This inspection took place on 13 June 2017 and was unannounced

Loretta House is registered to provide residential accommodation and personal care for up to ten adults, who have a learning disability. At the time of our inspection visit there were seven people living there.

There was 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.

Following our last inspection on 22 and 23 May 2015, we found the provider required improvement when it came to applying restrictions on people in their best interests. At this inspection we found there had been an improvement.

People and their relatives felt the home was a safe environment and staff knew what action to take if they had any concerns about people’s safety. The provider had systems in place to keep people safe from the risk of harm and abuse. Risks to people had been assessed and were appropriately managed and staff had a good understanding of how to reduce the risks to people. People were supported by sufficient numbers of staff, who had been safely recruited. People received their medicines, as prescribed, and there were systems in place to ensure people’s medicines were managed safely.

People were supported by staff that were suitably trained and sought people’s consent before providing support. The provider took action to protect people’s rights and adhered to the legal principles when depriving people of their liberty, in peoples’ best interests, where it was appropriate.

People were able to choose what they ate and drank and were supported by staff to maintain a healthy and nutritious diet. People were supported to access health care professionals to ensure their health care needs were met.

People were supported by staff that was kind, caring and respectful. People were treated with dignity and staff understood people's needs well. People were encouraged to be as independent as possible and were supported to make choices.

People’s health and support needs were assessed and reviewed and their relatives were invited to contribute to the review process. People were encouraged to participate in activities and interests they enjoyed. People knew how to complain, although there had been no complaints made about the service. The provider had internal quality assurance systems to monitor the care and support people received, to ensure it was to a good standard.

This inspection took place on 13 June 2017 and was unannounced

Loretta House is registered to provide residential accommodation and personal care for up to ten adults, who have a learning disability. At the time of our inspection visit there were seven people living there.

There was 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.

Following our last inspection on 22 and 23 May 2015, we found the provider required improvement when it came to applying restrictions on people in their best interests. At this inspection we found there had been an improvement.

People and their relatives felt the home was a safe environment and staff knew what action to take if they had any concerns about people’s safety. The provider had systems in place to keep people safe from the risk of harm and abuse. Risks to people had been assessed and were appropriately managed and staff had a good understanding of how to reduce the risks to people. People were supported by sufficient numbers of staff, who had been safely recruited. People received their medicines, as prescribed, and there were systems in place to ensure people’s medicines were managed safely.

People were supported by staff that were suitably trained and sought people’s consent before providing support. The provider took action to protect people’s rights and adhered to the legal principles when depriving people of their liberty, in peoples’ best interests, where it was appropriate.

People were able to choose what they ate and drank and were supported by staff to maintain a healthy and nutritious diet. People were supported to access health care professionals to ensure their health care needs were met.

People were supported by staff that was kind, caring and respectful. People were treated with dignity and staff understood people's needs well. People were encouraged to be as independent as possible and were supported to make choices.

People’s health and support needs were assessed and reviewed and their relatives were invited to contribute to the review process. People were encouraged to participate in activities and interests they enjoyed. People knew how to complain, although there had been no complaints made about the service. The provider had internal quality assurance systems to monitor the care and support people received, to ensure it was to a good standard.

At our last inspection compliance actions were issued relating to staff training and audits of the home. These issues have been addressed.

On the day of our inspection eight people were living in the home. We spoke with two staff members, the manager and two people about the service. We looked at the care records for five people who lived there and five staff files.

People were asked for their consent before providing care and support. One person said, “They always ask if it’s okay before they give me my medicine or do anything for me.” This meant that people were able to direct the care they received.

Records gave staff enough information to support people with their needs in the way they preferred. People's were supported by range of health professionals who saw them regularly so that their health care needs were monitored and met.

People helped themselves to food and drink during the day. One person said, “We choose our meals and help to make them.” People’s weight was monitored regularly so that action could be taken if people were gaining or losing too much weight.

Systems were in place to ensure that people were safeguarded from harm. Staff had regular training and support to be able to safely care for people in the way that they chose.

The furnishings and presentation of the home provided a homely environment. The home and garden was pleasant and safe.

Robust systems were in place to assess and monitor the quality of the service provided.

We spoke with four people about their experiences of living in the home. One person told us, "I love living here the staff really look after me and help me."

We observed how people were cared for to understand their experiences. We saw that attention had been given to their appearance and personal care.

Staff interacted well with people living there. We saw people were treated with dignity and respect.People could choose how they spent their time and what they ate and drank. One person told us “I go out on the ring and ride to the day centre or shopping. I am busy every day.”

Staff referred people to other professionals and followed their advice to ensure that people's health needs were met. Care plans did not always reflect people’s current support needs. This meant that staff did not always have all the information that they needed to support people safely.

Appropriate checks were made before staff started working at the home to ensure that staff were suitable to work with people living there.

Staff showed that they knew how to protect the people living there from being abused to ensure that people were safeguarded from harm.

We saw that staff training was not up to date. Records showed that staff needed additional training to give them the skills and knowledge to know how to meet people's needs and ensure their well being.

Systems to audit the safety and quality of care to ensure that people were safeguarded from harm were in place but not up to date.

This inspection took place on 28 and 29 May 2015 and was unannounced

Loretta House is registered to provide residential accommodation and personal care for up to ten adults, who have a learning disability. At the time of our inspection visit there were seven people living there.

There was 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.

Following our last inspection on 15 July 2014, we found the provider was not fully compliant with the regulations inspected. The home environment posed a risk to people’s safety and the provider’s process for managing risks for people in the kitchen, did not promote independence. There was no registered manager in post. We asked the provider to send us an action plan outlining how they would make improvements and we considered this when carrying out this inspection visit.

There had been some improvements. A new manager had registered and was in post. The flooring in the downstairs bathroom had been repaired although the bathroom floor upstairs remained damaged. A downstairs bath had been re-enamelled and the sealant replaced. The floor in the kitchen had also been repaired. Bedroom and lounge furniture had been replaced. Risk assessments had been reviewed and were person centred to promote independence and not risk averse.

People that lived at the home felt safe and staff was available to support them. Staff knew how to reduce the risk of harm to people from abuse and unsafe practice. The risk of harm to people had been assessed and managed appropriately. The provider had systems in place to keep people safe and protected them from the risk of harm and ensured people received their medication as prescribed.

There were sufficient numbers of staff available to meet people’s identified needs. Staff were suitably recruited and received the necessary training to meet the care and support needs of people. The provider took action to protect people’s rights. However, there was some misinterpretation concerning the principles of depriving people of their liberty, where it was appropriate.

People’s health and support needs were met and they were able to choose what they ate and drank. Staff were caring and treated people with respect and dignity.

There were a range of social and leisure activities that people could choose to take part in. There was a complaints process that people and relatives knew about. People’s concerns were listened to and addressed quickly.

The provider had internal quality assurance systems to monitor the care and support people received, to ensure it was of good standard.