The inspection was carried out on 15 June 2017 and was an unannounced inspection.

Homefield College Limited – 139 Homefield Road is registered to provide accommodation and personal care for up to four people with learning disabilities and autistic spectrum disorder who do not require nursing care. Accommodation is provided in a bungalow in Sileby. At this inspection, there were three people living in the service.

At the last Care Quality Commission (CQC) inspection on 2 February 2015, the service was rated Good overall with Requires Improvement in the Effective domain because one person had been identified as not having the mental capacity to consent to a specific area of their care. The mental capacity act had not been followed to make sure that the support the person received was in their best interests.

At this inspection we found the service remained Good overall.

People told us that they felt safe when receiving support from staff at 139 Homefield Road. People were protected against the risk of abuse. Staff recognised the signs of abuse, what to look out for and knew how to report any concerns. Medicines were managed safely and people received them as prescribed.

Staff followed guidance to minimise identified risks to people's health, safety and welfare. There were enough staff to keep people safe. The provider had appropriate arrangements in place to check the suitability and fitness of new staff.

There had been a change in how staff were deployed. This had been discussed with staff prior to the changes being made. However, staff felt that this continued to be a concern for them. The provider agreed to discuss this further with staff to resolve their concerns.

Staff received regular training and supervision to help them to meet people's needs effectively. Staff completed an induction to enable them to get to know the service. Team meetings had not been held regularly.

People were supported to follow a balanced diet. Where someone had a specific diet that they followed staff had a good understanding of this and guidance was in place for staff to follow. People received the support they needed to stay healthy and to access healthcare services.

Each person had an up to date support plan that was centred on them as an individual. This provided staff guidance on how to meet people’s support needs and their likes, dislikes and preferences. These were reviewed regularly.

People were encouraged to participate in activities, pursue their interests and to maintain relationships with people that mattered to them.

People were supported in line with the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). The provider and staff understood their responsibilities under the MCA.

Staff were caring and treated people with dignity and respect. They ensured people's privacy was maintained. People were supported to have choice and control of their lives.

People had access to a complaint’s procedure and felt confident to raise any concerns that they may have.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. The registered manager ensured that they met their legal responsibilities and obligations.

People, relatives and staff all told us that they could approach the registered manager. Staff told us that they felt supported by them.

There were systems and processes in place to monitor and review the quality of the service that people received. Where areas for improvement were identified an action plan was put in place to address these.

People and staff were encouraged to provide feedback about how the service could be improved. This was used to make changes and improvements that people wanted.

Further information is in the detailed findings below.

The inspection took place on 2 February 2015 and was unannounced.

At the last inspection on 3 September 2013 we asked the provider to take action to make improvements. We asked them to improve practice relating to obtaining people’s consent and acting in accordance with it. Following that inspection the provider sent us an action plan to tell us the improvements they were going to make. At this inspection we found improvements had been made to meet the relevant requirements.

Homefield College Limited - 139 Homefield Road provide accommodation, care and support for up to four people with learning disabilities. On the day of our visit there were three people living at the home. Accommodation was all on the ground floor.

The service had a 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.

People were supported to make informed decisions about their daily living and activities they undertook. People told us they were happy and felt safe living at the service. Staff promoted people’s independence and people’s privacy and dignity was respected.

People were supported by staff that had undergone a thorough recruitment and induction process. Staff received adequate training and felt supported in their roles.

There were robust systems in place to ensure that people’s medicines were managed safely. People told us they received their medicines when they needed them.

People’s human rights were protected because staff were aware of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The MCA is legislation that sets out the requirements that ensures where appropriate; decisions are made in people’s best interests when they are unable to do this for themselves. However, we could not evidence that these had been recorded appropriately. The DoLS are a law that requires assessment and authorisation if a person lacks mental capacity and needs to have their freedom restricted to keep them safe.

People using the service had access to information in appropriate formats to enable them to understand. Pictorial aids were used in people’s support plans and information was displayed around the service in formats for people to understand.

People were involved in the development of their support plans and were supported to pursue their hobbies and interests.

Staff told us they felt well supported and described the registered manager as approachable and supportive. Staff also told us that they felt valued and listened to.

There were effective quality assurance systems in place to identify improvements needed to the service.

When we arrived, two people who used the service had already left to attend a drama group. We saw that the other two people were getting ready to attend an art and crafts group at another of the providers’ locations. One person told us they enjoyed art. We later observed the art session and saw that people were engaged with drawing pictures of houses. Due to people’s limited and specialised communication we were unable to speak with people about the service in detail. However, we observed that people seemed comfortable and confident with staff.

We found that people had access to a wide range of community facilities and courses, dependent on their individual needs and choices. These included activities such as learning independent living skills, horticulture, art, drama and swimming. The service had a fully working café known as ‘Barrow Treats’ in a neighbouring village and people were supported to work within the café as part of their timetable of activities. In addition, the service also had an internet café known as ‘Sip and Surf’ in Loughborough. People were encouraged and supported to participate in cleaning, food shopping and meal preparation and we found that people’s independence was promoted by the service.

We looked at the records of two people who used the service and found care plans were detailed and thorough and provided clear guidance to staff about how the persons’ care should be delivered.

However, we found that the service did not have suitable arrangements in place for obtaining people’s consent and acting in accordance with the best interests of the person when they were unable to consent to the care and treatment being provided.

Staff had been appropriately screened to ensure they were suitable to work with vulnerable people. Staff we spoke with demonstrated a good understanding of the needs of people who used the service and treated people with dignity and respect.

Records we looked at were accurate and fit for purpose.

One resident was at the home when I visited and she she told me the following things:

"I enjoy making shopping lists with the help of my support worker. I have to estimate how much the food will cost and then we go to the shop to buy the food. Sometimes I find it easier than other times. When we get back home I cook the meal I’d planned. My support worker will help me if I want it."

"Today I am spending time on beauty therapy. When you came to the house I had just finished putting on a face mask and then had brushed my skin. When you leave I am going to the hairdressers. I will be keeping my hair the same red colour as it is know."

"I use skpe to keep in regular contact with my parents. The last time I used it I showed them a number of new clothes I had bought from a shopping trip on that day."