Ravenswood House is a residential care home providing care, support and accommodation for up to ten adults with learning disabilities. At the time of our inspection there were nine people living there.

The care service had 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.

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.

At our last inspection we rated the service 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 ongoing 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.

Staff understood their responsibilities to keep people safe from harm. Risk assessments had been carried out and support plans provided clear guidance for staff. Safe recruitment processes were followed and there were enough staff on duty to meet people’s needs. Medicines were managed safely. Incidents and accidents were reported and reviewed to prevent a recurrence and identify any trends.

Staff had been trained to carry out their roles and had regular opportunities for one to one support from a line manager. People were supported to have enough to eat and drink.

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. Advocacy services were available for people to access.

People appeared relaxed around staff; they were smiling and laughing. Positive interactions between people and staff were seen. People were regularly asked for their feedback.

Care plans were person centred and included details of people’s preferences and choices. The accessible information standard had been met.

At the last inspection we recommended the provider sought guidance on implementing governance systems. At this inspection, we saw improvements had been made and formal quality assurance systems were now in place. Staff spoke highly of the registered manager. The provider’s values were embedded in the day to day support of people. There were strong links with the local community.

Further information is in the detailed findings below.

This inspection took place on 29 April and 4 May 2016 and was unannounced. Ravenswood House provides accommodation and personal care for up to 10 people with a learning disability or autistic spectrum disorder. There were eight people living in the home at the time of our inspection. Ravenswood House consists of a lounge, dining room, a quiet/activities room, kitchen and 10 bedrooms set over two floors. People had access to a secured back garden.

A registered manager was in place as required by the service’s conditions of registration. 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 living at Ravenswood House. Staff were knowledgeable in protecting people from harm and injury. People’s risk associated with their care, environment and activities had been identified and were being managed well. People were encouraged by staff to make decisions where possible about their day. However there were inconsistent records of how staff had gained agreement about making significant and best interest decisions on behalf of people. This was being addressed in the implementation of the new care plans which would clarify the lawful consent to people’s care.

We observed staff treating people in a kind and friendly manner. Staff adapted their approach with each individual. Staff observed for changes in people’s behaviours which may indicate that they were becoming upset or there was a change in their well-being.

People were given their medicines in a safe and effective manner. Where a person’s mental or physical health well-being had changed it was evident that staff had worked with other professionals including the community mental health team and psychiatrist to seek additional advice and support.

Robust recruitment systems of staff were in place to ensure people were supported by staff who had been vetted and were of good character. People were supported by adequate numbers of trained staff. Additional staff were provided if people needed support for appointments or community based activities.

The managers and senior staff of the home provided people, their relatives and staff with support. They carried out frequent audits and checks of the quality of service being delivered. However, this was not consistently recorded. The provider was in frequent contact with the home, although they did not carry out any formal quality checks to ensure the home was providing high quality care.

We have made a recommendation regarding the governance and monitoring systems of the home.

Everyone we spoke with seemed pleased with the refurbishment and redecoration of the home. This included staff and people living at the home. The building appeared clean and fresh and staff told us it was easier to keep clean and tidy. There was a system in place to maintain a hygienic environment.

Care records had been comprehensively updated. All records now followed a logical structure. The information contained in the records had been checked and updated information included. The focus of the records was on people’s identity, needs and preferences. The registered manager was working on ways to ensure that the records remained up-to-date and accurate.

As part of our inspection, we spoke with four people living at the home, four members of staff, one relative and two professionals involved in people's care outside the home.

We received positive feedback from everyone we spoke with regarding the care provided by the home and the recent improvements since the home had changed owner and had a new manager. One person told us “I am happy here” and a relative told us that staff had “gone past just making an effort”. A new member of staff said “it’s fantastic here”.

Staff felt well supported and reported that they had access to the training that they needed. We verified this by looking at the training records for the home. Staff reflected that the new manager was “very approachable”. They had seen a “big change for the better”.

The environment of the home was very pleasant where redecorating had taken place. Some areas were waiting for redecoration and were tired looking. The bathroom that was yet to be refurbished posed a potential infection control risk.

The record keeping within the home needed reviewing to ensure consistency in both content and structure. The manager was addressing this issue but felt it was important to take time to get to know people properly before attempting to review their support plans.