About the service: The Lawrence provides accommodation and personal care for up to 14 people who have a learning disability. There were seven people using the service on the day of our inspection.

People’s experience of using this service:

¿ People were safe at The Lawrence. Systems associated with recruitment, risk assessment, medicines and safeguarding protected people from abuse and harm, and the building was clean.

¿ Choice was offered and respected, and people received the right support to enable them to make decisions. Staff had the training and support to provide effective care, and other health professionals were involved as needed.

¿ People lived in a caring environment, and were able to maintain friendships and their independence. There was consultation with people about their care, although we found some improvements could be made in documentation to ensure it was accessible and always responsive to their needs. People had access to meaningful activities in the home and in the community.

¿ There was good leadership in the home, and regular checks were made on the quality of care and support being provided, although there were some occasions when more discretion was needed when discussing care. People and staff were supported to express their opinions about the service.

¿ We have made recommendations about checking staff confidence in making safeguarding referrals and improvements to the format some of documentation.

Rating at last inspection: Our last inspection report was published in October 2016, and the service was rated ‘Good’. At this inspection the overall rating has remained ‘Good’, although one key question is now rated ‘Requires Improvement.’

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we are scheduled to return. We inspect according to a schedule based on the current rating, however may inspect sooner if we receive information of concern.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 15 September 2016 was unannounced. This meant that the provider did not know we would be visiting. The service was last inspected in July 2013, and at that time was meeting the regulations we inspected.

The Lawrence provides accommodation and personal care for up to 14 people who have a learning disability. There is a small garden area to the front and parking to the rear of the home. It is on a main bus route and close to the M1/M62 link roads. Situated in Wrenthorpe it is only a few minutes journey from the centre of Wakefield and all amenities.

There was a registered manager in place. 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.

Staff we spoke with understood the principles and processes of safeguarding. Staff knew how to identify abuse and act to report it to the appropriate authority. Staff said they would be confident to whistle blow [raise concerns about the service, staff practices or provider] if the need ever arose.

Risks to people arising from their health and support needs or the premises were assessed, and plans were in place to minimise them. Risk assessments were regularly reviewed to ensure they met people’s current needs. A number of checks were carried out around the service to ensure that the premises and equipment were safe to use.

We saw safety checks and certificates completed within the last twelve months for items that had been serviced and checked such as fire equipment and electrical safety. The service had a programme of redecoration and repair of the premises in place.

Accidents and incidents were monitored each month to see if any trends were identified. At the time of our inspection there had only been six accidents and incidents, however the deputy manager had found a trend to show why one person would have an accident or incident. The deputy manager had reviewed staff rotas to deal with this trend.

There was sufficient staff to provide the support needed and staff knew people’s needs well. At the time of inspection 91 hours were funded to provide a 'one to one' service.

Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers and obtaining a Disclosure and Barring Service (DBS) check before they started work in the home. The Disclosure and Barring Service carry out a criminal record and barring check on individuals who intend to work with children and vulnerable adults, to help employers make safer recruitment decisions and also to minimise the risk of unsuitable people working with children and vulnerable adults.

People were safely supported to access their medicines. Accurate records were kept of administration, and medicines were securely and safely stored in each person’s room.

Staff received training to ensure that they could appropriately support people, and the service used the Care Certificate as the framework for its training. The Care Certificate is an identified set of standards that health and social care workers adhere to in their daily working life.

Staff received support through regular supervisions and appraisals. Staff felt confident to raise any issues or support needs during supervision and found these meetings useful.

Staff understood and applied the principles of the Mental Capacity Act and the Deprivation of Liberty Safeguards to ensure that people’s rights were protected. Care plans contained evidence of mental capacity assessments and best interest decisions.

People were supported to maintain a healthy diet, and people’s dietary needs and preferences were catered for. People had nutrition plans in place.

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We spoke individually with five people who used the service and also with a group of seven people in the communal lounge. People told us they were happy living at the home. People told us, “The staff are great,” “The staff give me lots of help” and “I’m really happy here, happier than I’ve been anywhere else.”

Records checked showed that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

During the inspection we spent time sitting with people in the communal areas of the home. We found that care and support was offered appropriately to people.

We spoke with one relative and they told us that their family member was treated respectfully and that they were happy with the quality of support their family member received.

We found that staff were clear about what their roles and responsibilities were and what action they would take if they saw or suspected any abuse. People who used the service that we spoke with told us that they felt they were in a safe place.

We found that the service had enough qualified, skilled and experienced staff to meet people’s needs.

We saw that the service had provided people with information about how to complain. People who we spoke with told us that they regularly attended the resident’s meeting where they could raise any concerns they may have.

The people we spoke with who used the service said they liked living at The Lawrence. They told us all the staff were very kind and knocked before they went into their bedrooms.

We found that people's needs were assessed and care was planned and delivered in line with their individual care plan. We saw that staff had a positive attitude towards the people who used the service and we observed throughout the visit that staff took time to answer questions and engage with people.

People who used the service had regular monthly meetings with their key worker and this was documented in their care records. This enabled the staff time to get to know people’s likes, dislikes and discuss any issues or concerns.

During this inspection we saw that improvements had been made to the kitchen and laundry room. Also redecoration had taken place of the staircase, bedrooms and corridors.

We reviewed two staff files and saw evidence of bi-monthly supervision and annual appraisals. We looked at training records and saw that staff had completed their mandatory training including safeguarding.

We saw that there were good systems in place to assess and check that appropriate and safe care was being delivered. We saw a commitment to the continual improvement of the service.

One person said they like living in the home. Another says they enjoy cooking and making their own meals. Another said they like going to see Leeds United and Wakefield Wildcats. Another said they like gardening and showed the inspector some plants in their bedroom they had propagated. Another said they like music and have lots of CD’s. One person said they like their bedroom and in particular the big flat screen television.

People living in the home said they like living there and they feel safe.

People say they like living in the home. One person says they have everything they need. Another says their room is ‘great’ Another person said they like their room as it has all of the things they like. One person said they are waiting for their new wardrobe to be put together.

People say they like the people caring for them. One person says they like their support worker as they help them do things. Another said they like the people caring for them as they take them on holidays and out shopping.