This was a comprehensive inspection which took place on 10 January 2018. It was unannounced.

Multi-Care (Reading) Limited - 375 Old Whitley Wood Lane is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Multi-Care (Reading) Limited - 375 Old Whitley Wood Lane is registered to provide accommodation and care for up to four people living with a learning disability. At the time of the inspection four people resided at the service.

At the last inspection in November 2015 the service was rated Good. At this inspection we found the service remained Good.

The home is required to have a registered manager. 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. At the time of the inspection a registered manager was in post and assisted with the inspection.

People continued to receive safe care from the service. Risk assessments were completed and measures taken to reduce any identified risks without restricting people’s freedom. There were sufficient staff to support people safely. Staff were trained to safeguard and protect people. They understood their responsibilities to report concerns and did so promptly when necessary. Medicines were managed safely and people received their medicines when they required them.

People continued to receive effective care from staff who were trained and had shown they had the necessary skills to fulfil their role. However, not all refresher training was completed within the current recommended timescales. We have made a recommendation that the provider refer to the current best practice guidance on ongoing training for social care staff. Opportunities to gain recognised qualifications were available to all staff. Those who did not already hold a qualification had begun working toward one. Staff were supported through one to one meetings, appraisals, staff meetings and regular communication with the registered manager. They were encouraged to seek advice, discuss and review their work in order to develop their skills and knowledge.

People were supported with nutrition and hydration and had sufficient to eat and drink to maintain their health and well-being. People benefitted from a service that supported them to stay healthy. Healthcare advice was sought and followed through appropriately. Regular reviews of people’s health and wellbeing were undertaken. 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 in the service supported this practice.

People benefitted from a service and staff team who were caring. People were treated with kindness, dignity and respect. They and their relatives were involved in planning and reviewing decisions about their care. Staff were kept up to date with information related to the changing needs of people they supported. There were positive interactions between people and staff and we saw people were relaxed. People were helped to be as independent as possible and encouraged to maintain and develop skills.

People were supported by a staff team who knew them well. People’s individual support plans were person-centred and contained detailed guidance for staff. They focused on and respected the diverse needs and preferences of each person. People and their relatives knew how to complain but had not needed to use the formal complaints procedure. They told us they felt were listened to if they ever raised an issue. People were supported to engage in meaningful activities of their choice. Pe

This inspection took place on 17 November 2015 and was unannounced. Multi-Care (Reading) Limited provides a service for up to four people with learning disabilities or autistic spectrum disorder. On the day of the inspection four people were living at 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.

The registered manager had not sent a notification to the Care Quality Commission (CQC) to inform them of a significant event in the service. This was completed and sent retrospectively to the CQC following the inspection.

People were safe. The service had systems in place to manage risks to both people and staff. Staff knew their responsibilities and how to respond to concerns about people’s safety. They felt any concerns would be taken seriously by the registered manager and acted on. An effective recruitment procedure helped to ensure only suitable staff were employed to support people. There was a system to ensure people received their medicines safely and promptly.

Staff felt supported by the registered manager and provider. They received training and had the opportunity to express their views on the service. Staff understood their responsibilities in relation to gaining consent before providing support and care, therefore people’s right to make decisions was protected. People were supported to stay healthy. Healthcare advice was sought appropriately and people had sufficient to eat and drink in order to maintain a balanced diet.

People were treated with kindness, dignity and respect. They were involved in planning and reviewing decisions about their care. The registered manager ensured that up to date information was communicated promptly to staff.

We found an open culture in the service and staff were comfortable to approach the registered manager for advice and guidance. Feedback had been sought from people and relatives on the service and used to make improvements.

The quality of the service was monitored by the registered manager and provider through auditing of the service.

We spoke with people who use the service about how staff supported them and sought their consent before providing them with care.

We found the registered person introduced suitable arrangements for obtaining and acting in accordance with the consent of people who use the service. Improvements were made for establishing and acting in accordance with their best interests. Staff showed they had knowledge of their responsibilities under the Mental Capacity Act 2005.

The registered person had made improvements for effective recruitment procedures and had obtained required information in respect of people employed to work at the home.

We found staff records and other records relevant to the management of the home were now accurate, stored securely and could be located promptly when needed.

The provider had two people registered with us as managers for this location. We were aware that one of those managers, Mr Samba Deen Turay, had left the organisation. The provider was aware that Mr Turay must apply to CQC to cancel his registration. The other manager, Mrs Adama Challe, continues to work at the home and remains the registered manager. In this report, where we refer to the manager, we are referring to Mrs Adama Challe.

We spoke with people living at the home but what they told us did not relate to the arrangements at the home for obtaining their consent in relation to their care and treatment. What they told us also did not relate to how the service recruited staff or how records were managed at the home.

We found care staff had an improved knowledge of their responsibilities under the Mental Capacity Act 2005. However, the registered person had not introduced suitable arrangements for obtaining and acting in accordance with the consent of people living at the home. There were no suitable arrangements for establishing and acting in accordance with their best interests.

The registered person had not operated effective recruitment procedures and had not ensured that all required information was available in respect of people employed to work at the home.

We found staff records and other records relevant to the management of the home were not accurate, were not stored securely and could not be located promptly when needed.

The provider had two people registered with us as managers for this location. We were advised that one of those managers, Mr Samba Deen Turay, had left the organisation. Staff at the home were not able to tell us the date Mr Turay left. The provider was aware that Mr Turay must apply to CQC to cancel his registration. The other manager, Mrs Adama Challe, continues to work at the home and remains the registered manager. In this report, where we refer to the manager, we are referring to Mrs Adama Challe.

At the time of our visit there were four people living at the home and all had activities planned for the day. We spent time observing them and their interaction with staff. We saw people at the home making their individual choices known to staff and staff responding appropriately. We also spoke to people living at the home. One person told us they liked living at the home.

We found that the provider did not have suitable arrangements in place for obtaining the consent of people who live at the home in relation to their care and treatment. Staff told us they had not received any training in the Mental Capacity Act 2005 which would help them to know when capacity should be assessed.

We looked at the safeguarding arrangements at the home and found that there were policies and procedures in place. Staff we spoke with demonstrated an understanding of the policies and felt confident that they knew who to contact if they suspected abuse was happening.

The provider has a procedure in place for recruiting and appointing staff, We found that some necessary checks were carried out prior to appointment. However, the provider did not have all the necessary information available, such as evidence of references and full employment history for some members of staff. This may mean that people were at risk of being cared for by people who were not of good character.

In this report the name of two registered managers appear, neither was present at the time of the inspection.

At the time of our visit there were four people living at the home and one person was out for the day. Of the remaining people two used non-verbal communication. We spent time observing them and their interaction with staff. We were able to talk to the other person living at the home who told us that she 'liked living here'.

We saw people at the home making their individual choices known to staff and staff responding appropriately.

We also spoke to relatives of the people living at the home. One relative told us she felt her daughter had 'the best care she could get' and 'she is loved by the carers'. Another relative we spoke to told us the staff were 'good with my daughter and they encourage her to make choices'

In this report the name of a registered manager appears who was not in post and not managing the regulated activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time of this inspection. We have advised the provider of what they need to do to remove the individual's name from our register.