Oswald 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. The home provides accommodation for up to eight people with a learning disability. On the day of our inspection there were seven people using the service.

The home is an end terrace house that has been adapted to meet the needs of the people living there. 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.

The service had two registered managers in place, who were responsible for the five locations owned and run by the provider. 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. All the locations are in close proximity and use Oswald House as a central hub and meeting place.

Oswald House was last inspected by CQC in January and February 2016 when the service was rated as 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.

People told us they felt safe and there were sufficient staff to meet people's needs. We found that this was a consistent staff team who knew people well.

People received safe support with their medicines. Where people wished to manage their own medicines independently this was encouraged and there were checks in place to ensure it was done safely.

People had risk assessments that described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary, for example: their GP and social worker.

The premises were homely and suitable for people's needs. People were involved in decisions about the decoration and the provider had taken steps to make the environment more accessible in response to changes in people's needs. The environment and equipment was regularly checked and serviced.

Staff told us they felt well supported in their role; they received induction and training. Staff received supervision but some of this was informal and not recorded. Staff appraisals were planned but staff had not yet been appraised. We found this did not affect how staff performed their duties as the management spoke with staff on a daily basis and promoted opportunities for two-way discussions about performance and development. The registered managers had identified the need to formally record supervisions and appraisals and were working to a plan to ensure all significant discussions were recorded.

People had choice and control of their lives and staff supported them in the least restrictive way; the policies and systems in the service supported this practice.

Staff were aware of the importance of supporting people with good nutrition and hydration. People told us how staff supported them to eat healthily and reduce weight where this was a concern. We saw that people were encouraged to shop for and prepare their own meals.

People had access to healthcare services, in order to promote their physical and mental health

This inspection took place on 19, 28 January and 22 February 2016. We gave the provider 48 hours’ notice for this inspection to make sure someone would be available at the service.

Oswald House provides care and accommodation for up to 8 people with a learning disability. On the day of our inspection there were 8 people using the service.

The home had two registered managers in place, who were responsible for the five locations owned and run by the provider. 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.

Oswald House was last inspected by CQC on 25 June 2014 and was compliant with the regulations in force at that time.

Accidents and incidents were appropriately recorded and analysed for any trends. Risk assessments were in place for people who used the service and staff. People were protected against the risks associated with the unsafe use and management of medicines.

The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and training sessions were planned for any due or overdue training. Staff received regular supervisions. Appraisals were overdue however a new process had recently been implemented and appraisals were planned.

The provider was working within the principles of the Mental Capacity Act and was following the requirements in the Deprivation of Liberty Safeguards.

Care records contained evidence of visits to and from external health care specialists and people were supported to maintain a healthy diet.

People who used the service, and family members, were complimentary about the standard of care at Oswald House. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care records showed that people’s needs were assessed before they moved into Oswald House and care plans were written in a person centred way.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

People who used the service, and family members, were aware of how to make a complaint however there had been no formal complaints recorded at the service since September 2014.

The service regularly used community services and facilities and had links with other local organisations. Staff felt supported by the manager and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service.

At the previous inspection in October 2013 we found that although processes were in place, the provider had not obtained and recorded the valid consent of people who used the service about how they should be supported.

The provider sent us an action plan which had been completed following our inspection. This included the action they were going to take to meet the regulation and the timescale within which this would be achieved.

We returned to inspect on 04 March 2014 to review whether the provider had made improvements. We found improvements had been made in this area.

We found people’s risk assessments had been discussed with the individual’s they related to. All of the risk assessments we viewed had been signed and dated by the person who used the service, their key worker, other staff who supported them and the home manager.

This meant the provider had obtained and recorded the valid consent of people who used the service about how they should be supported.

People told us they were very happy at Oswald House and staff were nice and supported them to do the things they wanted to do. They told us they were happy with the care they received; one person told us “I love it here.”

We spoke to a relative who told us they were really happy with the care delivered by the staff and they were kept involved in their relatives care. They told us “I know they get well looked after” and added the staff were helping their relative lead the life they should be living.

During the inspection, the inspector answered five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and the staff told us.

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

Is the service safe?

People told us they felt safe and secure.

The staff that we spoke to understood the procedures they needed to follow to ensure that people were safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

We inspected the staff rotas which showed that there were sufficient staff on duty to meet people’s needs at all times. This meant people received a consistent and safe level of support.

Procedures for dealing with emergencies were in place and staff were able to describe these to us.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Although no DoLS applications had been made, staff were able to describe the circumstances when an application should be made and knew how to submit one.

Is the service effective?

People all had an individual care plan which set out their care needs. People told us they had been fully involved in the assessment of their health and care needs and had contributed to developing their care plan. Assessments included needs for any equipment, mobility aids and specialist dietary requirements.

People had access to a range of health care professionals. People told us that staff escorted them to healthcare appointments if needed.

This meant that people were sure that their individual care needs and wishes were known and planned for.

Is the service caring?

People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people. People commented, “I love the staff. I am very happy here.”

There was an advocacy service available if people needed help or support to speak for themselves.

We observed that peoples individual wishes for care and support were taken into account and respected and we saw these were regularly discussed with them and recorded in their care plans.

Is the service responsive?

People told us, that they were able to participate in a range of activities both in the home and in the local community. One person told us “We are going to see Mrs Brown’s Boys soon. There is lots for us to do like going to the cinema and bowling.” The activities provided included those where people could enjoy as a group and others that met their individual interests.

People told us they were involved in reviewing their plans of care when their needs changed. One person told us “I recently had my review meeting. I was involved in this where we talked about things I wanted to do.”

People knew how to make a complaint if they were unhappy.

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 home had a system to assure the quality service they provided. The way the service was run had been regularly reviewed. Prompt action had been taken to improve the service or put right any shortfalls they had found.