Station House is a 'care home'. People in care homes receive accommodation and nursing or personal care as 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 inspection was carried out on 10 May 2018 by two adult social care inspectors and was unannounced.

At our last inspection in November 2016 we rated Station House as good overall, although the well led domain was rated as requires improvement. This was because we identified that improvements in the monitoring systems were required to make sure audits undertaken were more robust and that where improvements were required these were identified with appropriate and timely action taken to address these.

The home caters for up to ten adults with learning disabilities and autistic spectrum disorder in two separate buildings. The provider also operates a domiciliary care agency from the same location. However, no-one was receiving personal care from the domiciliary care agency at the time of our inspection.

Station House is required to have a registered manager and there was one 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were systems and processes to assess and monitor the quality of the service provided. However, we found that audits were not always effective as they had not identified shortfalls to ensure that improvements would be made.

Staff were able to recognise signs of abuse should they occur and knew how to report concerns if they suspected a person was at risk of harm. There was a complaints procedure available in the service for people and relatives to raise concerns.

People received appropriate care from staff to meet their needs although not all staff training was up to date to develop their skills and knowledge. Staff monitored people's health and well-being. People had access to healthcare professionals according to their needs.

People were cared for by staff who were observant and ensured people were comfortable. People told us, and we saw, that staff were kind and caring.

Staff knew the needs and preferences of the people they cared for and promoted people's rights to privacy, dignity and independence.

We found that where people lacked capacity, there was no evidence that decisions had been made in accordance with the Mental Capacity Act 2005 (MCA) Code of Conduct.

People's diversity was respected and staff responded to people's social and emotional needs. People’s care needs were met because they were supported and cared for in accordance with their wishes and choices. People and staff were positive about the culture of the service. People felt the staff team were approachable and polite.

People gave positive views about the food they received and experienced pleasant mealtimes. There were activities for people and people were supported to take part in these, although their preferred, documented routines were not always carried out.

During this inspection, we found two breaches 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 this report. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

The inspection took place on 15 and 16 November 2016 and was unannounced on the first day. The care home was previously inspected in October 2015, when three breaches of legal requirements were identified. These were regarding the safe management of medicines, recruitment of staff and the lack of an effective system to assess and monitor the quality of the service provided. Following that inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to these breaches. This inspection was undertaken to check that they had followed their plan, and to confirm that they now met all of the legal requirements.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for 'Station House' on our website at www.cqc.org.uk'

At this inspection we found improvements had been made, and the provider had achieved compliance with the breaches found at the last inspection, but further development was needed to embed and improve the systems in place.

Station House is a care home situated on the outskirts of the village of Laughton Common. There are local facilities close by and good public transport links. The home caters for up to ten younger adults with learning disabilities and autistic spectrum disorder in two separate buildings. The provider also operates a domiciliary care agency from the same location. However, no-one was receiving personal care from the domiciliary care agency at the time of our inspection.

At the time of our inspection there were six people living at the home. To gain people’s opinion about how the service operated we spoke with two people who used the service and three relatives. They told us they felt there had been improvements made over recent months and they were happy with the service provision.

The service did not have a registered manager in post at the time of our inspection. An acting manager had been appointed in July 2016. They told us they had begun the process to register with the Commission to become the registered manager for the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. People we spoke with told us they were pleased with the new management team saying they were approachable, listened to their opinions and ideas.

People told us they felt safe living and working at the home. We saw there were systems in place to protect people from the risk of harm. Staff we spoke with were knowledgeable about safeguarding people and were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified any potential risks to people and plans were in place to ensure people’s safety.

Improvements had been made to ensure people received their medications in a safe and timely way from staff who had been trained to carry out this role.

We saw a structured recruitment process was in place to help make sure staff were suitable to work with vulnerable people. Overall staff had been recruited robustly; however we found a few documents missing from staff files. This was addressed within the week of the inspection, but more robust checks would be beneficial to ensure consistency in the future.

There was sufficient staff available to meet people’s needs. The use of agency staff had been reduced since the last inspection, which helped to make sure people received consistent care and support.

Staff had access to a varied training programme. However, training records did not evidence that all staff had completed refresher training in a timely manner. Staff told us they felt they had received sufficient training to carry out their roles, and further training had been planned. Staff support sessions had taken place, but not as regularly as outlined in the company poli

This inspection was to check if the provider had taken action to address the shortfalls we found when we carried out our last inspection in August 2013. These were regarding the processes in place to reduce the risk and spread of infection and the safe recruitment of staff. The provider sent us an action plan saying they would be compliant by the end of October 2013.

At this visit we found the provider had addressed the shortfalls we identified at our last visit. We saw they had completed thorough background checks on new staff before they started to work at the home to make sure they were suitable to work with vulnerable people. They had also introduced appropriate systems and equipment to monitor and minimise the risk of infection.

On this occasion we did not speak with people who used the service. However their experiences were captured through checking records and speaking with the provider and staff.

We saw that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People told us how they decided things, like how they spent their day and what meals they ate. If people could not tell staff what they wanted systems were in place to help them do so or other people were involved.

