This inspection took place on 20 September 2018 and was announced. We gave the provider 24 hours’ notice so we could be sure the right people would be available when we visited the service. At the last inspection we found three breaches of the regulations regarding risk assessment, recruitment practices, and records and the service was rated as requires improvement in safe, responsive and well-led. Following the last inspection, we asked the provider to complete an action plan to show what they would do, and by when, to improve the key questions of safe, responsive and well led to at least good. At this inspection we found there had been improvements and the breach of regulations had been met and the service is now rated as good.

Summer Wood Residential Care Home 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 provides accommodation and personal care to up to four people living with a learning disability.

The 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 using the service can live as ordinary a life as any citizen.

A registered manager was 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 and associated Regulations about how the service is run. The service continued to be well managed by the provider, long standing registered manager and staff team.

As far as possible, people were protected from harm and abuse. Staff knew how to recognise the signs of abuse and what they should do if they thought someone was a risk. The home was clean, and people were protected from the risks of poor infection and prevention control.

There were enough experienced and suitable staff to support people to stay safe and to meet people’s identified needs and preferences. Staff were supported with training, supervision and appraisals to help them develop the skills they needed to provide good quality care. Staff reported incidents and accidents properly, and if these did occur, the registered manager made sure they were investigated.

People were supported to eat and drink enough. Food was nutritious and people gave us positive feedback about the choice and quality of food. People accessed the healthcare they needed to remain well, such as the GP or practice nurse, and their medicines were managed safely.

People were able to express their choices and preferences and these were respected and promoted by staff. People led the lives they wanted to and staff supported people to go out or join in activities in the home in the least restrictive way possible. People were supported to maintain contact with those people that were important to them.

People experienced compassionate care that met their needs, and were supported by kind, caring staff. People had their privacy and dignity respected, and staff knew what to do to make sure people’s independence was promoted. People experienced person centred care and were supported to be involved in their care reviews as much as they wanted to be. People had their care needs regularly reviewed and updated. The building and environment met the needs and preferences of the people who lived there.

People were asked for their consent before any care was given, and staff made sure they always acted in people’s best interests. The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safegu

Summer Wood Residential Care Home is a semi-detached property close to Bexhill-on-Sea train station. It provides care and support for up to four adults who have learning disabilities and/or autism. Its focus is to provide a supportive family environment and home. There were four people living at the service at the time of our inspection. They varied in age and included a mix of females and males. Two people were out most days attending voluntary jobs and spending time with relatives and friends. People were able to tell us of their experience of living at Summer Wood.

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 registered manager was also the registered provider and they lived on site.

At our last inspection in November 2014 we issued a requirement notice as there was no effective recruitment and selection procedures in place and relevant checks on staff had not been completed. We received an action plan from the provider that told us how they would make improvements. At this inspection we found that the provider was still in breach of this Regulation.

We identified further areas that required improvement. Risk assessment documentation for one person had not been fully assessed including the person’s capacity to make decisions about their safety. This had the potential to leave the person at risk of harm.

There was a lack of monitoring to identify that record keeping in many areas such as care plans, daily records, staff recruitment files and fire drill records, were accurate and up to date. Whilst there were safe procedures for the management of medicines there was no formal system in place to assess staff competency before allowing them to give medicines.

Whilst the home sought assessment documentation as part of the pre admission process they had no system in place to carry out their own formal assessment of need to ensure the person’s needs could be met at Summer Wood and to assess compatibility with other people living at the home. When reviews were carried out there was no effective system to ensure that information was cross referenced to the current care plan and assessed in terms of impact for the person. We made a recommendation to the provider in relation to improving documentation in these areas.

Despite these shortfalls people told us they were happy with the care they received. People were treated with kindness and compassion in their day-to-day care. There was a very relaxed and calm atmosphere in the home and staff had a good rapport with people. Bedrooms had been personalised to reflect each person’s individual tastes and interests. People were supported by staff who knew them well as individuals and they were able to tell us about people’s needs, choices, personal histories and interests. We observed that staff talked and communicated with people in a way they could understand and people were encouraged to make decisions.

Staff understood what they needed to do to protect people from the risk of abuse. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People had access to healthcare professionals when they needed specific support. This included GP's, dentists and opticians. Where specialist healthcare was required, for example, from a community nurse, arrangements were made for this to happen.

Staff told us they felt supported and that the registered manager was very approachable. They had received regular supervision. As the home was small they had regular time with the registered manager.

