Upper Ford Lodge provides accommodation and personal care for up to 10 people living with learning disability or autistic spectrum disorder. At the time of our inspection there were eight people living in the home.

At the last inspection, in May 2014, the service was rated Good. At this inspection we found the service remained Good.

People continued to receive care in ways which helped them to remain as safe as possible. There was enough staff to provide support to people to meet their needs. Staff understood risks to people’s safety and supported people receive their medicines safely.

Staff received training which matched the needs of people who lived at the home, and had developed the skills to care for people. Staff used their knowledge of people’s preferences and how they liked to communicate to check people were agreeing to the care offered to them. People were supported by staff if they needed help making key decisions about their life, and people’s relatives were consulted. People were cared for so they had enough to eat and drink and their food preferences were met. Staff understood the links between people’s nutrition and health. Staff supported people to see health professionals so they would remain as well as possible

People had built strong relationships with the staff who cared for them and enjoyed spending time with staff. People were encouraged to maintain their independence and to make their own day to day decisions about their care. People were treated with dignity and respect, and their right to privacy was understood by staff. Staff spoke affectionately about the people they cared for and encouraged them to make their own day to day decisions. People were treated with respect and dignity.

Staff took into account what was important to people and their individual wishes and preferences when planning their care. Relatives’ and health and social care professionals’ views and suggestions were taken into account when people’s care was planned. People’s relatives and staff were confident if any complaints were made these would be addressed. Systems were in place to manage complaints.

Staff were encouraged to reflect on the care provided and to make suggestions to develop people’s care further. Relatives and staff told us communication with senior staff was good, and relatives and staff said the culture in the home was positive and focused on the care needs of the people living at the home. The registered manager, manager and provider regularly checked the quality of the care people received. Where actions were identified these were undertaken to improve people’s care further.

This inspection took place on 6 May 2015 and was unannounced.

The provider of Upper Ford Lodge is registered to provide accommodation for up to 10 people with learning disabilities, in particular people with autism. At the time of this inspection 9 people lived at the home.

The manager was appointed in November 2014 and is currently registering with us. 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 were supported by staff who knew how to recognise and report any concerns so that people were kept safe from harm. There were sufficient staff on duty to respond to people’s individual needs at the times they needed support. People were helped to take their medicines by staff who knew how to manage these in line with safe principles of practice.

Staff respected people’s rights to make their own decisions and choices abut their care and treatment. People’s permission was sought by staff before they helped them with anything. Staff made sure people understood what was being said to them by using gestures, short phrases, words or special systems of pictures. When people did not have the capacity to make their own specific decisions these were made in their best interests by people who knew them well.

Staff met people’s care and support needs in the least restrictive way. Where it was felt people received care and support to keep them safe and well which may be restricting their liberty the manager had made applications to the local authority. These actions made sure people’s liberty was not being unlawfully restricted.

Staff had been supported to assist people in the right way which included helping people to eat and drink enough to stay healthy and well. People had been assessed for any risks associated with eating and drinking and care plans had been created for those people who were identified as being at risk. People were supported to access health and social care services to maintain and promote their health and well-being.

People were treated with kindness, compassion and respect. There were many examples of staff showing they cared for people and the warmth of touch was used, such as, hugs. Staff promoted what people could do and supported people with dignity when they needed a little help. People’s right to private space and time to be alone and with their relatives was accepted and respected.

People indicated to us with their facial expressions and body language that they were happy with the support they received from staff. People received care and support to meet their diverse needs including people who had special communication needs. Staff offered people the opportunity to pursue their interests and try different things for fun. There were good arrangements in place for receiving and resolving complaints which took into account people’s individual needs.

The views of people who lived at the home and their relatives were sought to develop the service and quality checks had also been done to make improvements. The manager had strong values about encouraging inclusive opportunities for all and people benefitted from staff being involved in good practice initiatives.

We inspected Upper Ford Lodge and spoke with four people who lived at the home, two relatives by telephone, four of the staff on duty and the registered manager. We spent some time in communal areas and observed the interaction between staff and people who used the service.

We looked at care records for two people and other supporting documents for the service. Staff told us that: “I like to think it’s a homely place” and: “People have a choice about their care”. This meant that people were listened to and consented to the care and welfare they received.

People’s needs had been assessed and care and treatment was planned and delivered in line with their individual care plan. Staff told us they were aware of each person’s needs and how to give care and support to meet those needs. When asked, two people who used the service indicated with a ‘thumbs up’ that they liked living there.

We saw that people looked comfortable in their home and knew the staff that supported them. When we spoke with staff they told us: “They are all individuals and you get to know them all so well here” and: “The training is good and it’s relevant to the people that I care for”.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

The provider demonstrated that they took account of people views and experiences to improve and monitor the care and service people received.

We were not able to speak with some people during our inspection because they were not available in the home, another person was unwell. We observed how staff interacted with people to support them in making decisions about their lifestyles. We saw that staff respected the decisions that people made. We spoke with a person who said, "I am going to the library after lunch."

One care file that we reviewed indicated that arrangements had been made to support people in receiving their health care needs. The care file included information about their preferences about activities and accessing the community and how they were met. From discussions held with staff we found that people were well supported in leading a varied lifestyle that suited their individual preferences.

People were encouraged and supported to do things for themselves but were given choices. One person told us, "I choose what I want to eat."

We found that systems were in place to keep people safe. Staff had received training in safeguarding people and knew how to respond to concerns. We found that staff rosters ensured that people were supported in leading a lifestyle that suited them.

One person told us they knew how to make a complaint. How to make a complaint poster was displayed on a notice board in the reception area, it was in pictorial format to assist people's understanding of it. Staff told us how they would support people in making a complaint if they needed to.

We undertook this review of Upper Ford Lodge to check the care and welfare of people who lived there. We were aware since our last visit that the home had undergone significant changes in management at the home, head office and with its staff.

During our visit we spoke with five members of staff and the manager. There were no visitors to the home while we were there. As not everyone who used the service was able to speak with us we sat in communal areas observing how people were being cared for. One person we did speak with indicated through non verbal means that they were content there.

Overall people appeared relaxed in their environment. We observed positive interactions between the staff and the people who lived at the home. There was a daily planned programme of activities which individually specified what each person would be doing that day.

The care plans we looked at clearly set out people’s care needs and preferences. The health plans showed us that people were getting regular access to health care.

People were supported by staff that had access to a wide range of training to enable them to meet their needs. Staff we spoke with were knowledgeable about people’s individual care needs and received regular supervision where they could raise any concerns or issues about people’s care.

We saw that the quality of care and safety of people who used the service was continually monitored. We saw that the home had been proactive in making adjustments to improve safety such as purchasing anti suffocation pillows for people with epilepsy and installing window restrictors. They had also responded quickly to recommendations for improvement following visiting inspections and audits.

There were good communication processes to involve relatives in the running of the home and care provided. The home was also sensitive to the people who lived there such as obtaining easily understandable information from the fire service to explain the need for fire drills.