We undertook this announced inspection on 9, 16 and 19 May 2017.

Redpoll Lane is a semi–detached house located in a residential area of Warrington. It is registered to provide personal care for people who require support by staff on a twenty four hour basis. Each person has their own bedroom upstairs and share a kitchen, bathroom and lounge on the ground floor. There are gardens at the front and back of the house and parking outside.

Staff knew the people they were supporting well and provided a personalised service. Individual personalised care plans, based on a full assessment of need, were in place detailing how people wished to be supported. This helped ensure that personal care was provided in a structured and consistent manner.

We could see the people who lived there had good trusting relations ships with the staff and were able to make their needs known. It was vitally important that staff responded to each person’s needs, concerns and changes in mood in a positive and effective manner. We found that staff were skilled in this respect. They were able to communicate effectively with the people who lived at the home and were able to offer reassurance and support when required.

There was a registered manager in place at the home. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were appropriately recruited, trained and supported. They had undergone an induction programme, completed mandatory training and where necessary, had received additional training specific to the needs of the people they were supporting. Internal and external trainers were being sourced by the provider.

Communication was effective and regular meetings were held to discuss concerns. Staff demonstrated a caring approach and understood their roles and responsibilities and spoke enthusiastically about the work they did and the people they cared for.

Healthcare professionals were involved in people’s care and were being called upon for advice when appropriate.

The staff we spoke with had a good understanding of Safeguarding and the different types of abuse. There was a whistle blowing policy and staff knew what to do if they were concerned about any practices they observed placed the person they were supporting at risk of harm.

Safe medication management systems were in place and when we identified the need for timed intervals to be documented for one person’s PRN {Pro re nata, as and when prescribed medication}, the registered manager actioned this immediately.

We found risk assessments were also in place to effectively identify and manage potential risks.

Governance and quality assurance systems were in place with regular audits of the service. A complaints policy and process was in place and a system of recording all compliments and complaints.

People’s views were sought in a range of ways from asking relatives and healthcare professionals for their views, involving independent advocates for people and ensuring people were being provided with opportunities to make their own choices and to make decisions. Best interests processes were being followed when appropriate.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences.

We spoke with the staff members on duty during the visit. They were knowledgeable about the different needs of the people living at Redpoll Lane and how they showed their feelings and views.

The staff members we spoke with showed that they had a good understanding of the people they were supporting and they were able to meet their various needs. We saw that they were interacting well with people in order to ensure that they received the care and support they needed. The relationships we saw were warm, respectful, dignified and with plenty of smiles.

We did not have any concerns regarding either the numbers or suitability of the staff members working at the home.

The staff members we spoke to were very positive about the home and the standard of support that people were receiving.

We did not receive any direct comments about Redpoll Lane because the people using the service had complex needs which meant they were not able to tell us their experiences.

This inspection took place on 9 January 2015 and was an unannounced inspection. A further visit took place at the service on 12 February 2015 to access staff records.

29 Redpoll Lane is a semi–detached house located in a residential area of Warrington. It is registered to provide personal care for two adults who have an autistic spectrum disorder and a learning disability. People living at the home are supported by staff on a twenty four hour basis. Each person has their own bedroom upstairs and share a kitchen, bathroom and lounge on the ground floor. There are gardens at the front and back of the house and parking outside.

There was a registered manager in place at the home. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were two people living at the home on the day of our visit. People using the service had complex needs and we were unable to gain any comments with regard to their care and support due to their anxiety around unknown people and their level of disability. We spoke with a relative, a learning disability nurse who visits the service regularly, a Best Interest Assessor from Wigan social services and received a record of a monitoring visit from St Helens council. All action raised in the visit by St Helens council had been actioned by the home.

From our observations, and from speaking with relatives and professionals who visit the service and staff we found staff knew people well and were aware of people’ preferences and care and support needs. Staff communicated and engaged with people, using ways which were best for their individual needs. People were supported with their healthcare needs and medical appointments.

We found the home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and staff followed the Mental Capacity Act 2005 for people who lacked capacity to make decisions for themselves.

The staff we spoke with were aware of people’s risks and needs and how they should be supported. The staff we spoke with considered that they were effectively trained and supported to carry out their roles. However, not all staff had received training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People’s medicines were securely stored and safely managed. The provider had a policy to guide staff regarding the safe management of medicines. Staff were aware of the actions to take in the event of an error when giving medicines.

The registered provider had robust recruitment checks in place so that people were protected from being supported by unsuitable or unsafe staff.

The home was meeting people’s nutritional needs and people were supported to ensure they had enough to eat and drink.

Staff involved people in choices about their daily living and treated them with compassion, kindness, and respect. People were supported by staff to maintain their privacy, dignity and independence.

We looked at the duty rotas and spoke to staff about the numbers of staff on duty. We found there were adequate numbers and skill mix of staff on duty to meet the needs of people living at Redpoll Lane

Staff training had taken place and all staff were up to date with mandatory training so that people could be confident they were properly cared for.

We saw that the leadership and management of the home was good and there were systems in place to check that the quality of the service was effectively monitored.