Vosse court is a residential care home for six people with a range of needs, including learning disabilities and Downs Syndrome. The service is a small residential house situated in the London borough of Lambeth. At the time of the inspection there were six people using the service.

At our last inspection on 3 June 2016, we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing 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.

People continued to remain safe at Vosse Court as staff were aware of how to identify, escalate and respond to suspected abuse. Staff received safeguarding training and were confident in whistleblowing should the need arise.

The service continued to develop risk management plans that identified known risks and gave staff guidance when faced with those risks. Risk management plans were reviewed regularly to reflect people’s changing needs.

People’s medicines were managed in line with good practice. Systems and process in place ensured people received their medicines safely and as intended by the prescribing pharmacist.

Sufficient numbers of suitable staff were deployed to keep people safe. Records confirmed staff had undergone robust pre-employment checks to ensure their suitability in working at Vosse Court.

People were protected against the risk of cross contamination as the provider had systems and processes in place to effectively manage infection control.

Staff continued to receive on-going training to enhance their skills, experience and knowledge. Staff reflected on their working practices through regular supervisions and annual appraisals.

People were supported to access food and drink that met their dietary needs, requirements and preferences. People continued to access a wide range of healthcare professional services to monitor and maintain their health and wellbeing.

The service was aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA). People's consent to care and treatment was sought prior to being delivered. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The service had an embedded culture of ensuring people were treated equally and people’s diversity was respected and encouraged.

Care plans clearly detailed people’s social, mental health and medical needs. Care plans were person centred, reviewed regularly and gave staff clear guidance on meeting people’s needs in line with their preferences. People’s wishes in relation to end of life care were documented.

People were aware of how to raise concerns and complaints and felt these would be addressed in a timely manner. Complaints received were investigated and a positive resolution sought.

People spoke positively about the registered manager, however felt communication could be improved. The service had clear values of inclusion and treating people with compassion and enhancing their dignity which was shared by all staff.

The provider carried out regular audits of the service to drive improvements. Audits undertaken ensured issues identified were addressed in a timely manner.

People’s views of the service and the service provision were sought through regular quality assurance questionnaires and house meetings. Quality assurance questionnaires were audited to ensure any issues were identified and rectified in a timely manner.

Further information is in the detailed findings below.

We carried out this inspection on 12 and 14 April 2016 and the inspection was unannounced.

Vosse Court is a care home registered to provide care and support up to six adults with learning disabilities. At the time of the inspection there were six people living at the service.

The service had a manager in place, who was in the process of applying to the commission for to be 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 were protected against the risk of harm and abuse. The service had comprehensive risk assessments in place that identified risks and gave staff guidance on how to safely support people. Risk assessments were reviewed regularly to reflect people’s changing needs. Staff underwent training on how to safeguard people from abuse and were aware of the correct procedures in reporting any suspicions of abuse.

People were supported to receive their medicines safely. The service had clear guidelines for staff to follow when ordering, administering, storing and disposing of medicines. Medicine administration recording sheets [MARS] were regularly reviewed and identified errors were addressed in a timely manner.

People were supported by staff that had access to comprehensive care plans. Care plans documented people’s likes, dislikes, health care needs, abilities, medical needs and other important information. Care plans were person centred and detailed information in the voice of the person. People were encouraged to be involved in the development of their care plans where possible.

People received care and support from sufficient numbers of skilled and knowledgeable staff. Staff received on-going training to effectively meet people’s needs. Staff underwent training in all mandatory areas such as, health and safety, first aid, safeguarding, Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS]. Rotas indicated that there were sufficient numbers of staff on shift to meet people’s needs.

People were supported by staff that regularly reflected on their working practices. Staff received supervisions and appraisals from senior staff. Documents showed staff met with senior staff regularly to receive a supervision. Staff were encouraged to discuss areas of their work they found enjoyable or challenging and how they would best be supported. Staff were able to talk about any areas of work that they felt they required further training in. Staff received annual appraisals.

People’s consent was sought prior to care being delivered. Staff sought people’s consent and offered people choices on how they wanted to receive care and support. People’s choices were respected and encouraged. Where people were unable to give their consent staff were aware of how to support people effectively and in line with legislation.

People were supported to access sufficient amounts of food and drink. Staff monitored people’s food and drink intake enabling them to quickly identify any concerns regarding malnutrition or dehydration. People were encouraged to participate in meal preparation and could access food and drink as and when they wished. People were supported to access health care services to ensure their health was monitored and maintained. Records indicated people accessed, Dr’s, dentists and opticians as and when required.

People were treated with dignity and respect. Staff understood the importance of maintaining people’s privacy and dignity and were able to give clear examples of how to treat people with respect. People were encouraged to raise their concerns and complaints without fear of reprisal. Staff actively sought to support people share their concerns and documented their findings. Staff

We found the service provided at Vosse Court to be caring, responsive, effective, well led and safe.

People living at Vosse Court told us they were happy there and they liked their meals and the staff team. One person told us "I am happy here. I like my room and the staff".

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People were protected from the risks of inadequate nutrition and dehydration.

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

There were enough qualified, skilled and experienced staff to meet people’s needs.

People told us that they liked the staff and were happy living in the home.

One person told us about his enjoyment of the garden and that staff had helped to plant fruit and vegetables and arranged barbeques for friends and relatives.

People we spoke with told us that they were warm and comfortable in their bedrooms and some people told us about their hobbies and how staff had helped them to do things they enjoyed, like attending music classes, daytrips and holidays.

One person who uses the service showed us their bedroom which was personalised and reflected their personal interests, they told us "I have no complaints. The staff listen to me and treat me well. I am proud of my home and everything is fine. I feel very safe here."

We saw that people were enjoying their activities and they were given choices about how they spent their time. Two people told us that they were looking forward to their weekly foot spa treatment.

We saw that people were supported to develop their independent living skills. We found that staff knew how people liked to spend their time and the leisure activities they had requested were available to them. For example, we saw that people had requested that the service starts a weekly book club. This had been put in place and people were being supported to choose library books that were read aloud to them by a member of staff during the weekly book club evening. People told us that they enjoyed this.

Staff had supported people to make and attend appointments with healthcare professionals when needed and they had been commended for the support they had provided to one person during their hospital admission.

People who use 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.

There was an effective complaints system available.