We inspected the service on 21 September 2016 and the visit was unannounced.

Ty Gwyn Residential Care Home provides care and support for up to twelve people with learning disabilities or autism. At the time of our inspection seven people were using the service. The accommodation was offered over two floors accessible by stairs and a stair lift. There were two communal lounges and dining areas. There was a large well-maintained accessible garden for people to use should they wish to.

There was a registered manager in place. It is a requirement that the service has 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 and associated Regulations about how the service is run.

People felt safe with the support offered. Staff understood their responsibilities to protect people from abuse and avoidable harm and to remain safe. The provider had a system to manage accidents and incidents appropriately. Risks to people’s health and well-being had been regularly assessed. For example, where a person had risks to the health of their skin, staff followed guidance that had been made available to them.

The provider had a suitable recruitment process in place for prospective staff including undertaking relevant checks. People and staff were satisfied with the number of staff available to offer them care and support. We found that staffing numbers were suitable to help people to remain safe.

People received their prescribed medicines in a safe way. Staff received regular guidance and understood their responsibilities to handle people’s medicines safely. Medicines were stored appropriately and guidance was available and followed by staff about how people preferred to take them.

People received care and support from staff with the appropriate knowledge and skills. Staff had received regular training in topic areas such as epilepsy and fire safety. New staff received an induction when they started to work for the provider. They had regular meetings with the registered manager so they could receive feedback and guidance on their work.

People were supported in line with the Mental Capacity Act 2005. People were supported to make their own decisions and the provider had documented their capacity to make decisions where this was necessary. Staff understood their responsibilities under the Act. The registered manager had made an application to the appropriate body where they had sought to deprive a person of their liberties.

People chose what they ate and drank and were satisfied with what was offered to them. People had access to healthcare services such as to their doctor or dentist. Staff had guidance on people’s health conditions so they knew how to provide effective support.

People received support from staff who showed kindness and compassion. Staff protected their dignity but people’s care records were sometimes written in ways that could be seen as lacking respect for them. The registered manager told us they would remind staff about the use of professional language when writing in people’s care records. The provider had arrangements for storing people’s care records safely and discussions about their care needs occurred in private.

People were supported to be as independent as they wanted to be in order to retain their skills. People were, where they could, involved in decisions about their care including how they chose to spend their time. The registered manager considered involving advocacy services where people may have required additional support to speak up.

People had contributed to the planning of their care where they were able to. People had care plans that were regularly reviewed and were centred on them as individuals. Some people’s care plans lacked specific details about t

This inspection took place on 30 October 2015 and was unannounced. At our last inspection, 15 April 2014, the service was compliant with the regulations.

Ty Gwyn Residential Care Home is a registered care home providing care and support for up to 12 adults with a learning disability and autistic spectrum disorders. It is situated in Enderby, Leicestershire and can be reached by private and public transport. The accommodation is over two floors and the first floor is accessible using the stairs or the chair lift. At the time of our inspection there were eight people using the service.

There was a registered manager at the service. 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 living at Tw Gwyn Residential Home. Staff understood their responsibilities to protect people from abuse and avoidable harm. Incidents and accidents were recorded and action was taken to reduce the risk of similar occurrences happening again.

The service followed a safe recruitment process to ensure that staff were suitable for their roles before they started work. There were sufficient staff to meet people’s needs and support them.

People care needs were assessed. Care and support plans were then put in place to ensure that people’s needs were met. Risk assessments were carried out to ensure that people were kept safe. People were involved in decisions about their care and support. They were supported to access independent advocacy services when they needed them.

Staff understood people’s needs and provided care and support that helped people feel they mattered to staff. People were involved in decisions about their care and support. They were supported to access independent advocacy services when they needed them. Staff treated people with respect and dignity.

People were supported to follow their hobbies and interests as well as lifelong ambitions. People were supported to experience new areas of interest. There were social events held at the service.

People using the service, their relatives and health professionals had opportunities to provide feedback about the service.

There were checks made on equipment and the general environment to ensure that it was safe. There was a business objective plan that contained information about ongoing maintenance at the service. This was kept up to date although there were two areas that required action that had not been addressed.

People felt able to talk to staff if they had any concerns. Staff felt supported by the manager and able to raise any issues.

We recently undertook an inspection visit to Ty Gwyn Residential Care Home. We spoke with five people and observed three people who used the service. We reviewed three people’s care records. We spoke with two relatives. We spoke with three staff supporting people and reviewed their training records. We also reviewed the records in relation to the management of the service. We considered all the evidence we had gathered under the outcomes we inspected.

Is the service safe?

People told us they felt safe with the staff that supported them. They told us staff safely helped them with their daily care and support needs. One person said, “The staff are very caring towards me and I couldn’t ask for anymore.” People were supported to take part in activities that were of interest to them, which included activities organised by the staff at the home and using the community facilities.

People told us they felt both safe and secure because they were cared for in an environment that had been maintained. People were able to access all areas of home safely. Communal areas were furnished which made it homely and comfortable. People had decorated and personalised their room to reflect their interests and things that what were important to them.

We, the Care Quality Commission, monitor the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Staff training records showed staff had been trained in Mental Capacity Act 2005 and DoLS. This meant that people could be confident that their best interests would be represented and that their wellbeing would be met reliably.

Is the service effective?

People told us that they were happy with the care and support that had been delivered and that their needs had been met. Staff were attentive and encouraged people to maintain their independence. Records we looked at showed people’s care needs were met and that they had access to a range of health care professionals. We also found that people were supported to take part in meaningful activities and hobbies which they enjoyed. It was clear from our observations that staff had a good understanding of people’s needs and that they knew them well.

