We carried out this unannounced inspection on the 24 and 25 July 2018. At the last inspection carried out on the 25 January 2017 we found that the provider was not meeting all of the legal requirements. We identified that one person was having their liberty restricted without the necessary authority being in place and identified that the management team required further support and knowledge to ensure that they fully understood their responsibilities. We found a breach of Regulation 13 of the Health and Social Care Act 2008 ( Regulated Activities) Regulations 2014. We rated the service as requires improvement. At this inspection we found that the provider had made the required improvements and rated the service as Good.

Sparrowfields 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. Sparrowfields provides care and support for a maximum of six people who are living with a learning disability, autism or mental health conditions. There were six people living at the home at the time of the inspection.

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.

There was a registered manager in post at the time of our inspection. However, they were on annual leave and a senior staff member and the provider’s quality manager supported us with our inspection. 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 were cared for by staff who were trained in recognising and understanding how to report potential abuse. Staff knew how to raise any concerns about people’s safety and shared information so that people’s safety needs were met.

People were protected from risks associated with their health and care needs because risk assessments and associated care plans were developed holistically, reviewed and monitored. This ensured that people received the support they required to remain safe. Staff were aware of the risks to people when supporting them outside of the home in order to promote people’s safety in the community.

People were supported by sufficient numbers of staff who had the knowledge and skills they required to care for people safely and effectively.

Staff sought the expertise of specialist services and health and social care professionals to ensure that the care they provided to people was in keeping with legislation and best practice guidelines. This included advice and support specific to learning disabilities and autistic spectrum disorders.

Staff understood the importance of ensuring people agreed to the care and support they provided and when to involve others to help people make important decisions. The provider was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS) .

People were supported to enjoy a wide range of activities and were involved in their day to day care and chose how to spend their day. People were encouraged to maintain their independence and live active and fulfilling lives.

Staff were caring and treated people with respect. We saw people were relaxed around the staff supporting them and we heard and saw positive communication throughout our inspection. It was evident that people had developed positive relationships with staff and there was a friendly, calm relaxed atmosphere within the home.

People

We carried out this unannounced inspection on the 25 January and 01 February 2017. Sparrowfields provides care and support for a maximum of six people who are living with a learning disability, autism or mental health conditions. There were six people living at the home at the time of the inspection.

The home has been without a registered manager for almost 12 months. This has placed the registered provider in breach of their conditions of registration. The registered provider assured us the new manager was currently applying to the commission to become the registered manager. The new manager has been appointed and was present throughout our inspection. 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. Feedback we received from people living and working at the home, relatives and health professionals was that this manager was approachable, and was making a positive impact on the running of the home.

People were supported by care staff that had the knowledge they needed to work in line with the principles of the Mental Capacity Act (MCA) 2005. Staff described how they supported people with making choices and gaining consent. However we identified that one person was having their liberty restricted without the necessary authority, documents and processes being in place We identified that the management team required further support and knowledge to ensure that they fully understood their responsibilities and the actions required to protect this person’s legal rights and civil liberties.

People told us that they mainly felt safe living at the home. People also told us about how staff supported them when the impact other people’s unsettled behaviour affected them. The registered provider was aware of this and they had taken steps to manage this situation in both the short and longer term. Staff we spoke with had knowledge of possible signs of abuse and could describe the action they would take in reporting any concerns. There were enough staff available to meet people’s requests for support.

Risks people faced had been identified and measures had been put in place to minimise the risk for the person. Staff we spoke with were aware of people’s risks and could describe how the risks were managed. The systems in place to monitor the risks had been improved since our last inspection and were being effective.

Changes had been made to the management of medicines to ensure people would receive their medicines safely. There were systems in place to monitor medicines administration.

People we met had pride in their bedrooms, and described the help and support they had been given to decorate and furnish their room in a style that suited their tastes and preferences.

People were supported by staff who were positive about the training they had received. Our observations of staff working with people showed that staff were skilled and knowledgeable in meeting people’s needs.

People had access to regular healthcare, and specialist advice was sought from healthcare professionals when needed.

People had been supported to plan, shop for and prepare meals and drinks of their choice.

People were happy with the care and support provided and spoke warmly and with enthusiasm about the staff. People were supported to be involved in planning and reviewing their care to meet their individual needs. Staff we met and spoke with enjoyed working at the home and knew the people they supported well.

People were treated with dignity and respect and were encouraged to remain independent.

There were numerous opportunities for people to undertake interesting activities both inside the home and in the local community. People enthusiastically told us about the

We visited this service and talked with people to gain a balanced overview of what people experienced, what they thought and how they were cared for and supported. There were six people living in the home at the time of our visit. We saw all of the people during our visit.

We spoke with three members of staff, all of the people who lived in the home and the manager. We observed how people were supported and how staff interacted with them to get a view of the care they experienced.

We considered all of the evidence we had gathered under the outcomes that we inspected. Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We observed the interactions between the people who lived in the home and staff. People looked at ease in their surroundings. Staff spoke with them in a calm and friendly manner. There were enough staff on duty to meet the needs of the people who lived at the home.

We saw there were systems in place to ensure people received their medicines safely and as prescribed.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes and hospitals. No applications had been made. The manager understood how this legislation applied to people and protected their rights.

We found that equipment was serviced at regular intervals to ensure it was safe to use.

Is the service effective?

