Royal Mencap Society - 25 Barossa Road is a residential care home for seven people with learning disabilities and autism. It is a small home providing care to people over two floors. At the time of our inspection there were six people living at the home. Two of these people were receiving personal care.

At the last inspection, the service was rated Good. There was one breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, the provider had made improvements to meet the requirements of the regulation.

At this inspection we found the service remained Good.

Why the service is rated Good.

Risks to people were assessed with effective plans implemented to manage them. Staff understood how to safeguarding people form abuse and responded appropriately where incidents occurred. The provider carried out checks to ensure people were supported by suitable staff. Staff were deployed in a way that meant people’s needs were responded to safely. Checks were carried out to ensure the environment was safe and there were plans to follow in the event of an emergency. People’s medicines were managed and administered safely by trained staff.

People are 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. People were cared for by trained staff who had regular meetings with their supervisors. People’s nutritional needs were met and staff supported them to access the healthcare that they needed.

Staff knew people well and involved people in their care. People’s independence was encouraged by staff who helped to create an inclusive environment for people. Staff promoted people’s privacy and dignity when providing care to them. People were supported to maintain important family relationships.

People received care that was personalised and reflected their needs and interests. People’s needs were reviewed regularly. Staff supported people to identify activities and interests that they enjoyed. A complaints procedure was in place and people knew how to use it.

People and staff had access to management. Staff felt supported by their manager and were involved in the running of the service. People and relatives were regularly asked their views and involve d in decisions through meetings. The provider carried out regular audits to ensure people received care of a good quality. The provider maintained accurate and up to date records.

Further information is in the detailed findings below

This inspection was carried out on the 4 and 5 November 2015 and was unannounced. Royal Mencap Society – 25 Barossa Road provides accommodation and personal care for up to seven adults with learning disabilities. On the day of our visit five people lived at the service.

On the first day of the inspection the registered manager was on leave however they did support us on the 5 November 2015. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 regional manager supported us on the first day of the inspection.

People’s human rights could be affected because the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty (DoLS) were not always followed. There was not enough evidence of mental capacity assessments specific to particular decisions that needed to be made.

People’s needs were met safely because there were enough staff at the service. Accidents and incidents with people were recorded on the service computer with a written copy kept in a file. Staff had knowledge of safeguarding adult’s procedures and what to do if they suspected any type of abuse. Staff had undergone recruitment checks before they started work.

People’s medicines were administered and stored safely. Risks had been assessed and managed appropriately to keep people safe which included the environment. The risk assessments for people were detailed and informative and included measures that had been introduced to reduce the risk of harm. In the event of an emergency, such as the building being flooded or a fire, there was a service contingency plan which detailed what staff needed to do to protect people and make them safe.

People were supported by staff that were knowledgeable and supported in their role. Staff had received all the appropriate training for their role and their competencies were regularly assessed.

People told us that they enjoyed the meals at the service. People at risk of dehydration or malnutrition had effective systems in place to support them. People had access to a range of health care professionals, such as the GP and diabetic nurse.

People told us that the staff were caring. Comments included, “Staff are very nice, this is a nice home” and, “Staff are nice to me, my bedroom is nice too” and, “I like living here, I’m happy.” We saw that staff were caring and respectful to people.

People told us they were involved in planning their care. We saw that care plans had detail around people’s backgrounds and personal history and included people’s views on what they wanted. Staff knew and understood what was important to the person and supported them to maintain their interests.

People were supported by staff that were given appropriate information to enable them to respond to people effectively. Where it had been identified that a person’s needs had changed staff were providing the most up to date care. People were able to take part in activities which they enjoyed. One person told us that they were always busy.

People told us that they knew what to do if they were unhappy about something. There was a complaints procedure in place for people to access if they needed to and this was in a pictorial format for people to understand. We saw that complaints were investigated appropriately.

Staff said that they felt supported, valued and listened to. Systems were in place to monitor the quality of the service that people received. This included audits, surveys and meetings with people and staff.

During the inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We found that people had been consulted consistently and had consented to the support provided. Records were maintained in an easy read format which enabled people to understand their support plan more easily. One person told us, "If I don’t want to do something, that’s OK”.

People told us that they and their relatives had been involved in planning and reviewing the support that they received. We found that reviews included a pictorial report on activities and any achievements. The person in charge told us, "We do our best to make sure that people lead happy and fulfilling lives in the community”.

We found that people were provided with opportunities to pursue interests and hobbies at the service and in the community. People spoke enthusiastically about their activities.

We found that the premises were suitable in design and layout for the purpose. The service appeared clean and comfortable and was well maintained. This meant that the building and garden provided a safe environment for the people who used the service and staff.

We found that staff were adequately trained to enable them to perform their role and that their professional development was supported.

Effective systems for monitoring the performance of the service were in place and we saw evidence that changes were made in response. The person in charge said, " Mencap analyses the information contained in the reports we send and provides guidance on how to prevent repeats or reduce risk”

During our Review of Compliance visit on 10 October 2012 we identified that the service was not meeting this essential standard of quality and safety. The service was served a compliance action under Regulation 22; HSCA 2008 (Regulated Activities) Regulations 2010 to ensure that there were sufficient numbers of suitably qualified, skilled and experienced staff employed to safeguard the health, safety and welfare of people who used the service.

In our recent inspection we found that staff numbers had increased with the return of a care worker from long term leave. As a result an improvement in the individual support provided to people who used the service had been noted. Time had been made available for people to spend on activities or outings of their choosing on a one to one basis with a selected member of staff. One person told us, “We went to the garden centre and had coffee. Then we looked around all the departments”. A member of staff told us they felt that this had been beneficial for all of the people who used the service.

We found that staff training had been enhanced to meet changing needs within the service and to ensure the health, safety and welfare of people who used the service and staff.

Only one person was in the service at the time of the inspection and they did not wish to communicate with us.

We did speak with a relative who told us that people were specifically included in the support planning and delivery process. Also that it was tailored to meet the needs of the individual. We saw evidence to confirm this.

A relative also told us they believed that people felt happy, safe and secure in the service and that it provided a wide range of activities which reflected the choices made by people. These included annual holidays, theatre trips and parties.

The manager told us that the management of important areas of the service are supported by the Mencap Continuous Compliance Tool (CCT). This was demonstrated to us and we saw that the manager was given warning of issues that could affect the compliance of the service. This included staff training, fire safety and electrical appliance testing.

We noted that seven staff were shown on the duty rota. We were told that four of these were full time and the others were relief bank staff. We saw that four staff were rostered to work shifts in the week commencing 1 October 2012. This meant that other than day shift cover, care staff were working alone in the service. This had potential to impact on the health, safety and welfare of people using the service. The absence of an emergency support plan for the lone care worker was a concern and we did not consider staffing levels to be adequate.

Only one person using the service was home at the time of the visit. Discussions with this person, both in private and with assistance from a staff member, established their experience of life at the home. They said they liked living at 25 Barossa Rd and had formed good relationships with all staff. They told us there was autonomy in the way they lived their life and they were encouraged to be as independent as they could be. They were empowered to have choice and to make informed decisions in matters affecting them. They told us they participated in the running of the home. For example, they made their own breakfast and light lunch, vacuumed the lounge carpet each day, tidied and cleaned their room and chose the menu as a group. They were pleased that their preference to no longer attend day services or engage in community activities had been respected. They had no concerns or worries about the way their support needs were met. They said their bedroom was comfortable and had been personalised to their taste. They were happy that it was agreed that they could bring their cat with them when admitted to the home.