This inspection took place on 9 October 2018.

At our last inspection of Walsingham Support - 31 Budge in February 2016, the service was rated 'Good'. At this inspection we found the service continued to be 'Good'.

Walsingham Support - 31 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 - 31 Budge Lane accommodates up to six people with a learning disability in one single-story purpose built building which is wheelchair accessible throughout. 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 six people living in the service at the time of our inspection.

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.

People’s care and support continued to be planned and delivered safely. Staff understood the provider’s safeguarding procedures and their role in keeping people safe. The risks associated with people’s care were assessed and managed to reduce the possibility of them experiencing foreseeable harm. There were enough suitable staff to meet people’s needs and people’s medicines were administered as prescribed. Staff followed appropriate health, hygiene and fire safety practices within the care home.

People had detailed assessments of their needs in place. These had input from health and social care professionals and were regularly reviewed. People’s needs were met by trained and supervised staff whose performances were appraised by the registered manager. People ate well and were supported to do so in line with their assessments. The support people received was compatible with the Mental Capacity Act 2005 and they had timely access to healthcare services. The layout of the service and the equipment therein met the needs presented by people’s physical disabilities.

People and staff shared warm relationships that had spanned many years. Staff supported people to maintain friendships and contact with relatives. People’s privacy was maintained and staff promoted people’s independence. Where people chose to, they were supported around their spiritual needs and to participate in the wider activities of church groups.

The service continued to be responsive to people’s changing needs. People had person centred care plans and were supported to engage in a wide range of activities that met their individual needs and preferences. Staff supported people in line with their communication needs. A complaints process was available to people in pictorial and easy to read formats and they had access to advocacy services when required.

Walsingham Support -31 Budge Lane continued to be a well-run service. Staff felt supported in their roles and enjoyed their work. Management structures and arrangements were clear and the role modelling of good practice was promoted. The registered manager audited the quality of the service being delivered and worked closely with partner agencies to achieve positive outcomes for people.

This inspection took place on 22 February 2016 and was unannounced. At our previous inspection in October 2013, we found the provider was meeting the regulations in relation to the outcomes we inspected.

Thirty-one 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 six 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.

Relatives told us they thought their family members were 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 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 of people’s needs and care planning were of a good standard. Relatives told us they were engaged by the manager and staff in planning their family members care. Where possible people were also engaged in contributing to their own care plan. This process was assisted by the staff’s good knowledge of people’s needs a

During our inspection we met four of the people who use the service, the other people were on holiday abroad supported by staff. We spoke with one person, they told us “It is good” living at Budge Lane and that they were going on holiday soon. Most of the people living at 31 Budge Lane did not have the capacity to share their views regarding their care. In order to make judgements about the care that individuals received, we observed interactions with staff and the care provided. We saw that the staff spoke warmly with people. They understood each person’s non-verbal communication signs well and checked, as far as possible, that people were happy to be supported where needed. They treated each person with respect and offered reassurance if they showed signs of distress.

We found that people received effective and safe care and support from staff that were familiar with people’s individual needs and preferences. People using the service had personalised care plans which were current and outlined their agreed care and support arrangements. This meant staff had the information they needed to meet people’s individual needs. People were provided with a choice of suitable and nutritious food and drink.

Staff were knowledgeable about safeguarding procedures and knew how to raise concerns if necessary. We saw evidence that regular checks were made of equipment at the service and that there was an adequate supply of hoists and wheelchairs. Staff were trained to meet the needs of people at the service. Accurate and up-to-date records were held at the service.

At the time that we visited there were six people who were using the service. We were not able to communicate verbally with most people there. We therefore used observation methods to help us understand their experiences. We were able to watch for their interactions with staff, and to see how people looked and responded.

We observed that people received safe, effective care and support from staff that were familiar with people’s individual needs and preferences. They were able to anticipate people’s needs, check with them and provided choice. We saw staff treated people who used the service with great respect and dignity and knew them well. There was a lot of written detail and knowledge about people’s care, contained in their care plans. We observed the care given and talked to staff. We learnt too that although there had been some difficulties with staffing levels, they were adequate to meet the needs of people who used the service. A number of new staff had recently started or been appointed.

There was evidence of a fair and effective recruitment process in place in which people who used the service were invited to be involved. We also looked to check that there was an effective complaints procedure at the service.

The home appointed a new manager approximately a year ago; this has impacted on the service in a positive way. There is now a strategic overview and leadership which the home had been lacking for many years before.

People who use the service at 31, Budge Lane are helped to live ordinary and meaningful lives. They use community facilities, go to the supermarket, cinema or for a meal out. People are always well dressed with an emphasis on detail; there is an acknowledgement of special occasions which are celebrated.

We could not communicate verbally with people who use the service, but we were able to watch for their interactions with staff, and generally to see how people looked. This has been reflected in the report where possible.

Walsingham, the providers of the service 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.

Walsingham offer people who live in their homes a range of documents that are easier for people with learning difficulties to understand. People are also given the opportunity wherever possible to be involved in making decisions about every aspect of their lives including being on interview panels and shaping policies.

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