Templefields is a care home which specialises in supporting adults with a learning disability. It is registered to provide accommodation and support for up to 14 people. At the time of inspection 11 people were living there.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People received support which was individual to their needs, and risks were minimised wherever possible. Staff received training and support which helped them be effective in their roles. People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible. The service provider’s policies and systems supported this practice. We observed a good atmosphere in the service, and saw people were free to decide how and where they spent their time. The registered manager ensured the quality of the service was monitored, and improvements were made when required.

Further information is in the detailed findings below.

The inspection of Templefields took place on 18 May 2015 and was unannounced. We previously inspected the service in May 2014 and found the service to be non-compliant with regard to assessing and monitoring the quality of service provision. This was because the inspection team were not provided with the audit files on the day of the inspection but this was remedied soon after.

Templefields is a care home which specialises in supporting adults with a learning disability. It is registered to provide accommodation and support for up to 14 people. People had a range of complex physical and cognitive disabilities as well as verbal communication difficulties. The home is spilt into two units; the main house accommodates up to 9 adults and there is an annex to accommodate up to four people, including a connecting flat which accommodates one person. There is also an extensive enclosed garden with summer house. On the day of our inspection there were thirteen people living at Templefields.

We found that people were being cared for safely by staff who had a good understanding of safeguarding and how to manage people with more complex behavioural and communication needs. Staff were able to identify areas that might be perceived as safeguarding and knew how to report such concerns.

There were completed risk assessments written in a way to support the individual safely rather than restrict their freedom and enough staff on duty to ensure that people could have their needs met in the way they chose to.

Medicines were administered safely and appropriate records were maintained to ensure that people received their medicines in accordance with the prescription.

Staff received a comprehensive induction and were appropriately supported and trained following this. They demonstrated in-depth knowledge about the people they were supporting and were actively encouraged to seek further training and qualifications when they expressed a wish to do so.

The home had a sound understanding of the Mental Capacity Act (2005) Deprivation of Liberty Safeguards (DoLS) and made every decision in conjunction with the individual concerned, even where communication was limited. We saw staff used sign language and other techniques to engage with people, and ensure they understood their wishes. People were supported to make their own decisions as much as possible and these were recorded appropriately.

We found staff to be caring and knowledgeable about the people they were supporting, showing that the service was focused on enabling people to do as much as possible for themselves. The service was flexible to people’s needs encouraging people to decide which activities they wished to partake in.

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 demonstrated the values of the service by their leadership, ensuring that staff were supported, valued and encouraged as much as possible always endeavouring to meet people’s needs in the manner they preferred. They had responded to some recent serious concerns about the service in a robust manner by looking at key areas in depth and developing a coherent action plan to address these concerns. Staff were confident in their leadership and were able to develop as a result.

We asked our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with the deputy manager, staff members, people who used the service and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by staff.

There were some systems in place to ensure managers and staff learned from events such as accidents, incidents and concerns. This reduces the risks to people and helps the service to continually improve. However, we found issues with the timescales these systems were used in. We saw staff members had received training in all relevant areas to meet the needs of people who used the service.

The service was safe, clean and hygienic and equipment was well maintained. During our visit, we saw people had access to hand washing equipment in both communal areas and in each person’s room.

Staff personnel files contained all relevant information, including Disclosure & Barring Service (DBS) checks and reference checks from previous employers.

Is the service effective?

People were cared for and supported in an appropriate way. Individual care plans were up to date and were reviewed (at least) 6 monthly.

Is the service caring?

People were supported by kind and attentive staff. We saw staff showed patience and gave encouragement when supporting people. We observed staff speaking to people in a kind and caring manner.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. For example, one care record we looked at said; “I love buying new clothes and puzzle books. I enjoy reading, watching television and doing jigsaws”. The same record also stated; “I don’t like the smell of lavender.” This demonstrated support was personalised and records provided information to ensure care and support was person-centred.

Is the service responsive?

People completed a range of activities at the service. On the day of our visit we observed people watching television and interacting with staff members. There were a range of activities available, including jigsaws, puzzles, baking, sewing and pampering sessions. On the day of our inspection, some people who used the service had gone out for the day or were getting ready to go out on an activity.

One member of staff we spoke with told us; “It’s good here. We’re only a small team but we all get on great. We’re like a little family and we all actually want to be here”.

Is the service well-led?

The service worked well with other agencies and services to make sure people received the most suitable care. This included multi-agency work with doctors and other health professionals.

The service had some quality assurance systems in place and actions were identified. We saw audits of medication and health & safety.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service. This helped to ensure people received a good quality service.

We found people's care was appropriately planned and staff were clear about people's needs and associated risks. We also found there were the necessary safeguarding processes in place to protect people from abuse and there were adequate numbers of staff with the appropriate qualifications who provided care and support. The environment of the home was visibly clean and infection control processes were in place to protect people from the risks of cross infection. There was also an adequate complaints process and this was brought to the attention of people who used the service and/or their relatives/next of kin.

We spoke with four people who used the service and each of them appeared comfortable and settled at the home. One person we spoke with described how they were happy at the home and they enjoyed spending time in the large garden at the back of the property. Another person said staff were nice and they too were happy at the home. All of the people we spoke with were positive about their experiences of living at the home.

The people we spoke with told us they were well looked after. They told us they were supported to remain independent and felt staff listened to them. One person told us how they had chosen their room when they first came to live at Templefields. They told us they were very independent and staff supported them to remain independent. We saw evidence of monthly meetings where people could contribute to the running of the home.

People's needs were assessed and care and support was developed from an assessment of their needs. Risk assessments to help minimise identified risk and protect the person from unsafe care were in place. Staff had received appropriate training for their role and understood the importance of reporting suspected abuse.