This inspection took place on 5 December 2018 and was unannounced. The last inspection of this service was in March 2016. At that time, the service was rated good and there were no breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

United Response - 74 Oaklands is a ‘care home’. 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 home is registered to accommodate four people with a learning disability. At the time of the inspection, three people were living at the home. United Response - 74 Oaklands, is a semi-detached house within a housing estate, close to local amenities. There were four bedrooms, one of which was used when staff completed a ‘sleeping in’ shift. There was a lounge, separate dining room and central kitchen. There was a bathroom on the first floor and a downstairs toilet.

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.

There was a registered manager in post although at the time of this inspection, they were on a period of extended leave. 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.

The provider notified the Care Quality Commission of the registered manager’s extended leave and the cover arrangements in place. The manager providing oversight of the service and the registered manager when in post, were based at the organisation’s office rather than the service. They visited when needed and were contactable at any time. However, their limited presence in the service, increased the risk of things being missed.

The service was homely but did not always promote the prevention and control of infection. This was because for example, there was debris on the chairs in the dining room and clothing had been placed on the floor in the laundry room.

There was a programme of audits to check the quality of the service. These were undertaken at various frequencies and addressed areas such as health and safety, equipment and the management of medicines. The audits had not however, identify the shortfalls such as the prevention and control of infection found during this inspection.

The environment was comfortable and homely. However, whilst the temperature control was set at 22 degrees, people’s bedrooms and the dining room felt cold. Once brought to their attention, staff adjusted the thermostat and the heating came on. The visitor’s log showed an engineer had looked at the boiler but there was no documentation to evidence what work had been completed.

All staff had worked at the home for many years and knew people well. There were established relationships and a mutual fondness between people and staff. Throughout the inspection, the atmosphere was lively but relaxed and there were many positive interactions. People were fully involved in all conversations and daily activities. This included answering the door to visitors, making drinks and preparing food. People were supported to complete housekeeping tasks and help with the home’s shopping.

People enjoyed a range of social activity both at home and within the community. This included local groups such as Zumba, church and various social groups. People were encouraged to develop and maintain relationships with family and friends. Two people undertook voluntary work, which they enjoyed.

United Response – 74 Oaklands is a care home which provides accommodation and personal care for up to three people with learning disabilities. At the time of our inspection three people were living at the home.

This inspection took place on 4 March 2016 and was unannounced. Following the inspection we visited the provider’s local office on 9 March 2016 to complete the inspection.

There was a registered manager in post at the service, although they were on a period of leave at the time of the inspection. 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 provider had appointed a manager to cover for the registered manager and had informed us of the management arrangements.

People who use the service were positive about the care they received and praised the quality of the staff and management. Comments from people included, “ I am very happy living here – I feel safe” and “I would speak to any of the staff if I had a problem. They would help sort out any problems".

People told us they felt safe when receiving care and were involved in developing and reviewing their support plans. Systems were in place to protect people from abuse and harm and staff knew how to use them.

Medicines were safely managed and there were systems in place to protect people from abuse and harm that staff knew how to use. Staff understood the needs of the people they were supporting.

Staff received training suitable to their role and an induction when they started working for the service. They demonstrated a good understanding of their roles and responsibilities, as well as the values and philosophy of the service.

There was strong management in the service and the manager was clear how they expected staff to support people. The provider assessed and monitored the quality of care and took action to address shortfalls that were identified.

We were welcomed into the house by one of the people who lived there who made us a hot drink. The other person who was in the house also came to greet us. There were four people living at 74 Oaklands and two of them had already gone to their day activity when we arrived. We later met and spoke with one of them when they returned after lunch. They were all happy living in the home.

Staff confirmed they had received training in the Mental Capacity Act 2005 and said that ultimately people who lived in the home made decision for themselves. They were assisted with this because there were guidelines for staff for how to support them. This meant they had a lifestyle of their choosing that was backed up by good records and guidance for staff. People were given every opportunity and support to complain if they were unhappy.

The staff were flexible to meet the needs of people living at 74 Oaklands and worked collaboratively to achieve this. Staff we spoke with were happy working at the home and enjoyed the autonomy afforded them by the registered manager.

People lived in a comfortable and well maintained house and were protected by the organisation’s commitment to getting it right in respect of their safety.

People expressed their views and were involved in making decisions about their care and treatment. People were involved in making choices about the furniture they had and the decoration of the home.

We were told about the leadership meetings that were held locally and by the division within United Response. People who used services and their families were able to attend the meetings. There was a meeting on the day before our visit that was described by one of the service managers as “open and transparent”. During the meetings issues relating to management and finance were discussed.

One person we spoke with said “I love it here” adding they liked the staff and enjoyed the food provided. They said that if they were unhappy they would speak with a member of staff. They told us they volunteered at a care home for older people and enjoyed going to the gateway club.

Staff received appropriate professional development. Training plans focussed on the role of the support worker and their personal development. It also covered the principles of care including duty, person centred support, communicating effectively along with equality and inclusion. One person was supported by a volunteer who spent time with them going to the gym or pub. They told us about the recycling project they were involved in and going to their parents for occasional weekends.

The provider had systems in place to monitor service provision and gain the views of people who used services.

Three of the people that live in the home told us about their lifestyles and showed us their rooms. They spoke about their belongings and what they meant to them. All of the people were happy and said that they enjoyed living at the home. Two people told us about their forthcoming holiday and reflected on the previous times they had visited the holiday camp. They told us about their relationships with staff and each other. People were observed enjoying each others company.