What life is like for people using this service:

People said they enjoyed living at The Larkins. People felt safe and were cared for in a kind and compassionate way.

Staff were suitably trained to meet the individual needs of people.

Care records were current and relevant and gave staff guidance on how best to care and support people. People’s risks were managed well and people received their medications as prescribed.

The provider and the acting manager of the home were visible and approachable and had a good rapport with people, their relatives and with staff.

More information is in the full report.

Rating at last inspection: Good (8 April 2016)

About the service:

The Larkins provides accommodation and personal care for up to six adults who may have a learning disability. At the time of our inspection there were five people using the service.

Why we inspected:

This was planned inspection based on the date and the rating of the previous inspection. The rating continues to be Good overall.

Follow up:

We will continue to monitor the service through information we receive.

This inspection took place on the 3 March 2016 and was unannounced. At our previous inspection in 2013 we found there were no concerns in the areas we looked at.

The Larkins provided accommodation and personal care for up to five people with a learning disability. Five people were using the service at the time of the inspection.

The service did not require a registered manager as the registered provider is a single provider who has day to day charge of the home. We were supported throughout the inspection by the acting manager and registered provider. 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.

People were protected from abuse as staff knew what constituted abuse and who to report it to if they suspected it had taken place.

There were sufficient staff to keep people safe and to support people to follow their hobbies and interests.

Risks to people were minimised to encourage and promote people's independence. Staff were clear how to support people to maintain their safety when they put themselves and others at risk.

People's medicines were stored, administered and managed safely.

Staff were supported to fulfil their role effectively. There was a regular programme of applicable training and regular staff supervision.

The Mental Capacity Act 2005 (MCA) is designed to protect people who cannot make decisions for themselves or lack the mental capacity to do so. The Deprivation of Liberty Safeguards (DoLS) are part of the MCA. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. The provider followed the principles of the MCA by ensuring that people consented to their care or were supported by representatives to make decisions.

People's nutritional needs were met based on their individual preferences. People were supported to eat and drink sufficient amounts to maintain a healthy lifestyle.

People were supported to access a range of health care services. When people became unwell staff responded and sought the appropriate support.

People felt cared for and we observed that staff were kind and caring in their manner. People's privacy was respected and everyone had their own bedroom and facilities.

Care was personalised and met people's individual needs and preferences. People were fully involved in decisions about their care.

The provider had a complaints procedure and people knew how to use it.

The provider had systems in place to monitor the quality of the service. When improvements were required these were made in a timely manner.

We previously inspected The Larkins on 9 April 2013 and 26 June 2013. During these inspections we saw that people were not protected from the risk of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained. At this inspection we saw that the provider had made improvements to their record keeping.

We looked at the care records of three people who used the service. We saw that the provider had not notified us of events that had affected the welfare, health or safety of people who used the service.

At our previous inspection on 9 April 2013 we saw that medicines were not stored safely. We saw that people were not protected against the risks associated with medicines. At this inspection we saw that the provider had suitable arrangements in place for the safe storage of medicines and appropriate arrangements had been put in place to manage the risks associated with medicines.

At our previous inspection we saw that people were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained. At this inspection we saw that there had been no improvement to the way in which records were maintained. At our previous inspection we saw that records could not be located promptly. At this inspection we saw that systems had been put in place to enable staff to have prompt access to all records.

On the day of our inspection there were four people living at the home. We looked at three care records, spoke with two people living at the home and two staff members. This helped us to understand the outcomes and experiences of people using the service and to make a judgement about whether the service met essential standards of quality and safety. One person told us, “I like it here, I like the house and the staff look after me”. Another person told us, “I like the carer X, she takes me on walks”.

People experienced care, treatment and support that met their needs and were cared for in a warm and friendly manner. This was because staff had received appropriate training and support to look after people. People living at the home told us how much they enjoyed the food and we saw that people received adequate nutrition and hydration.

The provider did not have appropriate arrangements in place to manage medicines. Documentation was not always completed accurately and medication was not always stored safely and appropriately. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service but had not informed us of safeguarding incidents that had occurred in the home.

People expressed their views and were involved in making decisions about their care and treatment.

People's privacy and dignity was respected. The care records we saw recorded people’s likes and dislikes. People's health needs were monitored and they were supported to attend health related appointments.

We were told that people using the service were involved in decisions about their day to day lifestyle and saw in care records that where they were able people had been included. Attempts to ensure support records were accessible by using simple language supplemented by pictorial references had been made. This meant that people would be able to understand the information recorded.

One person told us, "I'm not sure about care or support records, but staff do talk to me about them and I know what I've agreed."

One person confirmed that a recent risk assessment had been completed and they had discussed it with the senior staff. "My key worker or the manager talks to me about any thing I want to do. I'm trying to be more independent."

People told us they were happy with the care and support they received and knew what to do and who to go to if they had any concerns.

We saw that staffing levels were sufficient to meet people's needs and staff received training and support to ensure they provided good quality care.