Vicarage Lodge is registered to provide accommodation and personal care for up to three people who may have learning disabilities, autistic spectrum disorder and physical disabilities. At the time of this inspection the service was providing accommodation to three people. Accommodation is provided in a purpose built unit catering for the specific needs of people with physical disabilities. This included, spacious living areas which were designed to enable people using wheelchairs comfortable access and overhead tracking within bedrooms and en-suite bathrooms.

The home is situated in extensive grounds alongside a larger regulated service registered for 14 people and run by the same provider; this service is known as the Old Vicarage. Each of the services is run independently of each other, with people from each of the services meeting up for planned social events when they chose to do so.

Local amenities for example, church, village shop, local public house and the village community centre are all within walking distance of the service.

At the last inspection in December 2014, the service was rated good.

At this inspection we found the service remained good.

People who used the service were supported by staff who understood the importance of protecting them from harm. Staff had received training in how to identify abuse and report this to the appropriate authorities. Staff had been recruited in a safe way and all checks were in place before staff started work. The staff had also received a comprehensive induction and essential training at the beginning of their employment and we saw this was followed up by periodic refresher training to update their knowledge and skills. People were supported by sufficient numbers of staff.

Staff had a good understanding of people’s needs and were kind and caring. People were treated with dignity and respect and were involved and included in decisions about the way their support was provided. Families and relatives were welcomed by the service.

People who used the service were assisted to have maximum choice and control over their lives and care staff supported them in the least restrictive way. Assessments were carried out to ensure people were protected from potential harm and staff took steps to minimise risks without taking away people’s right to make decisions.

Medicines were stored securely and administered safely. Records showed people received their medicines on time and in accordance with their prescription. Staff competencies, for example, around administering medication, were regularly checked.

The service met people’s nutritional needs and people were able to choose meals what they wanted to eat. Staff supported people to maintain their health and attend routine health care appointments. The service worked with various health and social care agencies and sought professional advice to ensure individual needs were being met.

People who used the service were provided an extensive range of activities to participate in, both in house and within in the local and wider community.

The service had a clear process for handling complaints which the registered manager had followed. The provider used an external agency to obtain regular feedback from relatives about their experience of the service.

Staff told us they enjoyed working at the service and felt supported by the registered manager. Quality assurance processes were in place and regularly carried out by both the provider and the registered manager to monitor and improve the quality of the service.

The service had an open and inclusive ethos and people’s relatives and staff were positive about the way it was managed. Feedback was sought from people who used the service through regular ‘resident meetings’ and feedback forms. This information was analysed and action plans produced when needed.

Further information is in the detailed findings below:

Vicarage Lodge is registered to provide care and accommodation for a maximum of three people who may have physical disability. It is situated in the village of Stallingborough. The accommodation is purpose built and has three ensuite bedrooms all with their own sitting rooms. There is a large communal open plan kitchen and lounge.

The service had a registered manager in post. 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.

This inspection was unannounced and took place on 23 December 2014. The previous inspection of the service took place on 27 January 2014 and was found to be compliant with the regulations inspected.

We reviewed the care records for two people who used the service both of whom could not make decisions for themselves. We found mental capacity assessments had been undertaken and when people needed support to make decisions appropriate best interests meetings had taken place and these had involved other relevant people outside of the organisation. We saw care plans were written after consideration of the least restrictive option.

We saw the service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and were aware of recent changes in law. This showed us that staff followed the Mental Capacity Act 2005 for people who lacked capacity to make decisions for themselves.

The registered provider had robust recruitment processes in place which protected people from unsuitable or unsafe staff.

The service met people’s nutritional needs; people were supported to ensure they had enough to eat and drink. Although the people who used the service were unable to talk with us, people’s gestures indicated they were happy with the quality of the food provided.

Records showed staff had been trained in safeguarding vulnerable adults. The registered provider had policies and procedures in place to protect vulnerable people from harm and abuse. Staff were also aware of the registered provider’s whistleblowing policy and how to contact other agencies with any concerns.

Medicines were stored securely and administered safely. Records showed people received their medicines on time and in accordance with their prescription.

Our observations showed people who used the service received regular positive interaction from members of staff. Daily activities were organised for people to promote their independence and to provide stimulation.

People were supported by staff to maintain their privacy, dignity and independence. When possible, staff involved people in choices about their daily living and treated them with compassion, kindness, and respect.

Staff told us they felt supported by the management of the service. The registered provider had put in place an electronic care record system which allowed staff to update people’s records instantly and allowed the management to analyse information that promoted people’s health and wellbeing.

Since the building had been purpose built for the needs of people with physical disabilities we saw each person’s room was ensuite and had its own sitting room, all equipped with ceiling tracked hoists to enable people to move around their rooms. The main lounge and kitchen area was a large open space designed to enable electrically powered wheelchairs and other large pieces of equipment to move around without causing inconvenience or harm to others.

We used a number of different methods to help us understand the experiences of people who used the service. This was because people who used the service had complex needs which meant they were not able to tell us their experiences.

People were involved as far as they were able in making decisions about their care and welfare. Where people found this difficult the person who should act on their behalf was identified.

Information was available for staff to follow to ensure people’s needs were met and they were safe.

People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

The provider’s recruitment and selection procedures ensured people who used the service were not exposed to staff who should not be working with vulnerable adults.

People who used the service could make complaints and these were looked into and resolved where possible to the person’s satisfaction.