Springfield Road is a care home that is registered to provide care for up to 12 people who have a learning disability. The care home consists of two separate bungalows. At the time of our inspection 11 people were living at this home. The service currently provides nursing care but it is the provider’s intention to cease providing nursing care in the future.

At the last inspection on 4 December 2014 the service was rated Good.

At this inspection we judged that the service provided remained Good.

Why the service is rated Good.

People received the support they required to live a full and active life, while maintaining their safety and well- being. There were enough staff to safely support people and the registered provider had robust recruitment checks to ensure new staff were suitable to work with people.

Risks relating to people’s healthcare needs and lifestyle had been assessed. Staff were aware of the support people needed in these areas, and we saw staff providing support that was consistent with these assessments.

People required the support of staff to manage their medicines. Staff responsible for administering medicines had been trained and people received their medicine when they needed it.

Staff had received training and support to ensure they were aware of people’s needs and how to meet them. People were supported to see a wide range of health professionals and they received the help they required to maintain good health. People were provided with a wide range of meals and drinks that they enjoyed and that would ensure they maintained good hydration and nutrition.

People were supported to have some choice and control of their lives and staff supported people in the least restrictive ways possible. When restrictions on people’s liberty were necessary the registered manager had ensured the correct applications had been made to protect each person’s legal rights.

Staff were caring in their interactions with people. The staff we met knew people well, and were able to tell us about people including their needs, preferences and things and people who were important to them.

A range of activities and opportunities were provided each day that were tailored to each person’s needs and preferences. People had been supported to maintain links with people, places and activities that were important to them.

As far as people wished and were able they were involved in developing and reviewing their care plans. When people could not or chose not to contribute to this process staff had involved people that knew the person well and used their knowledge of the person to plan care that they felt was in the person’s best interest and best fitted their known preferences and wishes.

We received consistent feedback that the home was well run, and that the registered manager and senior staff team were supportive and promoted good practice. The registered manager and registered provider had a wide range of checks and audits in place that ensured the on-going safety and quality of the service. These had been effective at providing assurance that the service remained good, and that the service was meeting people’s needs and all of the fundamental standards.

Further information is in the detailed findings below.

This inspection took place on 4 December 2014 and was unannounced.

Real Life Options – Springfield Road is a care home with nursing which provides accommodation and care in two adjacent bungalows for up to 12 women who have learning disabilities and/or a mental health diagnosis and who need support to live in the community.

At the time of our visit there was no registered manager at this service. The home was being managed by a manager who had applied for registration with CQC. 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 in this home told us that they felt safe. There were good systems for making sure that staff reported any allegation or suspicion of poor practice and staff were aware of the possible signs and symptoms of abuse.

The arrangements for the storage, administration and recording of medication were good and this meant that people were protected from possible errors.

People who lived in this home told us that they were happy with their care. People and, where appropriate, their relatives, were included in decisions about the running of the home and how the care was provided. People told us about how staff helped them to develop skills and to stay as independent as possible.

People told us that they were supported to attend social and educational activities of their choice. People had opportunities to be involved in the local community. People’s relatives were encouraged to visit and be involved in social occasions.

Throughout our inspection we saw examples of good care and we saw that staff treated people with dignity and respect.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care. This includes decisions about depriving people of their liberty so that they get the care and treatment they need where there is no less restrictive way of achieving this. The MCA Deprivation of Liberty Safeguards (DoLS) requires providers to submit applications to a ‘Supervisory Body’ for authority to deprive someone of their liberty. We found that the manager and staff had a good understanding in relation to recent interpretations of this legislation and they demonstrated an understanding of the impact on people at the home. This meant that people’s human rights were being protected.

Staff working in this home understood the needs of the people who lived there. We saw that staff and people living in the home communicated well with each other and that people were enabled to make choices about how they lived their lives.

Staff were appropriately trained and skilled and provided care in a safe environment. They all received an induction when they started work at the home and fully understood their roles and responsibilities. The staff had also completed relevant training to make sure that the care provided to people was safe and effective to meet their needs.

People were supported to have their mental and physical healthcare needs met and were encouraged to maintain a healthy lifestyle. Staff made appropriate use of a range of health professionals and followed their advice when provided to promote the health and well-being of people using the service.

The manager assessed and monitored the quality of care consistently. In addition to regular observations of staff, the manager consulted people in the home, their relatives and professional visitors to find out their views on the care provided.

The provider encouraged feedback from people who lived in the home, their family members, advocates and professional visitors, which they used to make improvements to the service.

We visited this home on a weekday. There were two bungalows and we visited each of these, but we spent the majority of our time in one bungalow and shared a meal with staff and the women who lived there.

We found that staff were good at meeting people’s needs. People told us that they were happy living in this home. One person said, “It is lovely here.” We saw many examples of how well staff communicated with people and offered them choices.

We saw that the care was planned so that people’s individual needs and preferences were taken into account. People had opportunities to engage in a range of activities and to be part of the community.

There were good arrangements for making sure that medicines were stored, administered and recorded in a safe way.

Staff were well trained and supported so that they were competent in their roles. A professional who works with the home told us that this home was, “...among the best homes I have ever worked with.”

The home was well-managed. There were good, effective arrangements for monitoring the performance of the home and for identifying areas for improvement.

At the time of our visit in January 2013, there were nine people living in the home. Most people had lived at the home for many years, and one person was new. We spoke to most of the people who lived at the home and they told us that they liked living there. We saw that staff interacted well with people, ensuring they were treated with dignity and respect. People were observed being involved in managing the daily activities of the home and some people were observed going out with staff. This ensured that they maintained both their independence and physical need to be active.

One person told us: “I like it” “I like all the staff”.

Evidence of verbal encouragement was noted to good effect and staff demonstrated their detailed knowledge of people by responding appropriately to gestures, tones or other expressions. During the course of the inspection, staff were heard to be offering people choices, ensuring person centred care, and to be responding appropriately to the more gregarious affections of some people living at the home.