People told us they received the care and support they needed and they were happy with how staff delivered their care. We saw people were encouraged to be independent, but support was available when required. They were also involved in social activities, attended day centres and carried out day to day living skills, such as cooking and cleaning their rooms.

The premises were in a good state of repair and were clean and fresh. One person told us how they had chosen what to have in their room and said, “It’s always nice and tidy." We saw that regular checks were made to make sure the home was safe and maintained to a satisfactory standard.

People who used the service and the staff we spoke with said there were enough staff on duty to meet people’s needs. We saw people received the support they needed in a timely manner from staff who were competent in their role.

We saw the complaints procedure was available to people who used and visited the service. People told us they felt comfortable taking any concerns to any of the staff.

As part of our inspection we talked with a number of people who use the service. Although some people were not able to communicate with us other people told us that they liked living at the home. We asked people questions about the home, the care they received and staff caring for them. Their responses indicated that they felt safe and were happy with the care they received. We received comments such as “The staff are nice” and “I like living here”.

We found that care staff were very aware of the individual personal and healthcare needs of the people that use the service and supported people who use the service to make choices about their care and daily life.

We saw that staff involved people in meaningful activities throughout the day and there was a positive, happy atmosphere within the home.

Relatives we spoke with during the visit expressed their satisfaction with all aspects of the service. Comments included “The staff are always encouraging and positive” and “We always feel very welcome when we visit, the staff always include us”.

The inspection took place on 8, 9 and 14 October 2015 and was unannounced on the first day. The care home was previously inspected in August 2014, when no breaches of legal requirements were identified.

Station House is a care home situated on the outskirts of the village of Laughton Common. There are local facilities close by and good public transport links. The home caters for up to ten younger adults with learning disabilities and autistic spectrum disorder in two separate buildings. The provider also operates a domiciliary care agency from the same location. It offers personal care to a small number of people with a learning disability who are living in their own homes.

At the time of our inspection there were seven people living at the home. We spoke with three people who used the service and two relatives about their experiences. They told us that overall they were happy with the service provided.

The service did not have a registered manager in post at the time of our inspection. An acting manager had been appointed in July 2015. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

In the past safeguarding concerns had not always been reported in a timely manner. However, further training had taken place and the staff we spoke with demonstrated a satisfactory understanding of safeguarding vulnerable adults, which included what action they would take if they had any safeguarding concerns.

We saw a structured recruitment process was in place to help make sure staff were suitable to work with vulnerable people; however this had not always been followed. We found not all staff had been recruited robustly. For example, in the seven staff files we checked five did not contain two written references and two files did not contain details of the staff members work history. You can see what action we told the provider to take at the back of the full version of the report.

The service had a medication policy outlining the safe storage and handling of medicines, but we found this had not always been followed. We found shortfalls in relation to recording, ordering and the administration of medicines. You can see what action we told the provider to take at the back of the full version of the report.

We found that overall there were enough staff available to meet people’s needs. However, the home had experienced difficulties in recruiting and retaining staff so was relying on agency care workers and existing staff to fill any gaps.

People who used the service, and the staff we spoke with, felt sufficient training was provided to meet people’s needs. However, training records were incomplete therefore they did not demonstrate that all staff had received essential training. Staff support sessions had taken place in the past, but recently this had not been on a regular basis. Records also failed to demonstrate that appropriate staff had received an annual appraisal of their work performance.

The service had a policy in place for monitoring and assessing if the service was working within the Mental Capacity Act and they were following local authority advice on this topic. Most staff had completed training regarding the Act and the procedures to follow should someone lack the capacity to give consent. The provider was working with the local authority to ensure decisions made in people’s best interest were applicable and applications under the Deprivation of Liberties Safeguards were made as necessary.

We saw people were provided with a choice of suitable and nutritious food and drink. Some of the people we spoke with told us about how they were involved in shopping and preparing meals.

People were supported to maintain good health, have access to healthcare services and received on-going healthcare support. The care records we checked showed they had received support from healthcare professionals when required.

People who used the service were supported to maintain friendships and we saw care plans contained information about their family and friends and those who were important to them. People had access to a varied activities programme that met their needs and preferences.

The people we spoke with said they had been involved in formulating and reviewing care plans. Care files checked contained information about people’s needs, preferences and risks associated with their care. However, this documentation did not always provide sufficient information. In some cases files were disorganised, which meant it was difficult for staff to find relevant information easily. Although this had not had any adverse impact on the person, staff did not have clear information about how to manage some areas of risk, and shortfalls had not been identified and addressed by the management team.

We saw the complaints policy was available to people using and visiting the service. The people we spoke with told us they would feel comfortable speaking to any of the staff if they had any concerns. Complaints recorded contained information about the concern, action taken and the outcome.

The provider had a system in place to enable people to share their opinion of the service provided and the general facilities at the home. This included surveys, meetings and care reviews.

There was a quality assurance system in place so the provider could make sure policies and procedures had been followed, and to monitor how the home was operating, as well as staffs’ performance. However, we saw that recently these had not been consistently completed and action had not always been taken promptly to address shortfalls. You can see what action we told the provider to take at the back of the full version of the report.