This inspection took place on 7 and 8 January 2019 and was announced. This was to ensure someone would be available to speak with and show us records.

Tigh Allene is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Tigh Allene accommodates up to five people with learning disabilities in one adapted building. On the days of the inspection there were five people using the service however only one person was in the house during our visit.

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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good however the Well-led key question had improved to outstanding. 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.

There was a strong emphasis on continuous improvement and research was carried out into best practice. Governance was extremely well embedded in the running of the service.

The service had a positive culture that was person-centred and inclusive. Family members spoke very highly about the management team. Staff were highly motivated and proud to work for the service.

The service worked well in partnership with other health and social care professionals to improve outcomes for people.

Accidents and incidents were appropriately recorded and risk assessments were in place. Staff understood their responsibilities with regard to safeguarding and had been trained in safeguarding adults.

The home was clean and suitably adapted for the people who used the service. Appropriate health and safety checks had been carried out.

Medicines were stored safely and securely, and procedures were in place to ensure people received medicines as prescribed. The manager and staff were working with healthcare professionals to reduce people’s needs for psychotropic medicines. Psychotropic means medicines prescribed to alter behaviour, perception or mood.

There were enough staff on duty to meet the needs of people. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

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.

People were protected from the risk of poor nutrition. Care records contained evidence of people being supported during visits to and from external health care specialists.

Family members were complimentary about the standard of care at Tigh Allene.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible. Support plans were in place that recorded people’s plans and wishes for their end of life care.

The service was person-centred and delivered support in a way that met people’s individual needs. Person-centred means the person was at the centre of any care or support plans and their individual wishes, needs and choices were considered.

The service protected people from social isolation and was responsive to people’s individual needs.

People and family members were aware of how to make a comp

We carried out this announced inspection carried out on 19 May 2016.

Tigh Allene is based in the village of Washingborough, which is a short distance from the city of Lincoln. It provides accommodation and support for up to five adults with a learning disability. There were five people living in the home at the time of our inspection.

There was an established registered manager in charge of 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 2008 and associated Regulations about how the service is run.

Staff were appropriately recruited to ensure they were suitable to work with the people who lived at Tigh Allene. They had received a structured induction and support to deliver a good quality of care to people. An active training programme was in place to enable staff to maintain and develop their skills.

Staff knew how to respond to any concerns which might arise so that people were kept safe from harm. People had been helped to avoid the risk of accidents and medicines were managed safely. There were enough staff on duty to give each person the individual support they needed.

People were supported to eat enough to keep them healthy. People had access to the drinks they wanted and a wide range of choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

Staff had ensured that people’s rights were respected by helping them to make decisions for themselves. The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered manager had worked with the relevant local authorities to ensure that people only received lawful care that respected their rights.

People were treated with kindness and compassion. Staff recognised people’s right to privacy, respected confidential information and promoted people’s dignity. Staff knew how to respond to people who had different communication needs. People had been consulted about the care they wanted to receive and all of the care they needed. People had also been supported to receive all of the healthcare assistance they needed.

Staff supported people to pursue a wide range of interests and to maintain their individual hobbies.

Regular monitoring and quality checks undertaken ensured that any issues related to the running of the home which might be identified would be quickly resolved. There was a clear system in place for resolving more formal complaints.

The home was run by the registered manager and provider in an open and inclusive way and people, their relatives and staff were supported to speak out if they had any concerns .

People living at the home, their relatives and visiting health and social care professionals provided regular feedback on the quality of the services provided at the home. The provider and registered manager had developed a culture based on listening and learning about how care should be provided in order to identify and take action to keep improving the services they provided.

On the day of our inspection we found that three people lived at Tigh Allene, which also had facilities for a further two people. We met and spoke with two people who were at home at the time of our visit. Owing to the nature of their conditions, the people were only able to share very basic information with us verbally. We observed them interacting with staff members and spending time in their home to support our inspection.

We also spoke with the registered manager, a senior member of care staff and a support worker. We looked at care records and staff files and reviewed the provider's policies.

We contacted relatives of people who lived at the home to gain their views of the service, and to advocate on behalf of people living there. One relative told us, “I can tell when xxx comes home that xxx is happy there, although xxx can’t say much xxx is very smiley and happy, and xxx is keen to go back after a visit.”

The provider had put in place provisions to monitor the quality of the service they provided, and staff demonstrated a clear understanding of the care and support needs of people living at the home.