Tentelow Lane is a care home for up to eight adults who have a learning disability. Some people also have autism and some people have physical disabilities. The service is managed by Voyage 1 Limited, a national organisation providing care and support to people with learning and physical disabilities, autism and brain injury. At the time of the inspection eight people were living at the service. They had all lived there for many years.

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 and associated Regulations about how the service is run.

The service was rated Good at the last inspection, which took place on 14 April 2015.

This inspection took place on 18 April 2017. At this inspection we found the service remained Good.

Why the service is rated Good.

People living at the service were happy. They had good relationships with the staff, who were kind, caring and supportive. People were able to make choices about their lives and how they spent their time. Care was planned according to individual needs and the staff had a flexible approach which responded to how each person was feeling at any given time. The staff had a very good knowledge about people's needs and there were clear, detailed and up to date support plans. People were supported to stay healthy and were able to eat a variety of freshly prepared meals which reflected their choices.

People were able to make choices and these were respected. They were not restricted in any way. There was information for staff about how to support each person to make informed decisions about their lives.

There were enough staff to support people and to keep them safe. The staff felt supported and communicated well with each other. They were well trained and had access to a range of information about the service and people's needs. They also had opportunities to discuss their work both informally with the registered manager and formally in team and individual meetings.

The registered manager was accessible and worked closely with the staff providing support. There were good systems for organising and managing the service and for checking that people were happy and the service was safe. People living at the service, their representatives and the staff were invited to speak about how they felt, and they were listened to. People were involved in making decisions about how the service was run, for example, the recruitment of new staff.

People lived in a safe environment which met their needs. The risks they were exposed to were assessed and the staff took action to help keep people safe and protect them from harm. People received their medicines in a safe way and were able to speak to the registered manager and senior managers if they had any concerns or felt uncomfortable about anything. Their complaints were listened to and acted upon.

The inspection took place on 14 April 2015 and was unannounced. The last inspection of the service took place on 1 April 2014 where we found no breaches of Regulation.

The service is registered to provide accommodation and personal care for up to four adults who have a learning disability. The provider owns and manages the next door property which is also a registered care home for four adults who have a learning disability. Although both homes are registered independently, the properties were joined by a connecting internal door and both services were run as one home with people from both houses sharing facilities, staffing, activities and meals. There were four people living in each of the homes.

There was a registered manager was 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 and associated Regulations about how the service is run.

People told us they liked living at the home and were happy there. Some of the things they said were, ‘’this house is fantastic’’, ‘’I am in the best place’’ and ‘’I am very happy here now.’’ One person told us the home and the support they received ‘’made them happy’’.

The staff told us they were well supported and enjoyed working there. They told us they cared about the people they supported and had good relationships with them.

There were procedures designed to safeguard people and the staff were aware of these. They had received relevant training and information. Risks to people’s wellbeing and safety had been identified, assessed and appropriately managed. People received their medicines in a safe way to meet their needs. There were sufficient staff employed and the provider had checked their suitability to work with vulnerable people.

The staff had the support, information and training they needed to care for people safely.

The Care Quality Commission monitors the implementation of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) to make sure registered providers are acting within their legal responsibilities. The provider had assessed people’s capacity to consent. People had consented to their care. The provider had made applications in accordance with their legal responsibilities.

People were given the support they needed to stay healthy and see other healthcare professionals as needed. They had a varied and nutritious diet.

The service was caring. People who lived at the home and the staff had positive relationships. People trusted the staff and thought they were kind and caring. People’s privacy and dignity was respected. The staff met people’s diverse needs, making sure they could access services, could communicate their needs and follow their chosen religion and culture.

People had their needs assessed, recorded and regularly reviewed. There were care plans and support guidelines which explained how the staff should support people to meet their needs. People living at the home took part in a wide range of activities both in the home and in the community. They learnt new skills and were involved in shopping, cooking and cleaning at the home.

