he liked the staff and that there were enough staff to look after people properly.

He told us he could get out of the home and visit different places.

He told us that he was happy living at the home and with the care and support he received and would talk to his key worker if he was unhappy.