This inspection took place on 4 April 2017 and was unannounced. The previous inspection was carried out December 2014 and there had been no breaches of legal requirements at that time. We had no previous concerns prior to this inspection.

Penleigh House provides accommodation for up to 10 adults with a learning disability. At the time of our visit there were 10 people living at the service.

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.

Some of the people living in Penleigh House had a profound physical disability and therefore did not communicate verbally. In order to understand their experiences we observed staff interactions with people over the course of our inspection. Staff were caring and attentive to people.

There was a great attention to ensure the facilities that people had were meeting their needs. In the grounds of Penleigh House, there was a purpose built activity room called the ‘Gate House. This was well equipped to provide people with opportunities to build on their skills of independence and spend time away from their home completing a variety of meaningful activities. In a separate building called ‘The Lodge’ there was a state of the art hot tub where people could relax. This was very beneficial as it also provided people with a sensory experience and was therapeutic to the mind and body.

Penleigh House provided suitable accommodation to people who used a wheelchair. The providers had ensured it was homely and all the necessary equipment that was required was in place. This was being kept under review with further works planned on areas of the home such as one of the bathrooms being refurbished to make it more accessible to people who use wheelchairs.

People were treated in a dignified, caring manner, which demonstrated that their rights were protected. Where people lacked the capacity to make choices and decisions, staff ensured people’s rights were protected by involving relatives or other professionals in the decision making process.

People remained safe at the home. There were sufficient numbers of staff to meet people’s needs and to spend time socialising with them. Risk assessments were carried out to enable people to receive care with minimum risk to themselves or others. People received their medicines safely.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management, checks on the equipment, fire systems and safe recruitment processes.

People continued to receive effective care because staff had the skills and knowledge required to effectively support them. People's healthcare needs were monitored by the staff. Other health and social care professionals were involved in the care and support of the people living at Penleigh House. Staff were proactive in recognising when a person was unwell and liaised with the GP and other health professionals.

The home continued to provide a caring service to people. People, or their representatives, were involved in decisions about the care and support they received. Staff were knowledgeable about the people they supported. People were treated with kindness and there was a happy atmosphere in the home.

People received an exceptionally responsive service. Care and support was personalised to each person. People were assisted to take part in a variety of activities and trips out. The home was commended on the activities available to people and the innovative ways that they were continuing to support people in finding appropriate

People’s preferences were respected and they were treated with dignity by staff. We saw that staff were warm and friendly to people and it was evident by their response to staff that they felt relaxed, safe and cared for. We spoke with two relatives who commented, “We couldn’t be happier with the care” and “the staff are very good and my relative is very well treated”.

Each person had an individual care plan which demonstrated people’s care needs had been assessed and any risks to their health and well-being identified. We saw that any concerns were addressed with the appropriate health and social care professionals. People were supported to access the community and to take part in activities within the home.

People had enough to eat and drink and were supported by staff to make choices about their meals. We saw that staff supported people to be as independent as possible with eating and drinking.

The home was decorated and maintained to a high standard. It was evident that the needs of people living at the home were the provider’s main consideration. There was a koi pond, hot tub facility and sensory room (snoozelum) available for people. Equipment was safe, suitable and regularly maintained.

Before new staff were employed the provider carried out checks to ensure people were of good character. The provider regularly monitored the quality of the service that people received.

We spent time in the communal lounge in order to assess how staff interacted with people. Staff spoke kindly and clearly and gave people time to respond. When staff discussed the care of people at the home they used respectful terms to describe individuals.

Staff understood how to obtain consent and the process to follow if a person did not have capacity to consent. Any best interest decisions had been taken appropriately and documented in the person’s records.

Care plans were person-centred and contained clear information about people’s care needs and risks to be aware of. Care plans were in picture format. Where needed the provider and staff cooperated with health care services for people.

People received their medicines safely and appropriate procedures were in place to manage the obtaining, storage and disposal of medicines.

The provider had a complaints procedure in place. This was available to everybody living at the home but was not used effectively.

The majority of people who lived at Penleigh were unable to speak to us in detail about their care and treatment due to their limited ability to communicate verbally. We observed care being given and staff interactions with people in the lounge. People in the lounge did not want to communicate with us at that time.

This inspection took place on 27 November and 2 December 2014 and was unannounced. There were no concerns at the last inspection of 11 November 2013.

Penleigh House provides accommodation for up to 10 adults with a learning disability and complex physical support needs. At the time of our visit there were 10 people living at the service. 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 and staff followed procedures which reduced the risk of people being harmed. Staff understood what constituted abuse and what action they should take if they suspected this had occurred. Staff had considered actual and potential risks to people, action plans were in place about how to manage these, monitor and review them. Medicines were managed safely and staff followed the services policy and procedures.

People were supported by the services recruitment policy and practices to help ensure that staff were suitable. The registered manager and staff were able to demonstrate there were sufficient numbers of staff with a combined skill mix on each shift.

People moved into the service only when a full assessment had been completed and the registered manager was sure they could fully meet a person’s needs. People’s needs were assessed, monitored and evaluated. This ensured information and care records were up to date and reflected the support people wanted and required.

Staff had the knowledge and skills they needed to carry out their roles effectively. They were supported by the provider and the registered manager at all times.

People were helped to exercise choices and control over their lives wherever possible. Where people lacked capacity to make decisions Mental Capacity Act (MCA) 2005 best interest decisions had been made. The Deprivation of Liberty Safeguards (DoLS) were understood by staff and appropriately implemented to ensure that people who could not make decisions for themselves were protected.

People received a varied nutritious diet, suited to individual preferences and requirements. Mealtimes were flexible and taken in a setting where people chose. Staff took prompt action when people required access to community services and expert treatment or advice.

References were made by relatives and staff about the “family atmosphere and homely feel”. Staff were knowledgeable about everyone they supported and it was clear they had built up relationships based on trust and respect for each other.

People experienced a lifestyle that met their individual expectations, capacity and preferences. There was a strong sense of empowering people wherever possible and providing facilities where independence would be encouraged and celebrated.

The provider and registered manager had a clear vision about how they would continue to improve the service for people and staff. The service was important to them and they wanted the best for people. There was an emphasis on teamwork and unison amongst all staff at all levels.