There was an appropriate complaints procedure and people knew how to make a complaint or raise concerns.

There was a registered manager who had worked at the home since it opened and knew the service well. People living there and the staff felt happy and involved in planning how the service was managed.

There were appropriate systems to monitor the quality of the service. These included asking people living at the home, staff and other stakeholders for their views. The staff and manager reviewed and analysed incidents, learning from these and managing the risks to people in a safe and positive way.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

This is a summary of what we found-

Is the service safe?

People were cared for in a way which met their individual needs. There were enough staff employed and they were suitably trained and supported. People’s individual needs had been assessed and were regularly reviewed. They took part in a range of different activities which met theses needs. The staff knew how to care for people and made sure they involved each person in making choices about the things that they did. The environment was well maintained and there were regular checks on the safety of the home. People were supported to take their medicines in a safe way. People knew who to speak to if they were unhappy about anything. People told us that they felt safe and well cared for.

Is the service effective?

People’s individual needs were met. They told us that they were happy and well cared for. They said that the staff knew them well and were kind and respectful. One person told us, ‘’this home is brilliant – I am very happy here’’. People told us that they had opportunities to learn new skills and had access to a range of opportunities. One person told us that the staff were supporting them to learn to use roads safely. Another person said that they were learning how to prepare meals. They said that they were supported to stay healthy.

Is the service caring?

People told us that the staff were kind and caring. We saw that the staff offered people choices and treated them with respect. Each person had a care plan outlining their individual needs and there were systems to make sure these were followed. People told us that the staff looked after them to make sure they were happy, healthy and well fed. People looked comfortable and well cared for. The home was well maintained and people had access to the things that they wanted and needed. One person showed us a new television, new clothes and new furniture which the staff had helped them purchase for their bedroom. People told us that the staff celebrated their birthdays and helped them to keep in contact with friends and family.

Is the service responsive?

People’s needs were reassessed on a regular basis and they were involved in planning their own care. These needs had been recorded in care plans and we saw these had been followed. Where people had become unwell or there had been a change in their needs – this had been recorded and acted upon. People had the right medicines to stay healthy and saw healthcare professionals whenever they needed. People living at the home and other stakeholders were asked for their opinions on the service and these were listened to.

Is the service well-led?

There were good systems for monitoring the quality of the service. Where problems had been identified these had been addressed. The manager was experienced and knew the service well. He and the staff team reflected on the work they did and whether things worked well or not. The staff team told us that they felt supported. People living at the home felt confident that the service was well managed.

During our visit we spoke with two people who use the service and two staff. We also contacted some of the relatives of people who use the service.

People told us they liked living at the home and said they got to do things they enjoyed, such as going to the shops. They said they were also able to spend time on their own when they wanted. Relatives told us that people were supported appropriately and were provided with meals appropriate to their ethnic backgrounds. Some relatives commented about the furnishings within the home as being worn and dated.

People received support for their needs from the service and from external health and social care professionals

Staff received support and training in their work and the staff we spoke with said they generally felt supported in their work.

However, we did find that the staff did not always treat the people who use the service with respect.

During our visit we spoke to three people who use the service. One person said “..I love living here..”. They told us that they got good support from the staff and that they could lead the lives they wanted to. The staff we spoke to said that they enjoyed their work and they demonstrated a genuine caring approach towards the people who use the service.

People told us about the different activities they got involved in throughout the week, such as going shopping, reflexology, tidying their room and going to the pub. We saw that each person had and individualised and full activity programme throughout the seven day week.

Some people spoke about the support they received with personal care, where they said they were supported to do what they could for themselves, and staff would assist them only where necessary.

People said they felt that the staff had the right skills and experience to support them with their needs.

However, we found that people who use the service were put at risk because appropriate checks were not carried out on staff prior to their starting work at the home. People were also put at risk where Criminal Records Bureau checks had not been carried out on staff for a number of years.