Staff we spoke with were trained for their job role to help ensure people’s needs were met reliably. Staff understood how to support each person, which helped to ensure risks, could be managed. We looked at the staff training matrix. That confirmed the provider had taken steps to ensure staff kept their knowledge and skills up to date and in line with current best practice.

Is the service caring?

People were supported by kind and attentive staff. We saw people were confident to ask staff for help when required. We also saw that staff were interested in what people had to say and replied in a manner that the person could understand. People told us that staff were caring and supported them in a manner that respected them as a person. We observed staff helped and supported people in a caring manner. We also looked at the records held about them and discussed people’s care needs with them. They told us that their individual wishes for care and support were taken into account and respected.

Staff were aware of people’s preferences and interests. This included supporting people to continue to attend day centres, take part in social events and outings, and use the local leisure facilities. We saw one person sat with a member of staff to have their nails painted whilst another read a magazine and a third person folded the laundry. People told us that staff helped them to keep in contact with their family, which promoted their wellbeing.

People were given information about the advocacy service when they moved to the home. Information was produced in a format so that it was suitable for the person to understand, which included the use of pictures and photographs. This meant that people could access additional support and/or advice when required. Staff had received ongoing training to help ensure the people received the appropriate support and knew how to access support from other health care professionals.

Is this service responsive?

People had the opportunity to visit the home to make sure it was the right place for them and that their needs would be met. One person said, “My son visited first, then I came here a few times before I decided it was the right thing to do.” People’s needs had been assessed before they moved into the home. People told us they were involved in reviewing their plans of care when their needs changed. People had access to health care professionals such as the doctor and the community nurse to meet their specific health needs. Records confirmed people’s preferences and expectations had been recorded, and care and support had been provided in accordance with people’s wishes.

Is this service well led?

People’s personal care records and other records kept in the home were accurate and up to date. People knew about the information in their care records. People told us their care needs were reviewed regularly to make sure any new needs could be met reliably. Records showed the home’s staff worked with other agencies and services to help ensure people received their care and support that was joined up.

The home had a system in place to assure the quality of service they provided and acted on any feedback and comments received. This included surveys to gather the views of people who lived at the home, relatives or their representatives. Regular meetings were held at the home where people made decisions about social events. They also had the opportunity to comment on any proposed changes to the home that could affect their wellbeing. The complaints policy and procedure were used effectively for the benefit of people living at the home and for making continued improvement to the quality of service provided.

Regular checks were carried out to ensure people’s health, safety and wellbeing were protected. Information from incidents and accidents had been analysed and used to identify changes and improvements, and minimise the risk of them happening again. Prompt action had been taken to improve the service and put right any shortfalls that were found.

People were confident that their personal information including medical records were completed, kept up to date and secure. Staff were aware of their responsibilities to maintain accurate records. Other records relating to the staff and the management of the service were also completed in a timely manner, kept up to date and stored securely.

We spoke with six people using the service and asked them for their views about the service they received and choices they are offered. People said: “When I first came here I wasn’t sure but now I really like it here. The staff are really nice,” and “I chose the colours and everything for my room. They (the staff) decorated it for me.” People told us staff supported them within the service and when going out into the community. They said they felt safe and confident that staff would protect them.

People told us they received their medicines on time. Appropriate arrangements were in place for the safe storage and administration of medicines. Records showed medicines were administered properly and people accessed health support when needed.

People knew who to contact if they were unhappy or were concerned about their care or support. One person said: “I haven’t got any complaints.” Another person said: “Staff do what I ask them most of the time or I’ll tell Claire (the manager).” They were confident that staff who looked after them were suitably qualified.

Record keeping arrangements were inadequate and improvements were needed. We found records were not kept of when checks and audits carried out, such as the provider’s monitoring visits, checks on the premises, equipment and medication audits. Risk assessments and protocols for people who managed their own medicines had not been completed.

People who use the service told us the felt the care and support provided by staff was good. Some people who had communication difficulties used other modes of communication to express that they were happy with the staff that looked after them.

People were protected because there was effective staff recruitment and selection processes in place. Records showed appropriate checks were undertaken before staff began work. Staff received training which enabled them to meet people’s care needs safely.

People’s needs were met by enough qualified, skilled and experienced staff. People received personalised support that met their aspirations, promoted their involvement in the community and their independence. Arrangements were in place to ensure sufficient, qualified and experienced staff were available in the event that people’s needs had increased and to manage staff absences.

We spoke with two people who used the service and asked them for their comments about their experience of the service and they said “I thought it was good fun doing the new care plans” and “I sat with her to do my care plan and I changed the pictures on my board” and showed us the picture board that they used to help them plan the day.

People also told us they were had regular house meetings to discuss any issues about the service they received and to plan social events.

We spoke with some of the people who live at the service and to some visiting relatives at the time of our site visit. People told us they were satisfied with the care and support they received and felt that the staff looked after them well. They told us that they felt confident to tell staff if they had any concerns about the care and support they received. Some of the comments we received included, “if there’s a problem I would tell …..”; “I like to do the baking” and “the staff are very good here and they know you.”

People who use the service enjoy attending day centres and taking part in social activities within the community to stay fit and healthy. Others told us they preferred to spend time quietly and occupy themselves with their own interests and hobbies.

People who use the service appeared comfortable, clean and well settled in their home. Staff were responsive to people’s requests and sensitive to their needs.

People said they have the opportunity to comment on the quality of care and support they received and had contributed in the social events planned and the improvements made to the service.