Little Wakering House provides care and support for up to 13 people with either a learning disability and or autistic spectrum disorders. At the time of our inspection there were 13 people living at the service. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. This unannounced inspection took place on the 08 November 2018.

At the last inspection the service was rated Good. At this inspection we found the service remained Good. 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 registered manager in post. 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.

Systems were in place to ensure people remained safe whilst promoting their independence. Risks to people had been adequately identified and measures put in place with guidance for staff to mitigate the risk of harm.

Staff were trained and supported to meet people's needs. Staff were available when people needed assistance and had been recruited safely. People were involved in the planning of meals and menus. They received appropriate nutrition and hydration support to maintain their health and wellbeing.

There was a system in place to receive and manage complaints with guidance written in a format which met people's needs. People were supported and encouraged to express their views and opinions about how the service was provided and how they lived their daily lives.

People were supported by staff to lead fulfilling lives, ranging from gaining education and employment to achieving their goals. The service was committed to ensuring that people were able to engage with their hobbies and interests as much as possible.

There were systems in place to monitor the quality and safety of the service. Staff spoke very positively about the leadership and the open and positive culture of the service, and felt supported by the registered manager and provider.

Further information is in the detailed findings below

The Inspection took place on 16 May 2016 and 26 May 2016 and was unannounced.

Little Wakering House is registered to provide accommodation and personal care without nursing for up to 12 adults who have a learning disability and/or mental health needs. There were 11 people living in the service at the time of the inspection.

There was a registered manager in post. 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 consistently received their care and support in a way that ensured their safety and welfare. Staff knew how to protect people from the risk of harm. They had been trained and had access to guidance and information to support them with the process. Risks to people’s health and safety had been assessed and the service had care plans and risk assessments in place to ensure people were cared for safely.

The service employed sufficient numbers of staff to care for people appropriately. Staff had been safely recruited, were well trained and supported to meet people’s needs and aspirations. People received their medication as prescribed and there were safe systems in place for receiving, administering and disposing of medicines.

The registered manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and had made appropriate applications when needed.

People had enough to eat and drink to meet their individual needs. People’s care needs had been assessed and their care plans provided staff with the information needed to meet their needs and preferences and to care for them safely. People’s healthcare needs were monitored and staff sought advice and guidance from healthcare professionals when needed.

Staff were kind and caring and knew the people they cared for well. They ensured that people had the privacy they needed and maintained their dignity at all times. People expressed their views and opinions and they participated in activities of their choosing. People were able to receive their visitors at any time and their families and friends were made to feel welcome. There were advocacy services available where people did not have family members to support them to have a voice. An advocate supports a person to have an independent voice and enables them to express their views when they are unable to do so for themselves.

The service had an effective complaints system in place and people consistently told us they were confident that their concerns or complaints would be listened to and acted upon appropriately. The registered manager strived to make life better for people. Staff were confident and shared the registered manager’s vision to provide people with excellent care that met their individual needs and aspirations. The service consistently sought people’s views and opinions and used them to drive improvements in the home. The quality assurance system was effective and well implemented. The registered manager and provider monitored the service and recognised when improvements were needed and swiftly took action to make them.

We last inspected Little Wakering House in January 2013 when we found them to be non-compliant in the following essential standards: consent to care and treatment, care and welfare of people who use services, staffing and supporting workers. We visited the service in July 2013 and found that there had been improvements made in all areas of non-compliance. All staff had received training in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). There were Mental Capacity Act assessments in place where necessary.

Staffing levels had been increased, there was a clear induction programme in place and training had improved. Safeguarding procedures were good and safeguarding issues had been dealt with appropriately. Staffing levels had been greatly increased throughout the day to ensure that there were sufficient staff to work with people on a one-to-one basis. Staff told us that the training had improved and that they were well supported by the manager.

