ILP Residential is a care home service registered to provide personal care and accommodation for up to 2 people who have a learning disability. The service had the size and feel of a family home. It had two employees; a husband and wife team who lived in the home on the second floor. The bedrooms and bathroom of people who use the service were on the first floor, and the shared kitchen, sitting room and conservatory were on the ground floor.

The inspection was unannounced and took place on13 October 2015.

The service had a registered person who was responsible for the day to day running of the home. 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. In addition to the registered person, one other member of staff was employed as a support worker. The staffing allocation was usually a minimum of one member of staff on duty at any time. Agency staff were not used at the home.

People and their families were very complimentary about the service provided at ILP Residential. One person said it was the best place they had ever lived. A family member said, “It’s home from home.” People were equally complimentary about the staff at ILP, one person said, “I think they are tremendous.” Another person said their relative received “lovely care” and “couldn’t be in a better place.”

Some of the records were not up to date and were incomplete. We have made a recommendation about this, but it is important to note that this did not negatively impact on the service because staff knew the people who use the service very well, and took necessary actions to promote their safety and well-being.

The Mental Capacity Act 2005 sets out what must be done to make sure that the rights of people who may lack mental capacity to make decisions are protected in relation to consent or refusal of care or treatment. CQC is required by law to monitor the application of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found that the service obtained people’s consent before care and treatment were provided. However, there were no records of necessary assessments of people’s capacity to make some decisions. For example decisions on how people wanted support for financial management to be provided. We have made a recommendation about this. However, the impact on people’s lives was very low because in practice, their finances were being managed according to their wishes.

The service provided person centred care which promoted equality and diversity. Each person who uses the service had their own personalised support plan which promoted their individual choices and preferences.

People were consulted and involved in developing the way their care was delivered. Family also said that staff kept them informed and worked in partnership with them. The service valued and acted on the feedback it received from people in a responsive, flexible way.

People’s independence was promoted and they were enabled to participate in meaningful activities which enriched and added to their quality of life. Staff listened to people and helped them express their views. Trusting relationships had been built up, and staff were highly motivated to provide compassionate care which maximised people’s well-being, safety and independence.

The service had systems in place to keep up to date with best practice and to promote improvement and development. There was a system in place to record and learn from incidents and accidents. The registered person said there had been no accidents since the last inspection on 17 December 2013.

Arrangements were in place to ensure people were protected from abuse. Staff showed good understanding and attitude towards safeguarding.

Two people lived with the owner at this service. Each person was mostly independent, with support available from the owner when required.

When we arrived, one person had already left for work, so we spoke with the other person about how they were supported to live their life as they wanted.

Both people at this service had busy lives. For example, they attended college and did various types of work independently, regularly shopped and cooked, walked the dog and went on extended holidays abroad.

The person we met showed us how they were involved in writing their own care records and in planning what they wanted to do each day. This included routine daily activities such as cleaning and tidying, as well as work commitments, leisure time and hobbies.

They also told us they felt safe and able to approach the owner with any concerns they may have. The owner told us that they provided people's routine support themselves, but that where the occasional bank or agency staff worked for any reason, they also ensured they were confident to raise concerns at any time.

The owner had systems in place to monitor the standard of quality in the service.

We spoke with one person that lived at the home about the care they received. The person we asked told us they made their own decisions and were able to give valid consent. This person told us they were able to make their own GP appointments without staff support. The staff on duty told us people at the home had given their consent to go abroad for a month on holiday with the provider and staff. They had also had given consent to have the flu vaccine.

The person we spoke with said they were involved in the planning of their care and confirmed they received the care described in their care plan. We were told by this person they were involved in the running of the home and they were expected to prepare their breakfast and refreshments, keep their bedroom tidy and help to keep the home clean.

One person told us they felt safe at the home and they were confident to approach the manager and staff with complaints.

We were told people at the home led busy lives, for example attend college, paid employment and were part of the community. The person we spoke with told us they did not need staff support in the local community and they were able to stay at the home without staff support.

One person told us that they had lived with Mr and Mrs Lewis for 18 years and did not want to live anywhere else because they liked the home and were treated very well.

People were given choices about how they spend their time. They said that it was up to them what they did each day, but they especially liked to go on holiday and told us that they were all going to Butlin’s soon. Staff confirmed that people living in the home had decided where they would go.

We saw that people had personalised their bedrooms with their choice of decoration, television and hobby items such as computer games. People chose when to get up, go to bed, when to have a bath and what clothes to wear. Routines within the home were flexible and fitted in with people’s activities.

We asked one person what it was like living in their home, they told us that it was like family because “Cherry and Jim look after me and I do lots of things”. They told us how they stayed safe, for example, by not touching the kettle. They said that they talked to their carers about being healthy, being safe and things they wanted to learn. Mr and Mrs Lewis are both employed within the home as manager and care worker