About the service:

Turning Point – Sybden is a residential care home for people with learning disabilities and

autistic spectrum disorders. Turning Point – Sybden can accommodate six people. At the time of our inspection there were six people using the service.

The service was working 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.

People's experience of using this service:

People were safeguarded from the risk of abuse. Staff were aware of what actions to take to ensure people were safe. Risks associated with people's care and support had been identified and plans were in place to help minimise these risks.

Sufficient staff were available to meet people's needs and to ensure they could go out when they wanted to. Trained staff supported people to manage their prescribed medicines.

Accidents and incidents were monitored to identify trends and patterns and the registered manager and provider took action to minimise incidents from re-occurring.

People received support from staff who were trained and supported to carry out their role. People were supported to maintain a healthy diet which catered for their likes and dislikes. People had access to health care professionals as required.

Policies and systems were in in place that supported people’s maximum choice and control of their lives. Staff supported them in the least restrictive way possible.

Staff and people had a good rapport with each other. Staff were kind and caring in their approach. Staff maintained people's privacy and dignity and were respectful of their home.

People received personalised care which was responsive to their needs and preferences. Support plans were detailed and provided guidance to staff on how people liked their care.

The provider had a complaints procedure and people felt at ease to raise concerns. No complaints had been received since our last inspection.

The service was well led and had a registered manager and a staff team who were dedicated to providing high-quality care which promoted an open and fair culture. Audits were in place to measure the performance of the service and to action any concerns as they arose.

Rating at last inspection:

The service was rated Good (report published in June 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor all intelligence received about this service to ensure that the next

planned inspection is scheduled accordingly.

This inspection took place on 18 March 2016 and was unannounced. The service provides accommodation and personal care for up to six people with a learning disability or autistic spectrum disorder.

The service did not have a registered manager as they had recently left the organisation. A new manager had been appointed but was not yet registered. 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.

People felt safe and they were protected against the possible risk of harm. Risks to individuals had been assessed and managed appropriately. There were sufficient numbers of experienced and skilled staff to care for people safely. Medicines were managed safely and people received their medicines regularly and as prescribed.

People received care and support from staff who were competent in their roles. Staff had received relevant training and support for the work they performed. They understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. They were aware of how to support people who lacked mental capacity. People’s nutritional and health care needs were met. They were supported to maintain their health and wellbeing and had access to and received support from other health care professionals.

The experiences of people who lived at the home were positive. They were treated with kindness and compassion and they had been involved in decisions about their care where possible. People were treated with respect and their privacy and dignity was promoted.

People’s care needs were assessed, reviewed and delivered in a way that promoted their wellbeing. They were supported to pursue their leisure activities both outside the home and to join in activities provided at the home. An effective complaints procedure was in place.

There was a caring culture within the service and effective systems in operation to seek the views of people and other stakeholders in order to assess and monitor the quality of service provision.

We visited Turning Point Sybden on 28 May 2013, when we arrived at the service we saw that all five of the people who used the service were out of the house for the day. We were shown the communal areas of the home and found them to be clean and well kept. We were unable to speak with the people using the service but we spoke with some of the relatives of people who used the service, the manager and healthcare professionals who also care for people who used the service. People we spoke with told us that home was 'wonderful' and that the people were 'very happy' living there and that there was a 'family atmosphere' within the home. We were told that the organisation was happy to 'listen' and if there were any problems they were forthcoming in resolving them.

Sybden is a small home which provides care for six people with complex needs relating to their learning disability. The house provides accommodation on one level. Sybden is in a rural setting and the employment of staff has been a problem.

We were made aware that people are unable to communicate verbally. We saw a programme had been put in place to ensure alternative means of providing communication and support. We were made aware that Turning Point had been advised about the condition of parts of the building and to ensure people's dignity and privacy is maintained.

During our visit we saw relationships between staff and people who use the service as being supportive and caring. Comments received from families and other visitors indicated that they were generally pleased with the service provision.

The people who live at Sybden are not able to verbally express their views and we were dependent on interpreting how people interacted and the signs they made. There were lots of smiles and thumbs up. Two people had recently celebrated birthdays. Pictures of their party with relatives and staff had been developed and one person was still singing and playing birthday songs.

We observed that people were comfortable and relaxed in their surroundings as they moved confidently between their own rooms, day areas and the garden. People were able to make drinks and access snacks in the kitchen as they wished. Individuals were able to sit and relax where they liked to be.

We observed that the people who live at Sybden House interacted positively with staff and went looking for them if they wanted help or to show them something.