Viola House 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.

Viola House provides accommodation and personal care and support for a maximum of 12 adults who have learning disabilities. There were nine people living in the home at the time of our inspection.

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.” Registering the Right Support CQC policy.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained 'Good'.

People were protected from avoidable harm. There were assessments in place, which identified support needs and how care was to be delivered. People were protected by staff who knew how to recognise if a person was experiencing or at risk of abuse. Staff had been carefully recruited to make sure they were safe to work with people. We observed people were supported by sufficient staff to meet their care needs, including making sure people were supported to take their medicines as prescribed.

People's needs had been assessed and there were care plans in place to ensure they received safe and effective care. Staff received an induction and regular training so they were able to meet people's specific care needs. They supported people to access specialist health care services. People were supported to eat and drink enough to meet their needs. There were policies and procedures to ensure people had maximum choice and control of their lives and that they were not restricted unnecessarily.

People were supported to maintain relationships that were important to them. This enabled people to develop meaningful relationships with the other people and staff at the service. People were involved in making decisions about matters important to them. They were encouraged to express their views as much as they were able to. We observed people being treated with privacy, dignity and respect.

The service was responsive to people's needs and staff listened to what people had to say. Staff responded to people speedily and understood the need of respecting people's individual wishes and choices. The service ensured that people had access to information they needed in a way they could understand and which complied with the Accessible Information Standard. This showed the service had ensured people were able to communicate their needs and understood information that was given to them. People and their relatives could be confident that any concerns or complaints they raised would be dealt with.

The service was well-run and had received compliments from people and their relatives. The registered manger and the rest of senior management were aware of their regulatory responsibilities. The service monitored the quality of care people received and took action to improve how people were supported. The registered manager worked in partnership to ensure people received quick and appropriate support.

Viola House provides accommodation and personal care for a maximum of 12 people with learning disabilities. There were 9 people at the time of this inspection.

The inspection took place on the 30 June 2015 and was unannounced. At our last inspection in June 2014 we found the provider was meeting the all the regulations we inspected. .

There was a registered manager at this home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.

Relatives of people receiving care felt their relatives were safe. Staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised.

Risk assessments were in place for every person receiving care. We saw these reflected current risks and ways to reduce the risk from happening.

There were appropriate arrangements for the management of people’s medicines and staff had received training in administering medicines.

Staff received an induction and training and they were supported through regular supervision and appraisal. We saw staff had received training in the Mental Capacity Act (MCA) 2005 and people’s capacity was assessed in line with the MCA.

People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the right care and treatment.

We saw that staff were caring and promoted people’s independence. They knew people’s needs well. People were treated with dignity and respect. Relatives told us they were well looked after. They felt confident they could share any concerns and these would be acted upon.

There was a positive and open culture at the service. Staff were encouraged to be involved in regular meetings to share their views and concerns about the quality of the service. Systems were in place to monitor and improve the quality of the service.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us. We observed the care provided and the interaction between staff and people who used the service. We spoke with five care staff and two relatives of people who used the service.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

We observed that staff were constantly supervising people to ensure that they were safe. Care records contained risk assessments which provided guidance to staff on action to take to keep people safe. CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLs) which applies to care homes. The home had proper policies and procedures in relation to the MCA and DOLs. The manager and some staff had been trained to understand when an application should be made, and in how to submit one. MCA and DOLs training had been booked for new staff. We saw from records that the provider had submitted a DOLs application for a person who used the service. This meant that people were safeguarded as required.

Is the service effective?

Comments from relatives and our observations indicated that the service was effective and responsive to the needs of people. People’s likes and dislikes were documented and staff we spoke with were aware of these. There was evidence that people’s needs had been attended to by healthcare professionals such as psychiatrist, dentists and their GP.

Is the service caring?

We observed that people who used the service were well cared for. We saw staff attending to people and offering them drinks. Staff were gentle and pleasant towards people. We noted that people were able to approach staff freely and came to them when they needed help. People’s preferences, interests, aspirations and their diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. A relative told us, “Staff do care for residents.”

Is the service responsive?

We observed that staff were attentive towards people and when people needed help or attention, staff responded immediately. We saw that the provider had responded positively to feedback from relatives. The provider may find it useful to note that feedback from one relative indicated their responses could be improved. The relative told us, “At times they do not feedback very well. I would give feedback a low score.”

Is the service well-led?

The home did not have registered manager. The new manager had recently submitted an application to CQC for registration. The new manager and the nominated individual were knowledgeable about their roles and responsibilities. There were arrangements for monitoring the quality of care provided.

We carried out this inspection to check if the provider had complied with a compliance action from a previous inspection of the service. We spoke with the manager and a care staff. We examined medication records and also checked medication stored in the home to make a judgement as to whether the provider was meeting Outcome 9 : Management of medicines and was compliant with Regulation 13 (HSCA 2008 Regulated Activities) Regulations 2010.

At this inspection we were satisfied that people who used the service were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We noted that there were arrangements for the recording of medication received, storage, administration and disposal of medicines. Medication administration charts (MAR) were appropriately signed by staff and there were no unexplained gaps.

People who used the service have learning difficulties and communication was limited. We were however, able to observe how they were being cared for by staff. People who used the service appeared comfortable and well cared for. Staff interacted well with people and they responded to encouragement given by staff. We spoke with two of their relatives. They informed us that they were satisfied with the care provided. Their views can be summarised by the following comment from one of them,”There is good communication with staff and my relative is treated with respect and dignity”.

Care provided was closely monitored and regular reviews of care had been carried out. People participated in various activities organised by the home and by community services. There were suitable arrangements for safeguarding people and relatives told us that people were safe in the home. We however, noted that improvements are needed in the administration of medication.

Relatives were of the opinion that the home had adequate staff to care for people. This was reiterated by staff who said they were able to take good care of people. Regular audits and checks of the service were in place. The results of a recent satisfaction survey indicated that those who responded were satisfied with the quality of care provided. An action plan had been prepared in response to issues which needed attention.

People who use the service have learning difficulties and communication was limited. We were able to observe how they were being cared for by staff and we spoke to three of their relatives to obtain feedback on the care provided. We noted that people were able to move freely in the home. They appeared comfortable and well cared for. We saw staff interacting well with people and people responded to encouragement given by staff.

People had been kept occupied. We saw people engaging in various activities organised by the home and by community services. Activities that people had participated in were recorded in their care records. Care provided was closely monitored and regular reviews of this care had been carried out.

The relatives who spoke with us stated that people who use the service had been treated with respect and dignity. They indicated that their relatives’ personal, social and healthcare needs had been attended to. They had been kept informed by staff who updated them regarding the welfare and progress of their relatives.

Relatives said the home was clean and tidy when they visited and people looked well cared for. They were happy with the quality of care provided and felt that it was of a good standard. Their views can be summarised by the following comment, “we are absolutely delighted with the staff. They are very good.”