Jane House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Jane House provides accommodation and personal care for up to five people and personal care for up to two people in supported living.

At the time of the inspection, there were five people living at Jane House and two people in supported living. We were unable to fully communicate directly with some people receiving support. We spoke with their relatives to obtain their views of the support provided.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection, we rated the service good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a manager at the service who was registered with the CQC. 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.

People receiving support and their relatives told us they were confident they or their family member was safe.

There were systems in place to protect people from harm, including how medicines were managed. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team.

Safe recruitment processes were followed and appropriate checks had been undertaken, which made sure suitable staff were employed to care for people.

People’s care records contained detailed information and reflected the care and support being given. The service provided a programme of activities to suit people’s preferences.

The service was responsive to people’s needs. People and their relatives could be confident that any concerns or complaints would be listened to and dealt with.

People’s privacy and dignity was respected and promoted. Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and they were involved in decisions about their care. Staff understood how to support people in a sensitive way.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems supported this practice.

Staff were provided with relevant training, supervision and appraisal so they had the skills they needed to undertake their role.

People were supported to access a range of healthcare services. People were also supported to eat and drink enough to meet their needs and to make informed choices about what they ate.

There were quality assurance and audit processes in place to make sure the service was running well.

The inspection took place on 29 February 2016 and was unannounced. The home was previously inspected in July 2014 and the service was meeting the regulations we looked at.

Jane House is a care home providing accommodation and personal care for up to five people and personal care for up to two people in supported living.

The service had 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.

The provider had procedures in place to safeguard people from abuse. The policy explained how to recognise abuse and how to report it. The staff we spoke with were knowledgeable about the subject and told us they would report abuse immediately to their line manager.

We looked at systems in place to manage people’s medicines and found this was done in a safe way. Medicines were stored in a safe, lockable cupboard. Medicines which required cool storage were kept in the fridge where food items were stored.

We observed staff supporting people and found there were enough staff with the right skills and knowledge to meet people’s needs. People were able to be supported in the community or at the service depending on how they preferred to spend their day.

The provider had a safe and effective system in place for employing new staff. We looked at staff files and saw this process had been followed. The staff files we looked at contained pre-employment checks which were obtained prior to new staff commencing employment.

We spoke with staff who told us they received training that gave them the skills to carry out their roles effectively. Most training was sourced from the local council, but the provider had used a training agency to supply training not supplied by the council.

The requirements of the Mental Capacity Act 2005 were in place to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including balancing autonomy and protection in relation to consent or refusal of care or treatment.

People were offered a nutritious diet which they had been involved in choosing. People using both services decided between them what they would like on the weekly menu. They then wrote a shopping list, went shopping and assisted in meal preparation.

We looked at people’s care plans and found that relevant healthcare professionals were involved in their care when required.

People’s likes and dislikes were documented in their care plans and we saw these preferences were respected when we observed staff supporting people.

Support plans we saw had an initial assessment of people’s support needs and how best to assist the person. This was followed by a series of support plans which were available in easy read format and clearly involved the person. Care and support delivered was in line with records that we saw.

People who used the service and their relatives felt they could raise concerns if they had to. They felt the registered manager would listen to them and resolve their concern.

We saw evidence that staff and people who used the service were able to comment about the service and felt their views and opinions were valued. Frequent meetings were held with people who used the service and staff.

An independent person completed an annual audit and was available to support the registered manager when required.

We saw daily checklists in place for fire safety, daily notes, observation and medication. Although there was a record that medicines were checked on a daily basis this was a tick sheet rather than a detailed audit.

An adult social care inspector carried out this inspection. At the time of this inspection four people lived at Jane House. One person using the service was at home and we were able to speak with them about living at Jane House. We also spoke with 2 people using the service over the telephone to obtain their views of the support provided.

We spoke with the staff on duty, which consisted of the registered manager and the responsible individual. We telephoned three staff and were able to speak with two senior support workers about their roles and responsibilities.

We telephoned four relatives and were able to speak with two parents to obtain their views of Jane House.

We gathered evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People supported by the service told us they felt safe.

We observed, and people told us they felt their rights and dignity were respected.

Systems were in place to make sure managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We found that risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The home had policies and procedures in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) although no applications had needed to be submitted. Staff had been provided with training about the MCA and DoLS so that they understood when an application should be made and how to submit one. This meant people would be safeguarded as required.

Staff had been provided with training in safeguarding people so that people's rights and safety were upheld.

Policies and procedures were in place in relation to the safe management of medication. This meant people’s health and safety was promoted.

Is the service effective?

People’s health and care needs were assessed with them and their representatives, and they were involved in writing their plans of care. People’s preferences and interests had been recorded and care and support had been provided in accordance with people’s wishes.

People were provided with a choice of food and drink in line with their preferences.

Staff were provided with a range of training to ensure they had the skills to meet people’s needs. Staff were provided with formal individual supervision to ensure they were adequately supported and their performance was appraised.

Visitors confirmed they were able to see people in private and visiting times were flexible.

Is the service caring?

We asked people using the service for their opinions about the support provided. Feedback from people using the service was positive, for example, “I am happy here. We do things and staff are kind”, “I like it here a lot. The staff are good”. Comments from relatives were also positive. They included, “I am very satisfied. The standard of care is always good” and “I am more than happy. I would recommend Jane House to anyone”.

Observations showed that people’s needs were met by staff in a patient and kind manner.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Is the service responsive?

People regularly completed a range of activities in and outside the service.

People spoken with said they had never had to make a complaint but knew how to make a complaint if they were unhappy. We found appropriate procedures were in place to respond to and record any complaints received. People could be assured that systems were in place to investigate complaints and take action as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system, records seen by us showed identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure people received a good quality service at all times.

During our visit we spoke with four members of staff and one person using the service. We spoke with two relatives of people living at Jane House over the telephone after the visit.

People using the service and their family members that we spoke with gave us positive feedback about the home. One person living at Jane House told us “I like the other people and the staff.”

We found that people who used the service were given appropriate information and support regarding their care or treatment. Information available in the home was accessible and appropriate for the people using the service.

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. A family member told us “I have been to the review meetings. I’ve been involved in the care plans."

We found that people who used the service were protected from the risk of abuse. We asked people and their family members about safeguarding from abuse in the home. One person told us “I feel safe here and well cared for."

We found that the service had a recruitment system in place to show that all staff had undergone the appropriate checks.

People were made aware of the complaints system. We asked family members if they knew how to make a complaint and they were able to tell us the process. One family member said “I have never had any complaints. They sent us the complaints information so we know what to do."