It was clear from our observations and from speaking with staff that they had a good understanding of people’s care and support needs and that they knew them well. We saw that people's support plans and risk assessments were reviewed on a regular basis to ensure that their changing needs were planned for.

We saw that actions were taken to protect people's health as needed. The staff and managers of the home worked with other agencies and health care providers to ensure people’s changing needs were met.

People living in the home were encouraged to maintain and develop their independence.

We saw people were involved in planning and shopping for the food they liked. Staff encouraged healthy eating where possible.

Is the service caring?

People were supported by kind and attentive staff. We saw support workers showed patience and gave encouragement when supporting people.

People appeared settled and content. The people that lived in the home that we spoke with told us they liked living there.

We saw that people were supported to take part in a range of activities of their choice. This ensured people led fulfilling lives. People were supported to maintain relationships that were important to them. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

People using the service, their relatives, friends and other people involved with the service completed satisfaction surveys on a quarterly basis. The suggestions and ideas voiced by people were followed up.

Is the service responsive?

We saw people's care plans and risk assessments were reviewed on a regular basis to ensure their changing needs were planned for.

Records confirmed people’s preferences, interests, and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. People had access to a range activities and were able to maintain relationships with their friends and relatives.

Records showed that staff responded quickly to changes in people's health. We saw people had access to a variety of health care providers to ensure their needs could be met.

Is the service well-led?

The registered manager had been in post for a number of years. The manager was experienced and caring and provided good leadership based on how best to meet the needs of people in an individualised way.

There were systems in place so that people who lived in the home could share their views about how the home was run. The manager was able to give us examples of actions taken and changes that had been made as a result of listening to the people living in the home.

There were systems in place to ensure the quality of the service was regularly assessed and monitored.

We spoke with four of the five men living at Sparrowfields and six of the staff on duty at the time of our inspection. Feedback was overwhelmingly positive that Sparrowfields was a good place to live and to work. Comments from people living at the service included: "I like all the activities. I have been to Alton Towers,Lion King and Thorpe Park." Staff members told us:"This is a happy place to work. I feel supported by my line manager" and"This is a very homely home. I really enjoy the people I support and like the other staff I work with."

We looked at the care and support people were receiving. We found this was individual to meet the needs and wishes of each person. People were supported to stay as safe as possible when they wished to take risks. People were supported to see the healthcare professionals relevant to them.

We found there were systems in place to reduce the chance of people experiencing abuse. Staff had received training and, advice and guidance was available in the home. Checks were made on new staff before they were recruited.

People received their medicines in the right dose at the correct time. People were encouraged as far as they were able to participate in administering their own medicines.

Systems were in place to ensure the service was safe and continued to meet people's needs. We found checks were made by care staff, team leaders, the manager and representatives of the provider.

During our inspection we spoke with four people who used the service, the relatives of two people who were visiting the home, three members of staff and the registered manager. We also looked at documentation which was made available to us.

When we visited the home, the atmosphere was calm and relaxed. We saw people happily chatting with staff and involved in various activities. Comments we received from people who used the service included: “ The staff do a good job; They look after me well” and “The staff are nice and care about you.”

We found the home was well maintained, clean and tidy. Staff were trained and supported so that they had the skills to meet people’s individual needs. We also found personal and management records were generally well maintained and helped in the smooth running of the home.

We visited Sparrowfields as part of a responsive review as we had not visited for a while and so did not have current information.

Sparrowfields is a home for six people with learning disabilities. All of the people living at Sparrowfields were male. The home was warm, clean and modern. The home was nicely decorated and displayed pictures of the people who lived at the home taking part in various activities.

The people who lived at the home appeared happy and relaxed in their environment. They chatted to the staff and manager in a relaxed way. One person said ‘Yes, it’s nice here, it’s my home.’ All the people who lived at the home were clean shaven, appropriately dressed and had suitable footwear on.

We inspected this home on 06 and 07 January 2016. The visit was unannounced. The home is registered to provide personal care and accommodation for up to six people who have a learning disability or autism. At the time of our inspection six people were living at the home.

The service was last inspected in October 2013 when we found the provider was fully compliant with the regulations we inspected. Sparrowfields does have a registered manager; however they were not present at the time of inspection as they were on leave and preparing to leave the service. A temporary manager was in post and the provider had begun recruiting for a new registered manager. 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 we spoke with told us they felt safe living at Sparrowfields. Staff were aware of the actions they needed to take to ensure people stayed safe, and we observed them working in accordance with the written plans and risk assessments.

People could be certain they would receive their medicines safely and as their Doctor had prescribed.

There were not always enough staff on duty, and sometimes the staff available lacked the competencies required to meet the needs of the people living at the home. Staff had been provided with training about the Mental Capacity Act 2005 (MCA). However the staff we spoke with were unsure of how this applied to their work.

People were supported to attend a wide range of health appointments. This helped to maintain their physical and psychological well-being.

People had the opportunity to choose, buy and prepare their own food; however people were not offered consistent help to make healthy choices.

Everyone we spoke with told us, and we observed that staff worked with kindness and compassion. The staff provided people with the support and reassurance they required to help them stay calm and to feel settled.

People had been supported to make plans for their life and to undertake activities that were of importance and interest to them.

The registered provider sought feedback from people, and had used this to further improve and develop the service.

The service was in a transitional phase with a new registered manager and a new shift leader being recruited. The registered provider had taken action to minimise the impact of this on people, and people had the opportunity to be involved in interviewing and recruiting the new staff.