We inspected Walsingham Support - 21 Budge Lane on 23 March 2018. The inspection was unannounced. At the last inspection on 10 February 2016, the service was rated 'Good'. At this inspection we found the service remained 'Good'.

Walsingham Support - 21 Budge Lane is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Walsingham Support - 21 Budge Lane accommodates up to six people with a learning disability in one adapted building. 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 were two people living in the service at the time of our inspection.

Since our last inspection the provider had employed a new manager who was now the 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 continued to be safe and received support from staff trained to keep them safe. Staff assessed and managed people’s risks. Staff understood the signs to be aware of that might indicate people were at risk of improper treatment and knew what actions to take if they observed it. There were enough staff available to support people safely and robust recruitment practices were used to ensure all staff were suitable to deliver care. People’s medicines were stored, administered and recorded appropriately and good hygiene practices were in place.

People had their needs assessed and staff were trained to meet people’s assessed needs. Staff were supervised and their performances were appraised by the registered manager. People continued to be treated in line with the principles of the Mental Capacity Act 2005. People had access to healthcare services and were supported to eat well and drink plenty.

People and staff shared positive relationships which had lasted for many years. People were supported with kindness and compassion when other residents passed away. Staff treated people with dignity and respect and supported them to maintain relationships.

Staff delivered personalised care and support. People engaged in a wide range of meaningful activities and their communication needs were supported. A complaints procedure was available in an easy to read format and the registered manager responded to complaints in a timely manner.

The service was well-led. People and staff felt supported by the registered manager and the wider provider organisation. There was an open culture and supportive atmosphere at the service. The quality of the service people received was subject to on-going checks and audits and the manager involved other agencies when required to ensure people’s needs were met.

This inspection took place on 10 February 2016 and was unannounced. At our previous inspection in May 2014, we found the provider was meeting the regulations in relation to the outcomes we inspected.

Budge Lane is a six bedded residential care home for adults with learning disabilities, autism and poor mobility. At the time of our inspection, there were five people living at the home. The service had a manager who had been in place for three weeks at the time of this inspection. He told us he was in the process of registering with the Care Quality Commission (CQC). We saw written evidence of his application. 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 and their relatives told us that they felt safe living in the home and when they received care and support from staff. Staff were knowledgeable in recognising signs of potential abuse and understood the relevant reporting procedures. Assessments were completed to assess any risks to people and to the staff who supported them. Appropriate guidance was in place for staff to follow to help keep people safe. There were other systems in place to protect people from the risk of possible harm. There were risk assessments in place to do with the environment and equipment to provide guidance to staff on how risks could be managed and minimised where possible.

People’s needs had been assessed and care plans included detailed information relating to their individual needs. Care plans were personalised and demonstrated people’s preferences, and choices. People’s care and support packages were amended as necessary to meet their changing needs.

There were sufficient numbers of staff available to meet people’s individual support and care needs. There were safe staff recruitment practices in place and appropriate recruitment checks were conducted before staff started work ensuring people were supported by staff that were suitable for their role.

Medicines were managed, stored and administered safely and people were appropriately supported to take their medicines.

There were processes in place to ensure new staff were inducted into the home appropriately and we saw staff received regular training, supervision and annual appraisals. Staff were aware of the importance of gaining consent for the support they offered people. The manager and staff were able to demonstrate their understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards legislation.

People were supported to maintain good health and had access to a range of health and social care professionals when required. People’s nutritional needs and preferences were met.

Staff demonstrated a good understanding of the needs of the people they supported and could describe peoples’ preferences as to how they liked to be supported. We observed staff speaking to, and treating people in a respectful and caring manner and interactions between people, their relatives and staff were relaxed and friendly.

People received care and treatment in accordance with their identified needs and wishes. Care plans contained information about people’s history, choices and preferences, preferred activities and people’s ability to communicate. Staff respected people’s privacy and dignity. People and their relatives told us they were made welcome in the home and they enjoyed the social events they were invited to attend.

Assessment and care planning were of a good standard. Where ever possible people were involved in planning their care and where this was not possible people’s relatives were engaged in this process. Care files were up to date and person centred. Care was reviewed by the staff team and by other professionals.

People in the h

This inspection took place on 6 November 2014 and was unannounced. At our last inspection on 5 August 2013 we found the provider was meeting all of the standards we inspected against.

Walsingham – 21 Budge Lane is a purpose-built one-storey care home providing personal care and accommodation for up to 6 adults with learning and physical disabilities. At the time of our visit there were five people using the service.

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.

Relatives of people who used the service spoke positively about the service and the care of their relatives.             

The provider had taken appropriate measures to protect people from abuse and discrimination and staff were aware of how to recognise and report these. Family members we spoke with felt their relatives were safe at the home.

