This comprehensive inspection took place on 12 April 2018 and was unannounced.

Progress House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service can accommodate up to five people in one house.

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.

At the last comprehensive inspection in April 2016, the service was rated Good. At this inspection we found the service remained Good.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘progress House’ on our website at www.cqc.org.uk’

The service had a registered manager in post at the time of our inspection. 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 was registered at three locations; a general manager was also in post to manage this location.

People continued to feel safe. People we spoke with all said they felt safe. Staff understood their roles and responsibilities to safeguard people from the risk of harm and risks to people were assessed and monitored regularly.

Staffing levels were maintained to ensure that people's care and support needs continued to be met safely and there were safe recruitment processes in place.

People continued to receive their medicines in a safe manner and received good healthcare support. People received a nutritious and balanced diet and their dietary needs and choices were met.

The service was well maintained and clean. Infection control was adhered to by staff.

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.

There were good systems in place to monitor incidents and accidents. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

There was a strong person centred and caring culture in the home. (Person centred means that care is tailored to meet the needs and aspirations of each person, as an individual.) The vision of the service was shared by the management team and staff.

We observed people had good relationships with the staff, people we spoke with told us the staff were caring and kind. Staff respected people’s privacy and dignity and promoted their independence. People were also supported in decisions regarding their end of life wishes.

There was a varied and appropriate activity programme and people had regular access to the community.

The service had an open and inclusive culture which encouraged communication and learning. People, relatives and staff were encouraged to provide feedback about the service and it was used to drive improvement.

There were policies in place that ensured people would be listened to and treated fairly if they complained about the service.

We saw that the registered provider and manager continued to effectively monitor and audit the quality and safety of the service and that people who used the service and their relatives were involved in the development of the home and were able to contribute ideas.

Further information is in the detailed findings below

The inspection was unannounced, which meant the provider did not know we were coming. It took place on 15 March 2016. The home was previously inspected in August 2014, and at the time was meeting all regulations assessed during the inspection.

Progress House is a care home for adults with learning disabilities. It is situated in Kilnhurst close to local amenities and good bus services into Rotherham. The service can accommodate up to five people.

The home 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. The registered manager had responsibility for three services and there was also a general manager at Progress House who also had management responsibilities to ensure the service was managed well.

Care and support was planned and delivered in a way that ensured people were safe. The individual plans we looked at included risk assessments which identified any risk associated with people’s care. We saw risk assessments had been devised to help minimise and monitor the risk, while encouraging people to be as independent as possible.

People’s needs were assessed and care and support was planned and delivered in line with their individual support plan. We saw staff were aware of people’s needs and the best ways to support them, whilst maintaining their independence.

People were supported to eat and drink sufficiently to maintain a balanced diet and snacks were available in-between meals. People we spoke with who used the service told us they liked the food and could choose what they wanted and when they wanted to eat. People were supported to maintain good health, have access to healthcare services and received on-going healthcare support.

The environment was well maintained and the standard of cleanliness was good. However, there are environmental improvements required to ensure there are adequate toilets and bathing facilities available for people who used the service.

We found there were enough staff with the right skills, knowledge and experience to meet people’s needs. We saw the staff training record for the service. This showed that staff were provided with appropriate training to help them meet people’s needs.

We found the service to be meeting the requirements of the mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good knowledge of this and said they could speak to the managers for further advice.

Systems were in place which continuously assessed and monitored the quality of the service, including obtaining feedback from people who used the service and their relatives. Records showed that systems for recording and managing complaints, safeguarding concerns and incidents and accidents were managed well and that management took steps to learn from such events and put measures in place which meant lessons were learnt and they were less likely to happen again.

Our inspection looked at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

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

Is the service safe?

We found adequate quality monitoring systems were in place. This ensured the risks to people were identified and reduced, to be able to continually improve.

We found people were encouraged to express their views and were involved in making decisions about their care and treatment. The staff we spoke with gave us good examples of how people were involved in making decisions about the care and support they received. We also saw staff encouraged people to be as independent as possible while offering the correct level of support. People told us the staff were very good and they liked living at Progress House.

Appropriate arrangements were in place to protect people who used the service from the risk of abuse.

