Saresta and Serenade is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. This service does not provide nursing care. Saresta and Serenade accommodates up to 10 people with complex needs, including learning disability and/or autistic spectrum disorder. Saresta and Serenade were two bungalows next to each other. Four people lived in each, one of the people in Serenade lived in their own adapted self-contained annex.

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

On the day of our comprehensive unannounced inspection on 7 February 2019, there were eight people living in the service.

At our previous inspection of 27 July 2016, this service was rated Good overall. We found the evidence continued to support the rating of Good overall. 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.

People continued to receive a safe service. There were systems in place designed to reduce the risks of avoidable harm and abuse. People were supported with their medicines safely. Staff were available to support people when needed and robust systems were in place to recruit staff safely. People were safeguarded by the service’s infection control processes. Where incidents had happened, the service learned from these and used the learning to drive improvement.

People continued to receive an effective service. People were supported by staff who had received training to meet their needs. Staff worked with other professionals involved in people’s care. People had access to health professionals when needed. People’s nutritional needs were assessed and met. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The environment was suitable for the people using the service.

People continued to receive a caring service. People shared positive relationships with staff. People’s privacy, independence and dignity was respected. People’s choices about how they wanted to spend their time and be cared for were valued and listened to.

People continued to receive a responsive service. There were systems to assess, plan and meet people’s individual needs and preferences. People’s had access to social activities to reduce the risks of isolation and boredom. There was a complaints procedure in place and people’s complaints were addressed.

People continued to receive a service which was well-led. The registered manager had a system to assess and monitor the service people received. Where shortfalls were identified actions were taken to improve. People were asked for their views about the service and these were valued and listened to. As a result, the service continued to improve.

Saresta and Serenade provide accommodation, care and support for people with complex needs including learning disabilities and autism. There were eight people living in the service when we carried out an unannounced inspection on 27 July 2016

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There was a registered manager in post. 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.

People received care and support that was personalised to them and met their individual needs and wishes. Support workers respected people’s privacy and dignity and interacted with people in a caring, compassionate and professional manner. They were knowledgeable about people’s choices, views and preferences. The atmosphere in the service was friendly and welcoming.

People were safe and support workers knew what actions to take to protect them from abuse. The provider had processes in place to identify and manage risk. Assessments had been carried out and personalised care records were in place which reflected individual needs and preferences.

Recruitment checks on staff were carried out with sufficient numbers employed who had the knowledge and skills to meet people’s needs.

Appropriate arrangements were in place to ensure people’s medicines were obtained, stored and administered safely. People were encouraged to attend appointments with other health care professionals to maintain their health and well-being. Where people required assistance with their dietary needs there were systems in place to provide this support safely.

People and or their representatives, where appropriate, were involved in making decisions about their care and support arrangements. As a result people received care and support which was planned and delivered to meet their specific needs. Support workers listened to people and acted on what they said.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). Support workers understood the need to obtain consent when providing care. Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLs and associated Codes of Practice

There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the care they received. People’s feedback was valued and acted on. There was visible leadership within the service and a clear management structure. The service had a quality assurance system with identified shortfalls addressed promptly which helped the service to continually improve.

Saresta and Serenade provides support and care for up to ten people living with learning disabilities and autism. There were eight people living in the service when we inspected on 6 August 2015.

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.

During our inspection the registered manager for the service was unavailable. A registered manager from another of the provider’s locations was covering and assisted us on the inspection.

People received care that was personalised to them and met their needs and wishes. The atmosphere in the service was friendly and welcoming.

Recruitment checks on staff were carried out with sufficient numbers employed. Staff had the knowledge and skills to meet people’s needs. People were safe and treated with kindness by the staff. Staff respected people’s privacy and dignity and interacted with people in a caring and compassionate manner.

Staff listened to people and acted on what they said. Staff knew how to recognise and respond to abuse correctly. People were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff understood how to minimise risks and provide people with safe care. Procedures and processes were in place to guide staff on how to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how risks to people were minimised.

Care and support was individual and based on the assessed needs of each person. There were appropriate arrangements in place to ensure people’s medicines were stored and administered safely.

Staff supported people to be independent and to meet their individual needs and aspirations. People were encouraged to attend appointments with other healthcare professionals to maintain their health and well-being.

Whilst people’s wellbeing and social inclusion was assessed, planned and delivered to ensure their social needs were being met. Improvements were needed to ensure people’s care records accurately reflected their needs and provided guidance to staff on how to meet them.

People were supported to make decisions about how they led their lives and wanted to be supported. Where they lacked capacity, appropriate actions had been taken to ensure decisions were made in the person’s best interests. People were encouraged to pursue their hobbies and interests and participated in a variety of personalised meaningful activities.

People were provided with a variety of meals and supported to eat and drink sufficiently. People enjoyed the food and were encouraged to be as independent as possible but where additional support was needed this was provided in a caring, respectful manner.

Systems for capturing people’s views and experiences of the service need developing further to ensure consistency in the way people’s feedback is received, acted on and used to continually improve the service.

There was an open and transparent culture in the service. Staff understood their roles and responsibilities and were aware of the values of the service.

Further developments were needed to monitor the quality and safety of the service provided and to drive improvements in the service forward.

The people living at Saresta and Serenade had complex needs and we were unable to ask them questions. However, some people were able to communicate with us using facial expressions or body language and we saw that they were relaxed and happy.

During the course of our inspection we saw that there were good interactions between members of staff and people living in the home; staff listened to people and treated them with respect.

We noted that the environment at Saresta and Serenade was spacious, with sufficient communal areas to meet the needs of people living there. We saw that people were comfortable in their surroundings.

Staff were able to demonstrate that they understood the complex needs of the people using the service and we saw that members of staff provided care in a person-centred manner.

As part of their quality monitoring process the home asked for feedback from relatives and health or social care professionals. We saw that positive comments were received including: ”We have found the home’s staff very willing to help, support and share their knowledge” and “It is a pleasure to visit Saresta. I always feel very welcome here.”