There were risk assessments and management plans in place to protect people from risks associated with the physical environment and also risks specific to them, such as those relating to medical conditions. Staff were aware of these and knew how to use the information to keep people safe. They were trained in administering medicines safely, and followed procedures designed to keep people safe from the risks of inappropriately stored or administered medicines.

There were enough staff to keep people safe. New staff were checked to help ensure they were suitable.

Staff received training, supervision and support from meetings and visiting healthcare professionals. This helped equip them with the knowledge and skills they needed to perform their roles effectively. People had access to healthcare services when needed.

Staff sought people’s consent before carrying out care tasks, even if people were not able to give consent verbally. Appropriate procedures were followed under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) to ensure decisions were made in people’s best interests when they did not have capacity to make them for themselves.

People were offered a variety of nutritious food, which they were able to choose themselves. Staff followed guidelines about people’s specific needs in relation to eating and drinking.

Relatives said staff were caring. People received care and support from staff who spoke to them with empathy and respect and in ways appropriate to their level of understanding. They responded to people’s distress promptly and in a caring way. People’s care was planned to include information on how to support their individual communication needs and enable them to express their views about their care. Staff made sure people’s privacy and dignity were respected.

People’s needs were assessed and the assessments were used to form care plans. These were updated when people’s circumstances or preferences changed so that staff had up to date information about the support people needed. People were given support to practise their religion where applicable. They were supported to be active members of their local community and engage in activities suitable for them both at home and outside.

Relatives fed back that staff were responsive to any concerns they had. There was an accessible complaints policy, which the service followed when complaints were made, and made sure complaints were resolved to people’s satisfaction.

The provider gave people opportunities to contribute to decisions about how the service was run. They held a conference that people who used services were invited to attend and discuss equality and diversity, staff recruitment and plans for developing services. Staff and relatives felt the home had a welcoming culture that embraced diversity and valued people.

The provider carried out regular checks to make sure the service was meeting standards set by the provider and based on care legislation. They used action plans to address any changes that the service needed to make were completed.

During our inspection we met the six people who currently use the service. We spoke with two people. They told us they liked living there and that they got on well with the staff. One person told us “It’s good here, the staff are nice and I am going on holiday soon.” Most of the people living at 21 Budge Lane did not have the capacity to share their views regarding their care. In order to make judgements about the care received, we observed interactions with staff and the care provided. We saw that wherever possible staff worked to check that people consented to the care being provided. Where people lacked capacity to make a decision their family were included and appropriate guidance followed.

We found that people received effective and safe care and support from staff that were familiar with people’s individual needs and preferences. People were provided with a choice of suitable food and drinks. Plans and health protocols were in place, where required, for those people who needed support to maintain adequate nutrition and hydration levels. The service worked closely and effectively with a wide range of other agencies and professionals.

We saw evidence that regular checks were made of equipment at the service and the staff we spoke with said that there was no shortage of equipment.

There were sufficient staff to meet the needs of people at the service. We learned that three of the people at the service had been supported by staff to have a holiday recently. We saw that there were procedures to deal with complaints and an easy read guide displayed in the office.

We were able to speak to three out of the six people who use the service. They told us that they liked living at the home; they had plenty to do and that they liked the staff. One person told us “I go dancing on a Thursday”, another person said “foods alright ……and I like the staff”.

For the people that we were not able to talk to we observed staff interaction. We saw that everyone had high levels of well being. There was a lot of interaction with staff, and a warm and friendliness between staff and people who use the service. Staff knew people who use the service well and could anticipate needs whilst giving options whenever they could.

Most of the communal areas had recently been redecorated making the rooms more comfortable and homely.

For people who live at 21 Budge Lane, it’s very much their home. They’re involved in making decisions about who is employed at the home, writing various policies and procedures ranging to what colour to paint their bedrooms and what to eat. There is a philosophy that the office door can only be closed for reasons of confidentiality; training and staff meetings are open for people who use the service to attend if they want to.

People who use the service are also helped to live ordinary and meaningful lives. They use community facilities, and undertake everyday tasks such as going to the supermarket or tea dancing. One person told me that that afternoon, he was going to ‘listen to some music and then watch Countdown’.

Everyone in the service goes on holiday every year, one person told me that he ‘went to Cyprus and laughed all the time’. Someone else said, ‘just been to Spain…look at my tan’, they went onto to say, ‘my friends going to holiday, I’m going to miss her’.

Walsingham have a commitment to training and supervision of staff, in this way they can make sure that their staff team is well able to meet the changing needs of the people who use the service.

The home has been without a registered manager for three months, we were told that a new manager had been appointed and was due to start working the following week.

We would like to thank all the people who use the service at 21, Budge Lane, the staff and in particular the assistant manager, for their time and co-operation during this inspection.

.