We inspected the service on 21 June 2018. The inspection was unannounced..

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. The Spinnies accommodates up to four people with a learning disability and or autism. On the day of our inspection, two people were using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy.

At the last inspection in June 2016, the service was rated ‘Good’ in all the key questions. At this inspection, we found the evidence continued to support the rating of Good. 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.

People were supported to remain safe and staff were aware of their responsibilities to protect people from abuse avoidable harm. People were supported with positive risk taking and risks were managed effectively. There were sufficient staff available to support people safely and safe staff recruitment processes were in place and followed. People’s medicines were managed by staff who had received appropriate training and competency assessments. People were protected from risks associated with cross contamination. Infection control measures were being used and understood by staff.

The provider used national guidance and tools to assess people’s needs. Staff received an induction, ongoing training and support to ensure they were competent in meeting people’s needs. People received a choice of meals and drinks and had access to snacks. Nutritional needs were assessed and monitored. The environment met people’s individual needs.

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 support this practice. Staff were aware of the principles of the Mental Capacity Act 2005.

People were supported by staff who were caring and compassionate who knew their needs, preferences and what was important to them. Staff respected people’s privacy and dignity, encouraged people with choice making, and promoted independence. Independent advocacy information was available. Relatives and external professionals were involved in meetings to discuss and agree how care and support was provided.

People’s needs and routines had been assessed and support plans provided staff with clear detailed information of how to support people. Staff had a person centred approach in how they supported people and enabled them to lead active and fulfilling lives.

Relatives and staff were positive about the management team, who were appropriately experienced, competent and good leaders. Systems and processes were in place to monitor quality and safety and these were up to date. The provider had an ongoing action plan that showed how the service was continually improving.

This inspection took place on 28 June 2016 and was unannounced.

The Spinnies is a care home (without nursing) for up to four people with a learning disability and/or autistic spectrum disorder. At the time of our inspection there were four people living at the service.

The Spinnies is required to have 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. At the time of our inspection a manager was in post and they had submitted their registered manager application and this was being processed. We will monitor this.

People who used the service were protected from abuse and avoidable harm. Staff were aware of their role and responsibilities in protecting people. Staff understood the different categories of abuse and had received adult safeguarding training. Information was available for staff about the provider’s procedure to report any safeguarding concerns.

Risks associated to people’s individual needs had been assessed and planned for. Staff had the required information to know how to support people to reduce known risks. Risk plans were reviewed regularly and amended when required. Risks associated to the environment and premises had been assessed and work was being completed to improve safety.

The provider had completed appropriate recruitment checks before staff began work to check their suitability. Staffing levels were sufficient in meeting people’s individual needs and safety. People who used the service received their medicines as prescribed and these were managed correctly.

Staff were appropriately supported to enable them to effectively carry out their duties and responsibilities. This included receiving an induction and ongoing training opportunities to keep their skills and knowledge up to date. Staff also received regular meetings to review their work and development needs.

The manager understood their role and responsibility in ensuring the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards legislation was adhered to. Staff were knowledgeable about the principles of this legislation.

People received sufficient to eat and drink and the menu choice was based on people’s needs and known preferences. Whilst staff understood they had a responsibility to promote healthy eating this area could be improved upon.

Staff supported people to maintain their health, this included accessing both routine and specialist healthcare services. The service involved external health and social care professionals appropriately in meeting people’s individual needs.

Staff were kind and caring, they clearly had a good understanding of people’s needs and what was important to them. Staff supported people to participate in activities, interests and hobbies of their choice. People’s privacy, dignity and independence were respected and promoted. People’s care records showed a person centred approach was used by staff. Information was based on people’s individual choices, routines and what was important to them.

A complaints policy was in place and staff were aware of how to respond to any complaints or concerns made. People had access to information that was presented in an appropriate format for their communication needs. The manager was aware of independent advocacy services should this support have been required. People, their relatives or representatives received opportunities to share their views about the service.

Staff felt valued and supported and were positive about the leadership of the service. The provider had checks in place that monitored the quality and safety of the service. These included daily, weekly and monthly audits.

We carried out an unannounced inspection of the service on 19 June 2015.

The provider took ownership of The Spinnies in August 2015. This was therefore the first inspection of the service since the change of provider.

