About the service:

The Sheiling is a small residential care home registered to provide personal care. Staff provide care and support for up to three younger adults who have a learning disability and whose behaviours may be challenging. At the time of our visit there were three people using the service.

People’s experience of using this service:

¿ The staff team were committed to ensuring people lived fulfilling lives. The whole focus of people’s care was person centred and focused on promoting their independence and social inclusion. Staff and the management team empowered people to have as much control over their lives as possible and to achieve their maximum potential. The service had taken steps to meet people's communication needs and we saw a range of communication plans and tools that were in use. These had been tailored to each individual and ensured effective communication took place.

¿ Staff empowered people with complex needs and behaviours to feel a part of their community, and to achieve their goals. Each person had a personalised pictorial activity plan and were supported to take part in activities of their choosing. Staff supported people by responding to their communication methods and body language to understand if they were unhappy or dissatisfied with any elements of the service.

¿ People were protected by staff who understood how to protect them from avoidable harm. The risks to people’s health and wellbeing were assessed and action taken to reduce them. There were enough staff deployed to keep people safe. People’s medicines were well managed and staff understood how to reduce the risk of the spread of infection. There were systems to learn from mistakes including the detailed analysis of accidents and incidents.

¿ Staff received training to enable them to do their jobs well. People were provided with care and support which protected them from discrimination. They were supported to maintain a healthy diet and had access to other health and social care agencies when needed. People were 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. The environment was adapted to meet their needs

¿ There were kind and caring relationships between people and staff which were based on dignity and respect. People and their relatives were involved with decisions and felt that staff respected their wishes. Families were welcomed to the service at any time.

¿ People had care and support provided which met their preferences. Complaints were handled appropriately and in line with the provider’s complaints policy. People did not currently receive end of life care.

¿ Staff enjoyed working at the service and felt respected and valued. The provider’s quality assurance processes were effective in identifying potential risks to people’s safety. There was a continued focus on learning, development and improvement.

More information is in Detailed Findings below.

Rating at last inspection: At our last inspection (report published 10 September 2016) we rated the the service as Good. This rating has not changed and the service remains Good.

Follow up:

We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

This inspection took place on 18 July 2016 and was unannounced. The Sheiling is a service that provides accommodation for up to three people who have a learning disability. On the day of the inspection, there were three people living at the service.

There was a registered manager employed at the home. 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 registered manager was also a director in the business and therefore the provider. The provider has been referred to as the registered manager throughout this report.

Appropriate plans were in place to guide staff in how to minimise risks to keep people safe. Staff knew what action to take to ensure people were protected if they suspected they were at risk of harm. They were encouraged to raise and report any concerns they had about people through safeguarding and whistleblowing procedures.

Checks were carried out to ensure the premises were safe, such as fire safety checks, water temperatures and health and safety.

Care records contained individual risk assessments and risk management plans to protect people from identified risks and help to keep them safe. They provided information to staff about action to be taken to minimise any risks whilst allowing people to be as independent as possible.

Safe recruitment practices were followed before new staff were employed to work with people. Checks were made to ensure staff were of good character and suitable for their role. There were sufficient staff employed to meet the needs of each individual living at the service. Staff did not start work until checks had been made to make sure they were suitable to support people and keep them safe.

Staff received a comprehensive induction and on going training, tailored to the needs of the people they supported. Staff were knowledgeable about the Mental Capacity Act and enabled people to make decisions for themselves as far as possible. Staff were supported through regular supervisions.

Care plans were written in a person centred approach and detailed how people wished to be supported. Where possible people were involved in making decisions about their care. People participated in a range of activities and received the support they needed to help them do this.

The registered manager encouraged an open, inclusive culture within the home. Relatives were free to visit their family members and were warmly welcomed. Relatives said they felt comfortable raising any issues or concerns directly with the manager. There were arrangements in place to deal with people's complaints and issues appropriately.

The management team assessed and monitored the quality of the service. A number of audits that had taken place. This ensured the service continued to be monitored and improvements were made when they were identified.

People who used the service were provided with choices at each stage of the development of their care plan. Choices and appropriate support were continually provided when reviews of the care plan were carried out. The appropriate support and methods were used for each individual to enable them to respond and express their preference.

People's health and welfare were maintained by appointments being made with healthcare professionals as was necessary. We saw that care plans were current and had been updated regularly. People living in the home were fully included in the review of their care. This meant that people could be assured that staff would provide the appropriate support and be aware of the choices people had made.

When reviewing the administration of medication and the medication administration records (MAR) charts, we saw evidence of accurate documentation to ensure that people were protected against the misuse of medication.

When we reviewed staff recruitment records we found there were appropriate checks completed before any new members of staff started working in the home.