We found some breaches of

People who were able to speak with us liked living at Summer Wood. One told us, "I am very happy here." Another said, "The staff are all lovely, X is like a mum to me."

We examined all the care plans and observed staff interaction with people and found that people expressed their views and were involved in making decisions about their care and treatment.

We looked at medication at the home and found that there were robust systems in place to ensure the safe acquisition, storage, administration and disposal of medication.

Staff we spoke with told us they felt very supported in their roles and enjoyed working at the home. One said," The best thing is the friendly atmosphere. It's not like being at work." Another said, "We laugh a lot. There is a lovely group dynamic."

We examined quality assurance records and systems and found the provider had an effective system to regularly assess and monitor the quality of service that people receive.

There were four people living at the home at the time of the inspection. During our visit we spoke with two people who were using the service and two members of staff. The other two people that used the service were attending college and work experience at a local animal sanctuary.

People were given information in a range of formats to assist them in understanding the choices available to them about how they wished to spend their time

People living at the home said they liked the home and felt safe. We made observations throughout the visit and saw people being offered choices as to how they wanted tospend their day. One person told us how they had moved to the service from hospital and had been able to choose how their room was decorated. Rooms we looked at were personalised and contained individual's personal belongings.

We saw people being addressed in a respectful manner. We looked at people's individual support plans and observed that these were discussed with people who used the service and that these discussions were recorded.

We saw that regular audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Staff told us that they had received training in protecting adults from abuse and that they felt that they were supported and trained to carry out their roles and meet the needs of people who used the service

People expressed that they were happy and safe within the service. They were comfortable in the environment and accessed amenities in the local community such as the local shops.

People told us that they liked living at the service and that they “Get on well with all the staff”.

Summer Wood Residential Care Home is a semi-detached property close to Bexhill-on-Sea train station. It provides care and support for up to four adults who have learning disabilities and/or autism. Its focus is to provide a supportive family environment and home. There were four people living at the service at the time of our inspection. They varied in age and included a mix of females and males and formed a group of people who jelled well although they had different needs and interests. Two people living in the home were out most of the day sometimes attending voluntary jobs and spending time in community with relatives or friends often spending time at the train station or in and around the shops. They came back to the home for evening meals and to sleep. Two people preferred to spend time together and with staff. Everyone was able to communicate verbally and were able to communicate their views on the service provided.

This inspection took place on 12 November 2014 and was unannounced. With a second visit undertaken on the 19 November to meet with people who were not present during unannounced visit.

The provider is an individual sole trader and also manages the home. As the registered provider they are the ‘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 recruitment practice followed did not ensure all the required checks were completed on staff before they started work.

People told us they felt they were safe and well cared for at Summer Wood Residential Care Home. Staff undertook safeguarding training and knew the correct procedures for reporting any suspicion of abuse

Staff were provided with a full induction and training programme before they worked unsupervised. Staffing arrangements ensured staff worked in such numbers with the appropriate skills that people’s needs could be met in a timely and safe way. People’s medicines were administered in a safe way by staff trained to undertake this role.

Staff responded to people on an individual basis. The care plans contained information on people’s preferences and risk assessments to keep people safe. Staff knew and understood people’s care needs well and there were systems in place for all staff to share information.

People were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), and related assessments and decisions had been appropriately completed.

People were able to have what they wanted to eat and decided between them. Mealtimes were a social event that included staff. Staff monitored people’s nutritional needs and responded to any changes in need.

People told us they were able to access health and social care professionals as needed. Records confirmed there was regular contact and input from relevant health and social care professionals. This included the local GP’s and community services including Opticians and practice nurses.

Staff treated people with respect and dignity. People were cared for by kind and polite staff. Staff knew people well and were able to describe detailed information about people their interests and preferences. There was a variety of activity and opportunity for interaction taking place inside and outside of the home. Links with family members was given a high priority and staff worked hard to support people in maintaining these.

People were given information on how to make a complaint and were encouraged to share their views. There was a system to deal with any complaint. Further feedback from people was gained through annual surveys, and regular daily contact with staff and the provider.

There were quality assurance systems in place to audit the home. This included regular audits on health and safety, infection control and medicines within the home. The culture in the home was open with the provider was readily available and willing to listen to anyone.

We found a breach of the Health and Social care Act 2008 (Regulated Activities) Regulation 2010

You can see what action we told the provider to take at the back of the full version of the report.