We carried out this inspection on 14 November 2018. The inspection was announced.

This service was last inspected in January 2016 and was rated Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The Croft 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.

There were 3 people living in the home at the time we carried out our inspection.

There was an experienced registered manager responsible for the day-to-day management of the service. 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 had been working for the provider organisation for a number of years.

Many of the values that underpin "Registering the Right Support" and other best practice guidance were seen in practice at this service. There was evidence that the core values of choice and promotion of independence were at the centre of people's day to day support. However, the service was located at the bottom of a hill at the edge of a community and all of the people living in the home had mobility needs so could only leave the home using transport. This made community inclusion more challenging but people were accessing local services and facilities such as the hairdressers. The staff worked very hard to ensure that the people had maximum power and control over their lives and day to day choices.

We looked at how the service managed its recruitment of new staff and saw that this was done well and all of the required checks were carried out before staff commenced working at the home.

We spoke with two relatives who gave positive feedback about the home and the staff who worked in it. They told us that the staff supported their relatives well. We saw that warm, positive relationships with people were apparent. The people had lived in the home for over 22 years and were living happy lives, as independently as possible, supported by staff who knew them well.

Staff spoken with and records seen confirmed training had been provided to enable them to support the people with their specific needs. We found staff were knowledgeable about the support needs of people in their care. We observed staff providing support to people throughout our inspection visit. We saw they knew people well and how they liked to be cared for.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were kept safely with appropriate arrangements for storage in place.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions. We saw that people were supported to make their own decisions whenever this was possible and their choices were respected.

Care plans were person centred and driven by the people who lived in the home. They detailed how people wished and needed to be cared for. We identified that some updates were required and the registered manager showed us that they were already in process of making amendments to show how people’s needed had changed.

The registered mana

This was an unannounced inspection, carried out on 27 January 2016.

The Croft is a care home for four adults with a learning disability. Although located in a residential estate in Ellesmere Port, the 'semi-rural' area surrounding the home ensures the privacy of service users is protected. A range of local shops, pubs and other facilities are within easy reach of the home. The home is a four-bed bungalow, with all the bedrooms being single.

The service had a 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.

We last inspected this location in April 2014 and we found that the registered provider met all the regulations we reviewed.

Relatives told us they felt people were safe at the service. Staff had a good understanding and were aware of the different types of abuse. Staff knew the process for reporting any concerns they had and for ensuring people were protected from abuse. Staff told us they would not hesitate to raise concerns and they felt confident that they would be fully investigated in partnership with the relevant external agencies.

There were safe systems in place for the management of medicines. Medicines were administered safely and administration records were up to date. People received their medication as prescribed and staff had completed competency training in the administration and management of medication.

People’s needs were assessed and planned for and staff had information about how to meet people’s needs. Support plans we reviewed were personalised and always promoted the involvement of the person or other important people such as family members. Staff were responsive in meeting changes to people’s health needs.

Staff were caring and they always treated people with kindness and respect. Observations showed that staff were respectful of people’s privacy and dignity and encouraged people to maintain their independence. Staff were skilled in recognising and using peoples preferred method of communication.

Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager and staff had a good knowledge and understanding of the Mental Capacity Act 2005 and their role and responsibility linked to this.

Robust recruitment processes were followed and there were sufficient qualified, skilled and experienced staff on duty to meet people’s needs.

Staff received support through supervision and team meetings which enabled them to discuss any matters, such as their work or training needs. There was a programme of planned training which was relevant to the work staff carried out and the needs of the people who used the service.

The service was well- managed by a person described as “approachable and helpful”. Systems were in place to check on the quality of the service. Records were regularly completed in line with the registered provider’s own timescales. We were notified as required about incidents and events which had occurred at the service.

Our inspection team was made up of one inspector. They looked at 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 people who used the service, the staff supporting them 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 are treated with respect and dignity by the staff. This was seen through the way the staff centred their work on the needs of people and the way they respectfully interacted with people. People were not able to tell us whether they felt safe but our observations noted people to appear relaxed and happy with the staff team. Safeguarding procedures are robust and staff understood how to safeguard the people they supported.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. No one had been subject to a Deprivation of Liberty Safeguards (DOL’s) application, although recent changes at a national level meant that this could change. Relative were informed of this, although no applications had needed to be submitted.

Is the service effective?

There was information about an advocacy service available if people needed it. No one accessed advocacy service yet this was under review given the differing levels of family involvement in people’s care.

People’s health and care needs were assessed with them, and given the communication needs of people. Family members had been involved in writing their plans of care. Specialist dietary needs had been identified in care plans where required.

Is the service caring?

Our observations noted that staff were attentive to the needs of the people and that their work focussed exclusively on the needs of people. People were not able to tell us about their experiences of the support they received yet we were able to tell from non-verbal communication that they felt at ease and happy with the staff team.

Is the service responsive?

The service had a Quality Assurance processes in place which sought the views of people involved in the support of people living at The Croft. When issues had been identified for improvement, they were dealt with promptly. Where changes to the overall care of people had occurred, we saw evidence that families had been informed of these. Staff considered that they were listened to by the provider.

Is the service well-led?

The service had a manager who was registered with us to carry out their roles. We noted that the service always told us when there were significant incidents. The service remained part of a larger organisation which had systems in place to ensure that people received a person centred level of support. We saw evidence in care plans that the service worked with other agencies to ensure positive outcomes for people.

You can see our judgements on the front page of this report.

The nature of the disability of those living at the Croft is such that it was not always possible to gain a direct verbal view of their experiences living there. We were introduced to each person and were able to tell them about our visit. One person responded that "it is like a party (living there)". Other people were able to respond non verbally and all appeared comfortable with the staff team. Staff maintained an approach with people that was centred upon their needs throughout our visit.

No relatives visited on the day of our visit yet an invitation was extended to them to comment on the support their relations received. No comments were received at the time of this report yet any comments will be used as part of our ongoing monitoring of the service. We spoke to two staff members. Staff felt supported in their role, looked forward to coming to work at the The Croft and felt that there was a good team working at the service.

The nature of the disability of the people who live at the Croft is such that it is not always possible to gain a verbal account of their experiences. We were able to meet with individuals and noted that throughout the visit, people appeared to be comfortable and relaxed with the staff team. We noted that comments had been made by visitors and recorded in a compliments book. Comments included:

'Staff have a calm and relaxed manner'

'What a lovely home'

'It has a calm atmosphere'

'Staff are caring and thoughtful'

'Thanks to all the staff for arranging the birthday for my relative'

'It is a lovely place'

We spoke with one person who was working there for a short time but was independent of the service. They commented that the service was excellent.