There was enough qualified, skilled and experienced staff to meet people’s needs. Staff told us there was enough staff on duty to ensure people were able to go out in the community and participate in activities they wanted. People told us when they wanted to go out there were staff available to go out with them.

Is the service effective?

People’s health and care needs were reviewed, and people were involved in the reviews.

Audits and reviews had taken place; the audits were thorough and detailed. We saw that any shortfalls had been identified and addressed.

On the day of our visit some people went out. One person went horse riding and another went out for a picnic. Another person told us, “I am going out this afternoon, I want to go shopping, I enjoy shopping and the staff come with me.” Another person told us I am able to go out independently and the staff respect my wishes, but also make sure I am safe.”

Is the service caring?

We observed care workers interacted positively with people who used the service. Conversations were inclusive and we observed staff and people who used the service laughing and joking together. One person wanted to make lunch and was supported to do this, they told us, “I like making lunch, I can choose what I want and staff help me.”

Care files contained information about people’s needs and preferences. We saw care and support had been provided in accordance with people’s wishes.

Is the service responsive?

The manager followed a robust quality monitoring system that identified shortfalls and ensured they were rectified. The manager had identified a number of areas which required repair and renewal to ensure the service was maintained to a good standard. The kitchen was to be replaced and other areas were to be decorated in August 2014.

Is the service well-led?

Staff told us they worked very well as a team. They told us they had regular meetings, which ensured communication was good. Staff we spoke with told us they enjoyed working at Progress House, they were supported and worked well as a team.

Staff told us they received regular supervision and could at any time raise any concerns or ideas and they were listened to. Staff were clear about their roles and responsibilities. We saw they had access to policies, procedure and a staff handbook to inform and guide them. Staff training and development needs had been assessed to enable the provider to arrange future training sessions.

People we spoke with told us they liked living at the service. They told us staff were good and looked after them. One person told us, “The staff are great they have helped me become more independent, which has made me happier.”

People also told us that staff treated them with respect, listened to them, gave them choices, made them feel safe and supported them. One person told us, “If I don’t want to do something I say no and the staff respect my wishes.” Another person we spoke with said, “The meals are good and sometimes I help cook as I enjoy this.”

We found that medicines were recorded and administered safely and appropriately. Care workers supported people living in the home to take and use their medicines appropriately.

Staff received appropriate professional development. A training programme was in place to provide staff with the training and support they needed. Staff we spoke with told us the training was good.

There was an effective system to regularly assess and monitor the quality of service that people received. There was a complaints policy that took account of complaints and comments to improve the service

As part of our inspection we spoke with a number of people who used the service. They spoke positively about the care and support they received. They told us they liked living in the home and confirmed staff supported them to make choices and decisions about their care. However, people told us they did not always get out in the community. One person said, “I like to go out on my own with staff, not with other residents and I don’t always get that.”

People's needs were assessed, however their care and treatment was not always delivered in line with their individual care plans. We looked at three care plans they all clearly detailed people’s needs and how to meet their needs. But we found evidence that they were not always followed.

Relatives we spoke with raised some concerns regarding the service. They told us some staff were very good but others did not seem to want to take people out to participate in meaningful activities.

People were protected from the risk of infection because appropriate guidance had been followed by the staff. People were cared for in a clean and hygienic environment.

There was enough qualified, skilled and experienced staff to meet people's needs. On the day of our visit we looked at staffing numbers on each shift. We found there was enough staff to meet people's needs. However, shift patterns were not always flexible to meet people’s recreational needs.

People we spoke with told us they liked living at Progress House and were looked after very well.

One person we spoke with told us he knew he had a care plan and staff wrote in it and he could look at it if he wanted.

One person told us, “I am very happy”.

Relatives we spoke with told us they were very satisfied with the care their sons received. Comments from relatives were;

“I can’t praise the staff enough, I have no worries”.

“I am kept informed of any incidents or changes and kept involved”.

“My son has improved a lot over the last year, as there is a very good staff team and manager”.

“Look after my son well, staff treat the residents as individuals”.

Relatives also told us they were kept informed and were involved. They also told us they regularly talked to the manager.

Relatives told us the service was very good and the new manager was, “Fantastic”. They also told us people were respected, given choices and supported to live an independent life.

Relatives told us the manager was approachable and if they had any concerns they would approach him and were confident any issues would be resolved.