About the service: Primrose Place is a residential care home that was providing personal care to 4 people at the time of the inspection. The service supported people living with sensory impairments and learning disabilities.

People’s experience of using this service:

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service 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 control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People were enabled to be visible and active members of their local community.

People could be assured that they would receive care in a way that maintained their safety. Staff knew people well and were motivated to provide consistently high-quality person centred care and support. People’s needs were considered and met in a holistic manner.

The registered manager and provider were visible role models within the home. They were committed to providing high quality care to people and staff were engaged by the positive person-centred culture within the service.

There was a strong system of governance that was working effectively at monitoring and improving the care that people received.

Rating at last inspection: At our last inspection in January 2016 we rated the service as ‘Good’.

Why we inspected: This was a scheduled inspection based on previous rating of ‘Good’.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme or if any issues or concerns are identified.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 21 January 2016 and was unannounced. At our last inspection on 22 April 2014, the provider was meeting all the regulations that we assessed.

Primrose Place is registered to provide accommodation and personal care for up to five adults with a sensory impairment and/or learning disabilities. The home was providing care and support to four people at the time of our 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.

People were safe and secure. Relatives believed their family members were kept safe. Risks to people had been assessed appropriately. Staff understood the different types of abuse and knew what action they would take if they thought a person was at risk of harm. The provider had processes and systems in place that kept people safe and protected them from the risk of harm

There were enough staff, which were safely recruited and had received appropriate training so that they were able to support people with their individual needs.

People safely received their medicines as prescribed to them.

Staff sought people’s consent before providing care and support. Staff understood the circumstances when the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) should be followed.

People were supported to have food that they enjoyed and meal times were flexible to meet people’s needs.

People were supported to stay healthy and accessed health care professionals as required.

People were treated with kindness and compassion. We saw that care was inclusive and people benefitted from positive interactions with staff.

People’s right to privacy was promoted and people’s independence was encouraged where possible.

People received care from staff that knew them well. People benefitted from opportunities to take part in activities that they enjoyed and what was important to them.

Staff were aware of the signs that would indicate that a person was unhappy, so that they could take appropriate action. Information was available around the home in easy read formats for people.

The provider had management systems in place to audit, assess and monitor the quality of the service provided.

We visited this service and talked to people to gain a balanced overview of what they experienced, what they thought and how they were cared for and supported. We spoke with two relatives; we met the four people that lived there, three staff and the registered manager. Most people that used the service had limited verbal communication skills so we observed their interactions with staff and their body language to understand their view of the support they received.

We considered all of the evidence that we had gathered under the outcomes that we inspected. We used that information to answer the five questions that we always ask;

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

Is the service safe ?

We observed that people were treated with dignity and respect by the care staff. We saw that people were given choice in their care.

Relatives that we spoke with told us that they were very happy with the care at the home. One relative told us, “I know my relative is absolutely safe in the home”.

We spoke with staff and the registered manager about Deprivation of Liberty Safeguards (DoLS). This applies to all care homes. The registered manager told us that there had been no applications and showed us that they had the information to refer to if an application needed to be made. They told us that they had received DoLS training and that care staff would receive some further training so they had an understanding of their responsibilities.

The service was clean, hygienic and safe. The home had an effective infection control policy and systems. Equipment was well maintained and services regularly so preventing any unnecessary risks.

We saw that systems were in place to make sure that learning takes place from accidents, incidents, complaints and investigations. This reduces the risks to people and helps the service to continually improve.

Is the service effective ?

A relative we spoke with confirmed that they could visit throughout the day. We saw that facilities were available so people could meet in private if they wanted to.

We saw that relatives were involved with people’s care. A relative told us, “They always ensure that my relative’s health care needs are well met, they involve other health professionals and inform me of what is happening”.

People’s health and care needs were assessed and care plans told staff what people’s care needs were so they could support people consistently. Referrals had been made to external professionals so people got the support they needed to maintain their health and wellbeing.

Staff had received most of the training they needed but some further training was needed to ensure that they continued to maintain their skills and knowledge needed to care for people effectively.

Is the service caring?

We saw that staff treated people with dignity and respect. We saw that staff were patient and caring they took their time and did not rush people. Staff were attentive and interacted well with people and we saw that people responded positively to staff.

People, their relatives and other professionals involved with the service had completed an annual satisfaction survey. We saw that relatives had made positive comments in the surveys we looked at.

People’s preferences, interest and aspirations and diverse needs had been recorded in their care records.

Is the service responsive?

We saw that people were supported to take part in a range of activities at home and in the local community. We saw that staff responded to spontaneous requests from people to do activities, or to spend their time in a way that they preferred. People had also been supported to go on an annual holiday.

We saw that when needed staff had requested the involvement of other health professionals in people’s care.

Is the service well lead?

The home had a manager who was registered with us, CQC. They were experienced and knowledgeable about the needs of the people that lived in the home.

We found that effective systems were in place to regularly assess the quality of the service that people received.

Staff that we spoke with were clear about their role and responsibilities. They had a good understanding of the ethos of the home and the systems in place to monitor quality assurance. This ensured that people received good quality of care.

There were three people living at the home on the day of our inspection and one person was in hospital. We met all the people who lived at the home, the owner, the manager, three staff members and a volunteer worker.

People living in the home had limited verbal communication so we spent time observing care practices and interactions between people and the care staff supporting them.

We saw good interactions between people living there and the staff team. The atmosphere was friendly and relaxed and we saw people being supported to do different meaningful activities.

Arrangements in place ensured people received their medication safely.

There were sufficient staff with the right knowledge and skills to support people safely.

There were systems in place for monitoring and improving the quality of the service for people living in the home.

There were four people living at the home on the day of our visit. No one knew we would be visiting. We met all four people who lived at the home, four members of staff, the manager and owner.

Some of the people living in the home had limited verbal communication so we spent time observing care practices and interactions between people and the care staff supporting them.

One person told us “I like living here, I like to do lots of things".

People’s privacy and dignity was respected. We found that care staff spoke with people in a respectful manner. We saw that interactions between staff and people who lived there were friendly and relaxed.

Staff spoken with were able to tell us about people's needs so that they receive care in a way that they prefer.

People were supported to take part in a wide range of activities in the home and local community so that they have a meaningful lifestyle.

Staff were trained in safeguarding procedures. Staff spoken with told us what they would do if they had any concerns about poor practices in the home. This ensured the well being and safety of people.

Staff had received a range of training including training specific to the individual needs of the people living at the home so that staff had the knowledge and skills to support people well and keep people safe.

There were systems in place to monitor how the home was run so that people received a quality service and their individual needs were well met.