Oak lodge 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.

Oak lodge provides accommodation and personal care for up to six people who have learning disabilities and some associated physical or/and sensory disabilities. There were six people using the service at the time of inspection.

Oak lodge was a purpose-built bungalow with spacious bedrooms and communal areas that were wheelchair accessible. There was ample and accessible outdoor space, with a sensory garden and fish pond.

The care service had 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 on-going 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.

The service had a registered manager. 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 were safe. Staff were recruited safely and there were enough staff to meet people’s support needs. Medicines were given safely by trained and competent staff. Areas of risk were continuously assessed and enabled people to remain safe and have choice over how they wanted to live their lives. The environment was well maintained and safe for people to live in.

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’s nutritional and dietary needs were met. People received support from a wide range of health and social care professionals to maintain their wellbeing. Staff had received a robust induction and had the skills and knowledge to meet all of people’s needs. They were further supported in their roles with regular supervisions, staff meetings and appraisals.

We observed people to have built good relationships with staff and the atmosphere was warm, positive and engaging. Relatives and a professional spoke highly of the kind and caring nature of staff. People’s independence, dignity and privacy was continuously respected and promoted.

Relatives and a professional told us that staff were responsive to people and any changing needs. There was a clear complaints policy and relatives were confident any concerns they had would be dealt with immediately. People’s communication needs were well known and supported using a variety of communication tools. People had been supported to understand death and bereavement when someone they knew passed away.

Relatives, a professional and staff were complimentary of the registered manager and felt the service was well-led. The provider sought views from people, relatives, staff and professionals to improve the service. The registered manager was passionate about providing care and worked with the provider to improve the lives of people.

Further information is in the detailed findings below.

Oak Lodge provides accommodation for up to six younger adults with physical and learning disabilities. There were six people living at the home at the time of our inspection. People’s needs were varied and included requiring support associated with cerebral palsy, autism and epilepsy. People had complex communication needs and required staff who knew them well to meet their needs.

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.

This comprehensive unannounced inspection took place on 17 and 18 March 2016.

There were enough staff who had been appropriately recruited, to meet the needs of people. Staff had a good understanding of the risks associated with supporting people. They knew what actions to take to mitigate these risks and provide a safe environment for people to live. They understood what they needed to do to protect people from the risk of abuse. Appropriate checks had taken place before staff were employed to ensure they were able to work safely with people at the home.

The registered manager and staff had training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They had assessed that some restrictions were required to keep people safe for example, the use of bed rails and lap straps on wheelchairs. Where this was the case referrals had been made to the local authority for authorisations.

Staff had a good understanding of people as individuals, their needs and interests. Each person had the opportunity to go out every day. A ‘You said, we did’ board was used to demonstrate that when people made choices about activities arrangements were then made for these to happen.

We observed safe and effective teamwork among the staff when supporting people with their mobility and healthcare needs and staff continually gave reassurance to people and respected their dignity at all times.

People had access to healthcare professionals when they needed it. This included GP’s, dentists, speech and language therapists and occupational therapists. Communication passports were used to ensure that all staff could work effectively with people and helped them to identify the subtle ways that people indicated their choices and made their needs known.

People were asked for their permission before staff assisted them with care or support. Staff had the skills and knowledge necessary to provide people with safe and effective care. Staff received regular support from management which made them feel supported and valued.

The registered manager was approachable and supportive and took an active role in the day to day running of the service. Staff were able to discuss concerns with them at any time and know they would be addressed appropriately. Staff and people spoke positively about the way the service was managed and the open style of management.

We sampled two care files and found these contained personal likes and dislikes and preferences. Therefore making care plans more individualised. We noted there had been an initial assessment of care needs when an individual had first arrived at the home.

When we spoke with visitors in the home, we were told: "the staff are lovely" and "my relative has thrived since they have lived in here".

We found people's nutritional needs were being met and supported.

We noted warm and respectful interaction between people who lived at the care home and staff who supported them. We observed that the environment was clean, bright and well decorated using art work of people who lived there and photographs documenting enjoyable shared activities and holidays. This meant that people were well supported and the environment was safe, suitable and homely.

One person told us about their active life in the community including independent shopping trips "to buy things for myself". We examined care planning and health and safety records which showed that care being delivered was effective and that the environment was safe and well maintained.

Staff were only employed following a structured recruitment and interview process and relevant checks were carried out prior to them starting work.

During our inspection we found that the premises were clean and well maintained and the atmosphere was relaxed and homely.

We found that comprehensive and well maintained person centred support plans enabled care workers to meet people's assessed needs in a structured and consistent manner.

In accordance with their individual care plans, people were enabled and supported to make choices about their daily lives. They had input into how the home was run and were able to influence decision making processes.

Appropriate arrangements were in place in relation to storing, administering handling and recording medicines.

We found that there were enough qualified, skilled and experienced staff in place to meet people’s needs

Care workers had developed awareness and a sound understanding of each individual's care and support needs. This was evident from direct observation of individuals being supported in a professional, sensitive and respectful manner.

Communication and consultation with people's family members was effective. Relatives felt well informed and had the opportunity to partake in individual assessment, care planning and reviewing processes.

Positive comments received from people living in the home and their relatives indicated satisfaction with the home and the services provided:

“The care and support provided is very good and the staff are excellent”.

“I’m very happy and have no grumbles at all about his care”.

People using the service were not able to comment on the care they received. However, some were seen to make decisions regarding opting out of activities offered. Another person showed pleasure in their activities and were vocal in showing their displeasure when they were taken away from their activity. Staff responded positively and respected the decisions made by people.