This inspection took place on 9 January 2018. The provider of is registered to provide accommodation for personal care for a maximum of 10 people who have a learning disability. There were eight people living at the home on the day of our visit. The service was rated as Good at our last inspection in October 2015. The overall rating has remained good following this inspection.

All people we spoke with felt safe in their home and when the staff were with them in case they needed some guidance or assistance with their care needs. Staff knew who to report to if they felt a person was at risk of potential abuse and were confident that any reported incidents would be addressed by the registered manager.

People told us they were encouraged to monitor and manage potential risks and what they felt able to do and were comfortable with. Staff knew how to encouraged people to learn and try new things safely. There were enough staff when people needed them and people medicines were administered and recorded when they had received them.

Staff were knowledgeable about people they supported and were confident in their roles and responsibilities. Staff told us they received regular training and supervisions that helped them provide care to people they supported.

People are supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were involved in making decisions about their care and their consent was appropriately obtained by staff when caring for them. People who could not make decisions for themselves were supported to have a decision made about their care and support which was in their best interest.

Care plans detailed what support people needed and provide guidance for care staff on how best to meet the care people wished to receive. People were supported to make their meals or staff prepared them where needed. People were involved in planning their meals which included their favourite choices. Healthcare appointments were arranged for people and care staff went with them.

People told liked the staff and told us their care needs were supported well. People were encouraged to be in control of their decisions and choices. Staff respected people’s dignity and privacy. People spoke with us about the registered manager being accessible and provided examples of when the registered manager had listened to them.

Everyone we spoke with felt the management team were available to talk with and would listen and act of any feedback provided on the service. The management team had kept their knowledge current with support from the provider and external professionals. The staffing team felt the provider and management team led by example and that they regularly checked on the quality of the care that people received and continually looked to improve these.

This inspection took place on 15 September 2015 and was unannounced.

The provider of The Oaks is registered to provide accommodation for personal care for a maximum of 10 people. There were 8 people living at the home on the day of our visit. At the time of our inspection 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 was on leave on the day we visited, however the deputy manager was available. Where we were unable to gain people’s views on the service by talking with them we saw how staff looked after people who lived there.

When people required assistance they asked or looked to staff to help them and staff were available when needed. Staff felt they had time to support people when required to ensure that people’s needs were met in a timely way. People received safe care and felt supported by staff who knew how to keep them safe. Staff knew the steps they would take to protect a person from the risk of harm and how to report any concerns. Staff provided people with their medicines and recorded when they had received them.

Staff knew how to care for people as their training and support provided them with the skills needed. Staff listened and respected people’s decisions about their care and treatment. Staff showed they listened and responded to people’s choice to choose or refuse care.

The registered manager had consistently applied the Mental Capacity Act 2005 (MCA). The assessments of people’s capacity to consent and records of decisions had been completed. Where needed staff had followed the legal process when considering a decision where a person had not had the capacity.

People enjoyed the food and had choices regarding their meals. Where people required or wanted a particular choice this had been arranged. People had access to other health and social care professionals to support their health conditions. They had regular appointments with consultants when needed and were supported by staff to attend these appointments.

People enjoyed the company of the staff that supported them. Them knew them well and were happy to chat and share stories with them. People felt involved in their care and treatment and that staff knew them and their care needs. Staff knew people’s individual care needs. People’s dignity had been respected and they were supported to maintain relationships with their families who also contributed in planning their care.

People spent their days doing things they enjoyed and said that they also spent time in their home, the garden or out on planned trips. People had raised comments or concerns and they had been addressed. There were systems in place for handling and resolving complaints. People knew how to raise a concern and felt their home was open and inclusive. Staff were encouraged to raise concerns on behalf of people at the home.

People were able to approach the management of the home and they knew who to speak to. The management team had kept their knowledge current and they led by example. The provider ensured regular checks were completed to monitor the quality of the care delivered.

We considered all of 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 safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

Staff we spoke with were clear about what was meant by abuse and what actions they would take should abuse be suspected. Families of people who used the service expressed confidence that could raise any issues with the registered manager and the staff team. A senior member of staff was on call at all times in case of emergencies. The provider had a policy for safeguarding adults from abuse. This was communicated to staff during their induction, was available in a policy file and on display in the office. This meant that people could feel confident that they would be protected from abuse.

Staff employed by the home had been recruited effectively. The manager demonstrated that appropriate checks had been obtained and that staff were trained and supported in their role. Staff completed one week of theory based training, and one week working with experienced staff to familiarise with the complex needs of people living in the home. The team leader monitored and checked staff to ensure they understood their roles and responsibilities before they began work unsupervised. Staff we spoke with also confirmed that they had worked with experienced staff until they had felt confident to carry out their role. Monthly supervisions were completed by team leaders, and annual appraisals were completed by the registered manager.

