The inspection took place on 18 September 2018, and was unannounced

Royal Mencap Society - 27 Larchwood Close is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service was registered to provide care and support for up to seven adults with learning disabilities. At the time of the inspection, six people were living at the service. They received support 24 hours a day. The service was managed by The Royal Mencap Society, an organisation that specialises in providing care services for people with learning disabilities.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion so that people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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 2008 and associated Regulations about how the service is run.

The last inspection of the service was on 1 December 2015 when we rated the service good.

At this inspection the service remained good.

People living at the service were happy, relaxed and well cared for. Their representatives were happy with the support they were receiving. People's needs had been assessed and their care and treatment were planned so that these needs would be met. People were given support to learn independent living skills and try new things. They lived as part of a friendly community within the home and cared for each other.

Information about people's needs, the risks they were exposed to and their capacity to make decisions had been clearly recorded. Records were regularly reviewed and updated. People using the service, their representatives and the staff were involved in developing how care was planned. People were supported to take appropriate risks and there were systems to keep them safe and protect them from the risk of abuse. People received their medicines in a safe way, had access to a range of health services and had their nutrition and hydration needs met. They were supported to take part in community activities, both inside and outside of the home.

The staff were kind, compassionate and had positive relationships with the people who they were supporting. They had the information, training and support they needed to care for people and make sure they led fulfilling lives. The staff were happy working at the service and communicated effectively with one another to achieve the best outcomes for people who lived there. They were praised for good work and encouraged to strive for excellence.

The service was well managed. The registered manager had worked there for several years and knew people well. They advocated on behalf of people and made sure they had access to the right services and support. There were effective systems for monitoring the quality of the service and making improvements. The complaints procedure was clearly laid out and people using the service, visitors and staff felt empowered to raise concerns and share their feedback about the service.

Royal Mencap Society (RMS) 27 Larchwood Close is a large, detached house that can provide accommodation for up to seven adults with learning disabilities. It is situated in a residential area of Banstead, Surrey. At the time of inspection, there were six people living at the home.

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 2008 and associated Regulations about how the service is run.

The home was light and airy. Good adaptations had been made for people with mobility needs, such as rails on stairs. The manager and staff worked well to keep the environment clean and feeling homely for people, although the décor of the building looked tired. People were positive about their experiences at the home. One person said, “It’s nice and cosy and staff are friendly.” A relative said, “It’s as close to a normal home life as you can get.” Staff said, “I’m so privileged to do this job.”

The inspection took place on 01 December 2015 and was unannounced. At our previous inspection in December 2013 we had identified no concerns at the home.

There was positive feedback about the home and caring nature of staff from people and their relatives. One person said, “Staff are good, they help me and I like them.” When asked if anything could be improved they said, “No, I think they are doing all right.” A relative said, “Staff are caring and they get on well with people. They are attentive and keep us informed.”

People were safe at Royal Mencap Society – 27 Larchwood Close. There were sufficient staff deployed to meet the needs and preferences of the people that lived there. One person said, “They are always here when I need them.”

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. One person said, “Staff explained to me how I could keep myself safe.” Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building. Each person had a plan which detailed the support they needed to get safely out of the building in an emergency.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received a comprehensive induction and ongoing training so they had the skills needed to support the individual needs of people.

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 registered manager carried out regular checks of staff’s competency when they gave medicine to people.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. People told us that staff did ask their permission before they provided care.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had enough to eat and drink, and received support from staff where a need had been identified. One person said, “The food is nice here. It’s different every day. People’s special dietary needs were clearly documented and staff ensured these needs were met.

People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. One person said, “I tell them if I don’t feel well, they listen to me and help make me better.” When people’s health deteriorated staff responded quickly to help people and made sure they received appropriate treatment. People’s health was seen to improve due to the care and support staff gave, for example improvements in mobility after an operation.

The staff were kind and caring and treated people with dignity and respect. A relative said, “Staff are caring and they all (people and staff) get on really well together.” Good interactions were seen throughout the day of our inspection, such as staff holding people’s hands and sitting and talking with them. People could have visitors from family and friends whenever they wanted.

Care plans were based around the individual preferences of people as well as their medical needs. They gave a good level of detail for staff to reference if they needed to know what support was required. The staff knew the people they cared for as individuals. One person said, “Of course staff know who I am!” when we asked them. People’s involvement in the review and generation of these plans had been recorded. People received the care and support as detailed in their care plans.

People had access to activities that met their needs. People told us about their hobbies and interests and how these were supported by the staff. A wide range of activities were on offer, most of them based in the community. Activities were based around people’s interests and to promote their independence and confidence.

People knew how to make a complaint, and said they had never felt the need to complain. The registered manager explained that complaints (if received) would be discussed with staff to improve the service for everyone.

Quality assurance records were kept up to date to show that the provider had checked on important aspects of the management of the home. Records for checks on health and safety, infection control, and internal medicines audits were all up to date. Accident and incident records were kept, and were analysed and used to improve the care provided to people.

People had the opportunity to be involved in how the home was managed. Meetings and surveys were completed and the feedback was reviewed, and used to improve the service.

We spoke with two people who lived at the home. They were both satisfied with the care and support they received, how it was delivered and were happy living at 27 Larchwood Close. One person told us, "I love living here. I have lots to do and the staff are like friends". Another told us told us, "I go out a lot and I'm very happy". We noted that the home provided a wide variety of social and educational opportunities in both group and individual settings in addition to placements at a local day centre. The people we spoke with were happy with the number and types of activities on offer.

We saw that people's consent was obtained where possible before care and treatment was undertaken. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and preferences were taken into account.

People were protected from abuse and cared for in a safe and inclusive environment. We noted that there were adequate numbers of skilled and experienced staff to deliver safe and appropriate care. We also found that systems were in place for people and relatives to make a complaint about the service if necessary.

We spoke with four people using the service. We also gathered evidence of people’s experiences of the service by reviewing feedback questionnaires, which had been completed by people who used the service and their representatives.

All people who used the service said that they were very happy living there and they liked the staff.

People said that their care was discussed with them. Two people said that they had meetings with their key workers and they were able to make choices. They also said they participated in home meetings.

People were involved in the running of the home and they were supported to undertake household tasks such as cooking and washing up. They participated in a range of activities and went away on holidays.

People told us that they enjoyed their meals, which they were able to choose.