The Spinnies is a care home (without nursing) for up to four people with a learning disability and/or autistic spectrum disorder. At the time of our inspection there were four people living at the service.

The Spinnies is required to have 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. At the time of the inspection an acting manager was in post and had been in this position since May 2015. They were in the process of applying with us to become the registered manager.

Relatives told us they felt their family members were safe and cared for appropriately. This included a safe environment and sufficient staff to meet people’s individual needs.

The systems in place to check the safety of the environment were not up to date. The provider took action to respond to these concerns. People received their medicines as prescribed, but the storage and management of medicines required some attention.

The provider ensured there were sufficient staff employed and deployed appropriately. People received one to one support to meet their individual needs. Safe recruitment checks were in place that ensured people were cared for by suitable staff.

Relatives said that whilst there had been many staff changes, they found staff to be competent and knowledgeable. Relatives had been involved in best interest discussions and decisions. No concerns were raised about people’s dietary and nutritional needs.

Staff were appropriately supported, which consisted of formal and informal meetings to discuss and review their learning and development needs. Staff additionally received an induction and ongoing training.

The acting manager understood their role and responsibility in ensuring the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards legislation was fully adhered to. Staff involved people as fully as possible and gained consent before care and support was provided.

People received sufficient to eat and drink; however, weights were not monitored for any changes that may have needed to be acted upon. People received support to access both routine and specialist healthcare services.

Staff had received appropriate accredited training in the use of physical interventions. Whilst risk plans were in place these had not been regularly reviewed. Behavioural management strategies provided staff with limited information about how to reduce anxiety that may cause risky behaviour.

Relatives told us that they found the staff to be caring and compassionate. Additionally, they said that their family member were supported to lead full and active lives. This included participating in a variety of activities, interests and hobbies. Staff used effective communication and they understood people needs and what was important to them.

People’s support plans included information about what was important to them including preferences and routines. Staff provided a service that was responsive to people’s individual needs showing a person centred approach to care and support.

Relatives told us that they found the acting manager approachable and supportive. Healthcare professionals also spoke positively about the leadership of the service and the quality and commitment of the staff team.

Staff told us that they felt the acting manager had made a positive contribution to the service and that they felt supported, valued and included in how the service developed. The provider was in the process of sending out feedback questionnaires and a newsletter as a method of seeking the views of others about the service. Additionally, this was an opportunity to develop open and transparent communication.

The provider had checks in place that monitored the quality and safety of the service. The acting manager had developed an action plan that identified the areas that they had assessed as requiring improvements.

The provider had failed to notify us of important events registered provider’s are required to do.

We found the service was in breach of one of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We spoke with a person who uses the service and they said, “Staff listen to me.” We saw that relatives of people using the service had been asked to review their care and provide information about their relatives.

We spoke with a relative of a person who used the service. They told us, “My relative gets the care they need. Staff have helped to calm down my relative and have shared positive relationships with them.” During our inspection we saw that people took part in activities and staff were able to meet people’s individual requirements.

We saw that care plans contained information in ‘easy read’ formats to help people who used the service to understand their care plans as fully as possible. We saw that care plans and risk assessments had been reviewed by the manager on a regular basis.

We spoke with three staff who were all able to tell us the procedures in place to make a safeguarding referral. We checked staff training records and found that most staff had completed safeguarding training.

During our inspection we did not observe any evidence of insufficient staffing levels during our observation of lunch and throughout the rest of our inspection.

One staff member told us, “I’m happy with my supervision and appraisal schedule. I’ve just had my appraisal recently.” The manager had identified training specific to the needs of people who used the service and staff had attended these courses or were booked to attend these courses, including autism and epilepsy. This meant staff were supported to deliver care effectively to meet the needs of people who used the service.

We spoke with a relative of a person who used the service and they were aware of the complaints system and felt happy to raise concerns with staff directly or with the manager. People who used the service had reported issues; these had been dealt with by the service and individuals who had raised issues were happy with the actions taken.

A person told us staff listened to them and they knew who to speak to if they were unhappy. A person told us staff helped them. They told us they were happy living at the home. They told us they played football, went for walks and went out for dinner.

A person told us they felt safe. A person told us there were enough staff and they liked the staff.