Walton House provides accommodation, care and support to up to eight people with a learning disability. At the time of our inspection seven people were using the service. These were the same seven people that were using the service at the time of our last inspection.

We undertook an unannounced inspection on 10 October 2017. At our previous inspection on 10 September 2015 we rated the service good. At this inspection we found the service remained good.

A flexible and responsive service was provided. Staff promptly identified signs that a person’s health was deteriorating or there was a change in their needs and provided the level of support the person required. The provider recruited additional staff to account for the changes in a person’s needs and the additional support they required. Staff had recorded changes in people’s behaviour to identify triggers and what was causing a change in a person’s health or causing them distress. Staff worked with people to understand what additional action they needed to take in order to improve their health and therefore improve their independence. Staff encouraged and empowered people to take control of their lives and develop their knowledge and skills, including through participation in activities, attendance at college and through work placements.

Staff continued to protect people from avoidable harm and were aware of safeguarding adults procedures. There were sufficient staff to meet people’s needs and safe recruitment practices were followed. Staff continued to assess and identify risks to people’s safety. People received their medicines as prescribed.

Staff completed regular training to ensure they had the knowledge and skills to undertake their duties. Staff continued to support people in line with the Mental Capacity Act 2005. Staff continued to support people to access healthcare services and to eat and drink sufficient amounts to meet their needs.

Staff continued to build friendly, kind and caring relationships with people. Staff knew the people they were supporting and their interest, hobbies and preferences. Staff supported people to develop their verbal communication and staff told us people had become more confident in making their choices known and making decisions about their care.

The registered manager remained in post and adhered to the requirements of their registration with the CQC. There was an open and honest culture at the service and staff, people and relatives were encouraged to express their views and opinions about service delivery. The registered manager continued to adhere to the provider’s procedures to review the quality of service provision and make improvements if required.

Further information is in the detailed findings below.

This inspection took place on 10 September 2015 and was unannounced. At our previous inspection on 16 July 2013 the service was meeting the regulations inspected

Walton House provides accommodation, care and support to up to seven adults with learning disabilities, some of whom have additional specialist needs including autism, physical disabilities, mental health needs and dementia. At the time of our inspection seven people were using the service, many of whom had been living at the service for over eight years.

The service was delivered from a large house, providing people with private bedrooms, access to a number of communal rooms and a large landscaped garden, close to community amenities.

The service has 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.

The service provided met the needs of the people living there. Staff provided people with the support they required with their personal care and encouraged them to develop their skills and independence. People engaged in a number of activities and staff supported people to identify hobbies that interested them. Some people were also supported to participate in college courses and voluntary employment.

Staff supported people to maintain relationships with friends and family, and supported them to visit their loved ones. Staff supported people to celebrate key events in their life.

Staff supported people to maintain their dignity, and spoke to people politely and respectfully. People told us they liked the staff and felt comfortable speaking with them. There were sufficient numbers of staff on duty to provide people with the support they required and enable people to receive one to one support when necessary.

People were kept safe at the service. Staff were aware of the risks to people’s safety at the service and in the community and provided people with the support they required. Some people were subject to the Deprivation of Liberty Safeguards (DoLS) to protect them from harm. DoLS ensure people’s liberty is only restricted when it is in the person’s best interest and is required to maintain the person’s safety.

Staff supported people in line with the Mental Capacity Act 2005 and enabled people to make a choice and be involved in decisions about their care. If people were unable to make decisions about certain aspects of their care, support or any treatment they required the registered manager helped organise for best interests meetings to be held.

There were safe medicines management processes at the service and people received their medicines as prescribed. People were supported to access healthcare services and received any support they required to maintain their physical and mental health. The service worked with other health care professionals to ensure they provided people with the support they required. People were supported as necessary with any additional needs they had during mealtimes.

Staff had the skills and knowledge to support people with their individual needs, and they frequently attended training to ensure the support provided was in line with current good practice. The registered manager supported staff to ensure they undertook their role and responsibilities effectively.

The management team checked the quality of service provision and ensured appropriate action was taken when concerns were identified. The service learnt from complaints and incidents to improve the service provided. People’s views and opinions were sought and listened to and improvements were made to the service in line with people’s comments.

Two people talked to us about their day to day lives and their experiences of Walton House. Due to their needs, other people that we met during our visit were unable to share their direct views about the standards of care. We therefore used observations and looked at care records to help us understand their experiences. We met with the registered manager and four members of staff during our visit.

One person told us “we go on nice holidays here and do lots of activities.”

People received the right amount of support to enable them to consent to their care and make decisions and staff clearly understood each person's way of communicating their needs, wishes and choices.

People using the service had personalised support plans, which were current and outlined how they wanted their care and support to be provided. This meant staff had the information they needed to meet people’s individual needs.

People told us that they felt safe and could tell staff if they were unhappy about something. One person said, “I like X (name of staff). I would talk to them if I had a problem.”

Staff we spoke to liked working at Walton House and felt supported by the manager. One told us, “The home is professional and run very well.”

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained. There were appropriate arrangements in place to manage medicines.

The provider’s staff recruitment procedures were thorough and ensured that staff were vetted correctly. This meant that people using the service were protected from unsuitable workers.

Three people talked to us about their day to day lives and their experiences of Walton House. Due to their needs, other people that we met during our visit were unable to share their direct views about the standards of care. In order to make judgements about the care that people received, we observed care practices; interactions with staff and tracked three people's records of care. Case tracking means we looked in detail at the care people receive. We also looked at various records in relation to the staff and the way the home was being run.

The people who spoke with us all gave complimentary feedback. They told us they are treated well, make decisions about the care they receive, and chose how they wanted to spend their time. They told us that they got involved in lots of activities and helped out around the home. People said that they regularly go out and had gone on holidays with their keyworker staff.

People told us what they liked best about Walton House. They told us that they liked living there and got on well with the staff. Comments included, “it’s comfortable” and “all the people are really nice and we get on really well.”

We saw people were given support to make choices and decisions for themselves' wherever they could do so, and staff clearly understood each person's way of communicating their needs, wishes and choices. People's care records were detailed and up to date so that staff understood what people's needs were and how to support them.

People told us that they felt safe and could tell staff if they were unhappy about something.

At the time of our visit, Walton House was well furnished, homely and decorated to comfortable standards. The premises were clean and safely maintained.

People had the right specialist equipment to promote their independence and meet their assessed needs.

Staff told us that they were happy working at the home. They said that there was a good atmosphere and they had the training and information they needed to care for people. One said, “Management treat the staff well” and another told us, “The manager is really open and will answer any queries.”