Staff records and other records relevant to the management of the service were accurate and fit for purpose. People spoken with were positive about the service, their comments included: ‘I am very happy here’, ‘always someone around when I need them’, I go out all the time’, ‘the food is good’.

People told us that they felt safe, they said that staff were kind and caring and that the manager was very responsive to their needs. This showed that the service is safe, caring, responsive and well led.

Records showed that people had an individualised support plan detailing their specific care needs and any potential risks.

We found that staff interactions with people who live at the service were positive and staff were seen to have a good rapport with individuals. People told us that they liked living at Little Wakering House and found staff to be kind, caring and supportive. Staff on duty at the time of our visit were observed to have a good understanding and awareness of people's support needs. Staff confirmed to us that they liked working at the service and that team work and morale was very good.

Our findings showed that improvements were required to ensure that people who use the service received meaningful activities in line with their commissioned one-to-one hours. We also found that improvements were required to ensure that staff working at the service received training in core and specialist subject areas relevant to their role and completed a comprehensive induction.

People told us that they were involved in their care. They said that they were treated well and that staff were respectful to them. They told us that they had been out locally for shopping and out on trips to London, Clacton and to the Tropical Wings Zoo.

People said that they were happy with the care provided at Little Wakering House. They were very positive when interacting with members of staff. People told us that they liked living in the home and that they felt safe. One person told us that the home was always nice and clean.

Little Wakering House provides care and accommodation for up to 12 people who have learning disabilities and/or mental health needs. This inspection took place on 13 and 14 November 2014 and was unannounced and carried out by one inspector.

The registered manager had been in post since the service was first registered. 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 and associated Regulations about how the service is run.

People felt safe, secure and happy living in Little Wakering House. They felt safe both in the house and when they were out in the local community with staff. We saw that there was good interaction between people living in the home and members of staff. People were treated respectfully and were spoken to in a calm, kind and caring way. Staff had a good knowledge about safeguarding adults procedures. They had received safeguarding training which had been regularly updated and they clearly explained the actions they would take to protect people if they suspected abuse.

We saw that good recruitment practice had taken place and that staff had not been able to start work until all of the appropriate pre-employment checks had been carried out. The duty rotas showed that there had been sufficient numbers of skilled and qualified staff on duty throughout the day and night. They showed that additional staff had worked when needed for extra activities.

Regular supervision and staff training had taken place and staff were supported to do their work.

Medication practice was good. Staff who administered medication had received training and the manager had carried out regular checks to test their competency.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and are required to report on what we find. The MCA sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The DoLS are a code of practice to supplement the main MCA code of practice. People’s rights were protected because the service worked in line with legislation.

There was a good supply of fresh food including fruit and vegetables. People told us that they were supported to ‘eat healthily.’

People had access to local advocacy services. An advocate is someone who can both listen to a person and speak on their behalf if needed. People would request an advocate when they were unable to fully express their thoughts and feelings and had no family or friends to speak on their behalf.

Staff had a good knowledge about people’s needs and preferences. The service was responsive to people’s needs and supported them to go on many activities in and around the local community. Relatives and health professionals told us that the service had an excellent understanding of people’s social and cultural diversity. They said that the service promoted a good quality of life and went the extra mile to provide ‘exceptional person centred care.’

Thorough assessments of people’s needs had been carried out before people moved into the service. The care plans that we looked at were person centred, detailed and informative. They included risk assessments and management plans for all areas of identified risk. People had consented to their care plans and had signed some of the documents to confirm this.

People knew how to complain. There was a clear complaints procedure in place and the records showed that any complaints had been dealt with appropriately.

We found that the service was well-led and that it provided people with good quality care. The quality assurance system was effective. Regular checks on the systems and processes in use had been carried out and improvements made where necessary. People were listened to and staff told us that they were encouraged to talk about their ideas at staff meetings. Staff members told us that they felt that people were at the heart of the service and they said that they were happy in their work. Staff, relatives and health professionals all told us that they were confident in the management of Little Wakering House.