About the service:

Salcasa is a care home for five people with a learning disability. The accommodation is a single storey building with a large garden. At the time of the inspection five people were living at the service.

The service had 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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s experience of using this service:

People received care and support from a stable staff team who knew them extremely well. Care was delivered in a person-centred way based on people’s preferences.

Staff encouraged people to be as independent as possible. Risks that people were exposed to were assessed and measures were put in place to minimise them. People were supported to have maximum choice and control in their lives and staff supported them in the least restrictive way.

Staff provided consistent care and support to people. People were involved in their care and support and staff respected their privacy and dignity. Staff had a good understanding of people’s needs, preferences, histories and routines. People received appropriate support to maintain their health and to achieve good health outcomes. People had opportunities to take part in a wide range of activities which met their individual choice and preferences. This enabled people to achieve positive outcomes and a good quality of life.

The registered manager was experienced and passionate about providing people with support to enable them to develop. Staff felt listened to and valued and they felt involved in the development of the service. Relatives praised the management of the service and the impact that living in the service had on the people accommodated.

Rating at last inspection: Good (report published 13 April 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection

Follow up: We will continue to monitor all intelligence received about this service to ensure that the next planned inspection is scheduled accordingly.

Salcasa is a service that provides accommodation for up to five people. It offers residential care for adults with learning disabilities and mental health conditions. On the day of our inspection five people were living in the service. This inspection took place on 3 March 2016 and was unannounced.

The service had a registered manager (‘the 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.

People living in the service were safe and benefited from the support of sufficient numbers of staff, who were well trained, supported and felt valued in their work.

Staff and the management team understood their responsibilities in safeguarding people from harm. When appropriate they contacted the local authority to report concerns. The home knew how to support people’s needs without restricting their freedoms.

Appropriate recruitment procedures were followed and pre-employment checks were carried out to ensure staff were suitable to work with people receiving care and support. There was a robust induction programme for new staff.

Medicines were managed and administered safely in the home and people received their medicines as the prescriber had intended.

Staff were skilled and motivated to support and care for people. Staff also knew people and their needs well. All staff received appropriate training and were supported well by the manager.

The Care Quality Commission (CQC) is required by law to monitor the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The manager told us that some people living in the home did not have capacity to make certain decisions for themselves. The manager had appropriately made DoLS referrals to the local authority because they were restricting some people’s freedoms in order to keep them safe.

People had enough to eat and drink and the staff who prepared food provided good quality food and catered for individual preferences. People also had access to the community on a daily basis and often had meals out.

People had regular access to healthcare professionals and were supported to attend appointments. Staff managed people’s health appointments and made appropriate health and social care referrals.

All staff at the service were caring and supportive and treated people as individuals. The care provided was sensitive and person centred and people’s privacy, dignity and wishes were consistently respected. Friends and relatives were welcome to visit as and when they wished and people were supported to be as independent as possible.

People were happy living in Salcasa and their interests were encouraged and supported by staff. There was a positive atmosphere in the service and people were supported to have regular access to the community if they wanted to. People were also involved in planning their care.

There was an open and positive culture at Salcasa. People using the service and their relatives were given opportunities to raise issues about the quality of the care provided. Relatives knew how to make a complaint if needed.

The service was being well run and people’s needs were being met appropriately. The manager was approachable and communication between the manager and staff was frequent and effective.

There were a number of systems in place to ensure the quality of the service was regularly monitored and maintained. The provider carried out regular audits to identify areas that needed improvement and an action plan was put in place for the manager to complete.

One person we spoke with told us that they loved living in Salcasa and said: “I love it here, it’s brilliant.” This person also told us that they had settled in very well and always had plenty of things to do. They told us: “We’re going to the fair this afternoon and then I’m going to Sheringham tonight to see my friends. We’re going to have a meal and watch a band.”

Our observations during this inspection showed the staff on duty interacting in a jovial and friendly manner and speaking respectfully with people. We also noted that any personal care requirements were carried out privately and in a dignified manner.

One person we spoke with told us that they felt safe living in the home and had no problems with how they were supported by staff. Other people we observed appeared comfortable and relaxed in the presence of the staff on duty.

One person we spoke with said, of the staff: “They’re all good here, they look after us really well. The staff take me to different places when I need them to.”

This person also said: “I haven’t got any complaints, I’m really happy here with everything.” They replied, “Yes” when we asked if they were happy talking to the staff or the manager if they did have any concerns and added: “I talk to all of them, they’re all good.”

One person we spoke with told us that they loved living in Salcasa and that they were able to see their friends and family a lot. They explained that, although their relative had sorted everything out for them to be able to move in, they had personally been involved in meetings and discussions before making a final decision.

This person also told us that they joined in with the weekly tenants' meetings and was able to make choices about things like menu options, outings and activities as well as being able to raise any issues or concerns.

The person we spoke with showed us a letter they had written to staff to say thank you for helping them move in. They also said that they really liked their keyworker.

Other comments made by the person we spoke with included: "I love it here, I never get bored and I know the staff understand my needs." "The food is really good here and I often help in the kitchen with the food prep." And, "I really like my room, it was all decorated and the furniture put in it, just as I wanted it."

This person told us that the staff always had time to spend with people and that there were always enough staff around if they needed anything. They also said that they knew how to make a complaint or raise any concerns and that the staff listened to them if they did raise anything.

Two people were spoken with during this visit. It was not always easy for people to answer our questions but the overall observations and conversation that took place throughout this visit gave us a picture of the way each person was involved in their day to day lives. They told us that “I like it here” and “I like my cup of tea”. Comments written in the ‘residents meeting book’ provided evidence that people were involved and have a say about what and when things happen within their home.