About the service: Paradise House provides accommodation to 30 people with a learning disability aged 18-65 years. At the time of our inspection there were 30 people living at the service. The accommodation is divided into four individual houses, which all have their own facilities. There was also a café and workshops on site for people to access. The accommodation is set in substantial grounds where there are stables, therapy rooms and a walled garden.

People’s experience of using this service:

The service was developed and designed before the guidance Registering the Right Support was produced. Registering the Right Support and other best practice guidance ensures that people who use services can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include choice, control and independence. We found Paradise House worked to make sure it was run in line with the values that underpin Registering the Right Support and other best practice guidance. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

People were supported by staff who had been recruited safely and had the skills needed to provide effective care. Staff received support from the organisation and enjoyed working at the service.

People’s risks had been identified and appropriate safety measures were in place. People had detailed care plans which provided up to date guidance for staff to follow to provide person-centred support.

People received their medicines as prescribed and medicines were managed safely. People could see healthcare professionals when needed and supported to live healthy lives.

People were able to attend many various activities. People were supported to access their local community to follow their interests. People’s independence was promoted by positive risk-taking approaches. This meant people could maintain life skills and enjoy a community presence. People were being supported by exceptionally kind and caring staff.

People, relatives and staff told us the service was well-led. The registered manager was a visible presence and knew people and their relatives well. People’s feedback was encouraged and used to shape the service.

The service met the characteristics of Good overall; more information is available in the full report below.

Rating at last inspection: At the last inspection in October 2016 we rated the service as Good overall.

Why we inspected: This was a planned inspection based on the date and rating of the previous inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

Paradise House is a care home for up to 30 people who predominantly have a learning disability. The home is divided into four individual houses. There was a café and workshops on site which people could access if they wanted to. Workshops included: arts and crafts, pottery and textiles. The layout of the service was four individual houses that could accommodate up to 33 people. There was a flat for two people who were supported by staff when needed. People had individualised care needs and each house had a staff team who knew people well and how to support them.

This was an unannounced inspection completed on 20 and 21 October 2016. The inspection was completed by one adult social care inspector.

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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment. The premises were well maintained.

People were receiving effective care and support. Staff received training which was relevant to their role. Staff received regular supervisions and appraisals. The service was adhering to the principles of the Mental Capacity Act 2005 (MCA) and where required the Deprivation of Liberty Safeguards (DoLS).

Staff told us there was an open culture and the environment was an enjoyable place to work. Staff were extremely passionate about their job roles and felt integral to the process of providing effective care to people. Family members said the management team were approachable.

The service was caring. We observed staff supporting people in a caring and patient way. Staff knew the people they supported well and were able to describe what they liked to do and how they wanted to be supported. People were supported sensitively with an emphasis on promoting their rights to privacy, dignity, choice and independence. People were supported to undertake meaningful activities, which reflected their interests.

The service was responsive to people’s needs. Care plans were person centred to provide consistent, high quality care and support. Daily records were detailed and contained sufficient information for staff to read and support people effectively. People were encouraged to have a say about things that mattered to them and to raise any concerns they may have.

The service was well led. Quality assurance checks and audits were occurring regularly and identified actions to improve the service. Staff, relatives and other professionals spoke positively about the registered manager. The provider continually looked to make things better so that people benefitted from an improved service. Any planned improvement actions were followed up to ensure they were implemented.

Some of the people using the service had complex needs which meant that they were not able to directly tell us about their experiences. We therefore used a number of different methods to help us understand their life at the home. These included visiting people in all four houses on the site and sitting with one group of people whilst they had their lunch. We also observed staff support, looked at records and spoke with staff who supported the people living at the home.

People were protected from the risk of abuse because appropriate procedures were in

place and staff had received training in this area.

We spoke with nine members of staff during our visit. Staff were very motivated and caring and attentive of the residents. One member of staff told us “we can discuss things with the manager to improve the services we provide.”

We spoke with a relative who told us “I think the services provided here are brilliant ! It took us about four years to find this home”. They also told us that “we live a long way away but there’s nothing equivalent to this standard of care near to where we live.”

We saw that appropriate recruitment checks had been undertaken before staff began working at Paradise House.

The provider had an effective system to regularly assess and monitor the quality of service that people received. The provider had a sound knowledge of the people they were providing a service for and systems were in place to ensure standards were maintained.

We were not able to speak to any relatives but we managed to obtain their feedback and comments on their involvement with their family members and the service provider. We saw a request made to the provider for the latest social photographs, the written correspondence was respectful. We saw another note expressing their “thanks for a lovely day” following a bereavement of one to the resident’s. One person told us that “I have regular contact with my family and I am able to Skype them anywhere in the world”.

We met and talked with people from the different houses and asked them about their experiences. One person told us “I like it here it’s good”. Another person told us “I’m being looked after the staff are helpful”. Parents wrote positive comments to the management and staff team of Paradise House. One parent commented “thank you for such a special barbeque day at Paradise”.

We saw the menus for all four houses and people told us that the food was good. We met and spoke with the cook in Oak and Pine house, who shared with us the winter menu.

The Health & Safety Officer and Care Supervisor showed us around all four properties and four people showed us their rooms. We found the properties to be in safe, clean and tidy conditions. The rooms were personalised and where relevant there were sensory door attachments for those people with epilepsy.

We spoke with and saw the staff training programme. We found it to be on-going, with regular appraisals and supervision meetings. Staff told us they felt supported and there were opportunities for staff and training and development.