We saw that people were treated with dignity and respect by staff. Staff told us they called people by their preferred name, and ensured people had privacy when they were being supported with personal care. One relative we spoke with told us that: "They (staff) are respectful....just outstanding".

Systems were in place to ensure that the provider learnt from events such as accidents, incidents. This meant that risks to people were reduced and helped the service to improve.

Is the service effective?

An advocacy service was available and had been used by people living in the home. This meant that people had access to additional support if they needed it.

People's health and care needs were assessed with them, and they were involved in planning their care. The care plans had been reviewed regularly and there was evidence that the provider had worked closely with other health professionals such as the community learning disability team, social workers, psychiatrists and occupational therapists.

Families were able to visit at any time and one relative told us: "I always visit unannounced".

Is the service caring?

People were supported by kind and attentive staff. We saw interactions that were thoughtful and which supported and encouraged people to make their own decisions. We saw that people were supported with a range of activities to help them achieve their full potential.

A health professional we spoke with was complimentary about the service and told us: "They really understand person centred care, and have embraced and implemented what we have taught them, they offer fantastic support".

People who used the service, families, external professionals and staff were all invited to participate in an annual satisfaction survey. Actions were taken in response to any concerns or shortfalls identified.

Is the service responsive?

People completed a range of activities in and outside of the service on a daily basis. A person centred approach meant that each person living in the home had services and opportunities available based on their current and perceived needs.

People or their families knew how to complain, and there were copies of the complaint procedure in people's care files.

The manager worked well with other health professionals who provided support with training and recommendations which would be incorporated into the care plans. A health professional from the community learning disability team expressed their view that the staff provided an excellent service and were committed to quality improvement.

Is the service well led?

The provider had an auditing and quality monitoring programme in place. The programme included completion of internal and external audits. Action plans from these audits were completed and progress was monitored the following month.

Unannounced nights checks were completed periodically which meant that people could be confident that the quality of the service was monitored over a twenty four hour period.

The views of people who used the service were taken into account. For example, people participated in staff recruitment, had representation on the health and safety committee, and provided feedback for the monthly visit by the director. There were also 'service user' meetings which were recorded, and any actions documented. This demonstrated that the people using the service were enabled to contribute to the running of the home.

Care documentation was reviewed formally on a six monthly basis by the management team or more frequently if there were any changes.

Accident and incident reports were completed by staff, and the registered manager had a process in place for analysing all information on a regular basis. This ensured that any required actions or identified trends could be addressed.

Complaints and compliments were monitored and recorded and all people living in the home had a copy of the procedure in their file.

Positive comments had been received about the staff from families and health professionals about the quality of the service provided, and the commitment of the management team to provide the best possible care for the people who used the service.

When we inspected six people lived at the home. They had varying levels of learning disabilities. We talked with three people who lived at the home. They told us they were happy with the home and the staff. One person told us: “We are looked after. They take us on trips.” We spoke with two relatives. One said: “I couldn’t rate it more highly. The Oaks is a wonderful home.” We also spoke with the registered manager and three members of staff.

We watched staff as they cared for people. Staff always asked for permission before providing personal care. Some people had been supported by their relatives to make decisions about care and support they needed. Information about people’s consent had been recorded in their care plans.

Staff provided care and support that met people’s needs. We found that staff knew about the needs of the people they cared for. We looked at care records for three people and found that these contained guidance for staff on how to meet their needs. We saw that people’s needs had been reviewed regularly. When it had been necessary staff had co-operated with medical professionals.

The registered manager had taken reasonable steps to ensure that suitable people had been employed to work at the home. Records had been maintained appropriately and stored securely.

During the inspection we spoke with two people who used the service, two visitors and four members of staff. We also spent some time in communal areas observing the interaction between staff and people who used the service.

We saw that people who used the service had good relationships with staff and that staff appeared to know them well. We found that people who used the service expressed their views and were involved in making decisions about their care and how they wanted to spend their time and those that we spoke to told us they felt safe.

We spoke to the relatives of one person who used the service. They told us that they were very satisfied with the care their relative received. They said they were ‘totally involved in XX’s care and always kept in the picture’. They felt comfortable raising concerns if necessary and were confident they would be listened to .They said ‘we can tell staff anything good or bad’.

People who used the service were supported by staff that had a good understanding of their individual needs. The relatives of one person who used the service told us that staff were quick to notices changes in the person’s well being and that when the person had been unwell staff were very vigilant and provided good care towards them.