About the service:

Rodney House provides accommodation, personal care and support for up to 20 people living with a learning disability, some of who will also have physical disabilities. The accommodation is provided in four houses with no more than five people living in each home. One home provides for people who receive short term care only. There is also a communal building which holds the manager's and administration offices and a common room.

At the time of the inspection there were 14 people living there, in three separate houses. Three people also arrived for a weekend stay during our inspection.

The YMCA London South West own the buildings and is the registered provider with the Care Quality Commission. The manager and staff are employed by Surrey County Council, who have also taken on the monitoring of the quality of the service and care since January 2019 with the agreement of the YMCA.

People’s experience of using this service:

People living at Rodney House were supported by staff who were kind and respectful. People were supported to be themselves and develop their own individual interests. Staff knew how to communicate with each person and people were involved in day to day decision making as much as possible.

However, the service was inconsistent in their approach to meeting the legal requirements of the Mental Capacity Act 2005 and improvement was needed. There had been several changes in manager in the last year and there was a need for consistent leadership and oversight.

The service had systems in place to keep people safe. There were enough staff to meet people’s needs. Risks were assessed and actions taken to reduce avoidable harm. There had been learning from mistakes with medicines administration and new systems put in place to prevent reoccurrences.

People lived in a suitable, safe and comfortable environment. The home met the national standards of Registering the Right Support for people who live with a learning disability. People had access to the right equipment and professional support to help promote their independence.

People could access the local community on a regular basis and take part in activities they each enjoyed. At home, there was a relaxed atmosphere. People took part in choosing and cooking their meals and people’s nutritional needs were monitored.

People were given care which was personalised to them. Some work was being done to update people’s care and support plans. We recommended that people’s end of life wishes should be recorded in the most appropriate way.

The registered manager was new and aimed to develop the service and staff. Improvements were continuously identified and there was support from a quality assurance team. Statutory requirements were being met. Staff were positive about their work and the future of the team.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was related to the need to fully implement and keep under review meeting the legal requirements of the Mental Capacity Act 2005. The provider started to take action immediately following the inspection.

More information is in the full report.

Rating at last inspection:

The last inspection report was published in August 2017 and the service was rated as Good.

Why we inspected:

We inspected the service as part of our scheduled plan of visiting services to check the safety and quality of care people received. This was an unannounced comprehensive inspection.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned in line with our scheduling guidance.

The inspection took place on 26 July 2016 and was unannounced.

The last inspection took place 3 January 2014 when we found the service was meeting all the Regulations we inspected.

Rodney House is a care home for up to 20 adults who have a learning disability. The registered service is made up of four semi-detached houses which can accommodate up to five people in each house. There is also a communal building which holds the manager's and administration offices and a common room. The buildings are all on the same site. One house is a dedicated short stay unit offering a service to approximately 25 different people (up to five at a time) for short breaks. At the time of the inspection there were 11 people living at the service permanently and one person was there for a short stay. People living at the service had a variety of needs which included some physical disabilities and autism. Each building had a dedicated staff team, although the staff had all spent time in the other buildings so that they knew the people who lived there and could cover in event of other staff absences.

The service was run by YMCA London South West, a charitable organisation responsible for managing this service and another care home in the county of Surrey. However, the staff were employees of Surrey County Council. The two organisations worked in partnership with different roles and responsibilities for managing the service.

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 and associated Regulations about how the service is run.

People living at the service and their relatives were happy with the care they received. They felt well supported and had good relationships with the staff. They were appropriately cared for and had opportunities to pursue social, leisure and educational activities of their choice. People were supported to learn new skills and achieve personal goals. Their wishes and preferences were respected and were considered when planning their care and support.

The staff were well supported. They had the training and information they needed to carry out their roles. They enjoyed their jobs and were fond of the people who they supported. They knew them well and showed a genuine interest in providing individualised care which met people's needs and reflected their interests.

There were good systems for managing and monitoring the quality of the service. The manager and assistant manager had worked for the service for many years and were involved in delivering care as well as overseeing how the home was managed. Records were clear, detailed and up to date. There were regular reviews of all aspects of the service and of individual care. People were involved in this and in planning improvements for the service.

The service comprised four houses and one shared common room. One house was used for respite care and the remaining three houses were for permanent residents. The houses catered for people who required different levels of support. On the day of our inspection there were eleven permanent residents and two people in respite care.

During our visit we observed staff talking to people with respect and compassion and assisting them in making choices. We were told that the home ' had a lovely atmosphere'.

We read in care records that every person had a personalised care and support plan that was suitable to their needs and reviewed regularly and that people were involved with these. We saw that there were regular resident meetings where people's views were listened to and valued. Through observation we saw people being offered choice as to what they wanted to do.

We saw that regular audits of the service were completed by the provider ensuring that people who used the service benefited from a service that constantly monitored its quality of care provided. We found that staff had adequate training and were well supported in order to carry out their role and to meet the needs of the people in the home. We found that safeguarding training had been received by all staff and that their responsibility was well understood.

In addition to people who used the service and a relative, we spoke with a healthcare professional who had regular involvement with the home and representatives of the registered provider, including the Director of Operations and the Head of Care Services.

People who used the service told us that they liked living at the home. They said that staff were always available when they needed them and that staff were polite and treated them with respect. People told us they could choose how they spent their time and that they could have privacy when they wanted it. They said that they had opportunities to take part in activities they enjoyed. One person told us, “I like the staff. They’re all polite.” and another said of staff, “They’re brilliant.” The relative we spoke with told us that their family member received good care at the home. The relative told us, “They’ve been marvellous at Rodney House. They understand [family member’s] needs very well and he gets on very well with the staff.”

We found that staff had access to the training and support they needed to do their jobs and that the staff team shared important information effectively. The provider had an effective system to monitor the quality of the service that people received, which included regular quality audits. People who used the service had opportunities to give their views about the home and about the care and support they received.

A person using the service was looking forward to their bedroom being redecorated this year. They said staff had told them they could choose their own colour scheme. People were pleased that new settees were on order for their lounges, which they had helped choose, with staff support.

People had been supported to develop and maintain important personal and family relationships. They had been encouraged and supported to budget and manage their money. Staff promoted their rights, enabling informed choice in their daily lives, whilst considering their protection.

People had been supported to be as independent as they could be. They had opportunity to learn and use practical life skills. They accessed meaningful activities of their choice, in the home and the community. These were in accordance with individual interests, diverse needs and capabilities. People had been involved in planning their own lifestyles. They had been encouraged to take up opportunities for further education, employment and to access day services. They had the option of annual holidays which they were involved in planning. Also to go on organised outings, individually and in groups.