Watery Lane Cottage is a care home providing accommodation and personal care to a maximum of three Deafblind people with additional complex care needs. At the time of our inspection there were three people living at Watery Lane Cottage.

The service was all on one level and was well suited to the needs of the people who lived there. Accommodation included three ensuite bedrooms, a staff sleep-in room, office and open plan kitchen, living and dining area. The wide corridors and open plan living area enabled people to move around independently where possible.

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

Why the service is rated Good:

Risks to people were assessed, recorded and actions were taken to minimise or manage risks. People's medicines were administered as prescribed and managed safely by suitably trained staff. The provider planned to resume regular medicines audits.

Policies, procedures and checks were in place to manage health and safety. This included the reporting of incidents and accidents, as well as regular equipment checks and maintenance. Systems were in place to ensure that the quality of the service was monitored, and that improvements were made where necessary.

Effective recruitment procedures were followed to ensure prospective staff were suitable to work in this service. Sufficient staff were employed, and they received training in a range of subjects to make sure people received safe and effective care. Staff were warm and caring, and there were positive interactions between staff and people using the service.

People’s wishes and preferences were considered, and the design and decoration of the service promoted people's independence and reflected their needs and interests.

People’s needs were assessed and regularly reviewed, and people received personalised, effective care. People had access to a wide range of personalised activities.

Staff liaised with other professionals as needed. For example, regarding finances, advocacy or when there were concerns about a person’s health. Routine health checks and monitoring were arranged as required.

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.

Further information is in the detailed findings below.

This inspection took place on the 3 June 2016 and was unannounced. When the service was last inspected in February 2014 there were no breaches of the legal requirements identified.

Watery Lane Cottage provides accommodation home for three deafblind adults who may need additional support with learning or physical disability or their emotional development. At the time of our inspection there were three people living at the service.

A registered manager was in post at the time of 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 cottage was adapted to meet the needs of the people who live there. The lounge, kitchen and dining area is open plan. There is a large seating area, a dining area and a U-shaped gallery style kitchen. This enabled the staff to support people with discrete supervision without always having to physically engage. This allowed people to explore their independence and home despite their dual sensory loss. The service was homely and individualised to the people who lived there.

People’s rights were being upheld in line with the Mental Capacity Act 2005. This is a legal framework to protect people who are unable to make certain decisions themselves. We saw information in people’s support plans about mental capacity and Deprivation of Liberty Safeguards (DoLS). DoLS applications had been applied for appropriately. These safeguards aim to protect people living in homes from being inappropriately deprived of their liberty.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks. Staff worked on the premise of how people could be supported to do fun, but risky activities, rather than trying to stop people doing things they liked. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified.

Care plans were based around the individual preferences of people. People and relatives were involved in their care plans and the decision making process. They gave a good level of detail for staff to reference if they needed to know what support was required. People received the care and support as detailed in their care plans.

People were supported by keyworkers. They developed opportunities and activities, and in conjunction with the registered manager, took part in support plan development with the person. The process ensured the person was fully involved with their own programme of events.

There was positive feedback about the service and caring nature of staff from people and relatives. Comments included; "The staff are very attentive. Five gold stars. It couldn’t be any better"; “We consider our relative is well-supported by the staff team who are all able to communicate effectively with him”. A recent compliment stated; “We would like to say how extremely impressed we were with [staff member’s name] in Watery Cottage and the remarkable insight into the care for his residents.”

Staff received a comprehensive induction and on-going training, tailored to the needs of the people they supported. They were confident and knowledgeable in their ability to support and care for people and their commitment for supporting people live a fulfilled life was evident throughout the inspection. There were sufficient staff deployed to meet the needs and preferences of the people that lived there.

People received their medicines when they needed them. Staff managed the medicines in a safe way and were trained in the safe administration of medicines.

The staff were kind and caring and treated people with dignity and respect. Good interactions were seen throughout the day of our inspection, such as staff holding peop

We spoke with two people who used the service using hands on British Sign Language and other forms of communication such as the Deaf Blind Manual Alphabet. We observed how the staff team cared for people. We saw their interactions with all three people who used the service was kind, thoughtful and caring.

The staff team encouraged people to reach their full potential. For one person this meant they were assisted to attend a cookery course leading to a qualification. They cooked a meal for all members of the house each week. The kitchen had been specially adapted to make this as safe as possible. The manager said “we value people here." A staff member told is “I really like it here. It’s a great place to work.

People’s privacy and dignity was respected by the staff team.

People knew how to make a complaint and were confident they would be treated seriously by the staff team.

When we visited the Watery Lane Project we took an 'expert by experience' with us. The expert by experience in this case was someone who is deaf themselves and has experience of communicating with deaf people with complex needs. We took an interpreter with us to further assist our communication with the ‘expert by experience’ and people who use the service. The purpose of involving an expert by experience is to help us understand the views of people using the service.

We spoke with people who used the service using sign language and other forms of communication such as lip reading.

People told us that they felt safe at the home and one person told us "I like the staff being there ".

A staff member told is “I look forward to going to work. The team are excellent”. Another staff member told us “there are always staff around and the manager is very supportive".

There was assistance for people to maintain their personal hygiene and that their privacy and dignity was respected. People told us that their rooms were warm and comfortable.

During our inspection, we met with people who used the service and members of staff, including the deputy manager.

We observed staff members supported people who used the service in a thoughtful and considerate manner.

A member of staff told us "we help people be as independent as they can be. If they need our support then we do what ever we can. People who live here are brilliant".

The deputy manager told us” we use a communication tool to assist people make complaints or express any concerns they may have about their care”.

We completed a tour of the building and saw the toilets and communal areas were well maintained. They were clean and hygienic.