Webb House provides accommodation for up to 20 people. There were 17 people living at the home at the time of the inspection. People living at Webb House had a range of learning and physical disabilities including multiple sclerosis, stroke and acquired brain injuries following accidents. Some people had lived with their disability since birth and a number had lived in care all of their adult lives. Accommodation was provided over two floors with a passenger lift that provided level access to all parts of the home. The home was built on a slope which meant both floors had level access outside.

There is a registered manager at the home. 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 registered manager is also the registered manager for two other homes and spends time at each location during the week. The deputy manager was responsible for the day to day running of the home and was present throughout the inspection.

We carried out an inspection on 16 and 17 December 2015 where we found improvements were required in relation to the quality assurance system and maintaining accurate records. The provider sent us an action plan and told us they would address these issues by 1 June 2016.

We completed this inspection on 15 and 17 February 2017 and found the provider was meeting the legal requirements that were previously in breach. However, these improvements need to be fully embedded into practice. Some aspects of people’s records needed more detail to demonstrate the full range of support people were given.

People received person-centred care from staff who had a good understanding of them as individuals and of their needs. Staff supported people to maintain and improve their independence and live as full a life as possible. Staff treated people with kindness and compassion and were respectful of people’s individual choices. People were supported to set and achieve their own goals and maintain their own hobbies and interests.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) had been submitted when required. Staff understood that people had the choice to make unwise decisions and risk assessments were in place to support them to do this. Individual risk assessments were in place and staff understood the risks associated with people they looked after.

Staff understood their responsibilities in protecting people from the risk of abuse. They received regular training and knew how to report any concerns. There were systems in place to ensure people’s medicines were managed safely.

There were enough staff to support people and meet their needs. Recruitment records demonstrated staff had been appropriately employed and were suitable to work with people who used the service. Staff received appropriate training and support to enable them to look after people at Webb House and staff had the skills to perform their roles.

People had their nutritional needs assessed and were supported to maintain a healthy diet of their choice. People were supported to maintain good health and they had access to relevant healthcare professionals when required.

The registered manager and deputy manager had developed an open and positive culture. This was focussed on ensuring people received good, person-centred support that promoted their independence. People and staff spoke highly of them and told us they would always address their concerns. People were actively encouraged to be involved in the day to day running of the home. They were asked for their feedback which was listened to and used to improve and develop the home.

We spoke with the manager, two care workers and four people who used the service.

People’s consent was gained when planning care and before care was given. Staff worked within relevant legal frameworks.

People told us they were happy and appeared contented and settled. One said, “I’m reasonably happy, as much as can be expected. The staff are very kind and they get to know your idiosyncrasies”. People had individual care plans of and they confirmed they received the support they detailed.

Staff had been trained in Safeguarding and knew how to identify and report suspected abuse. One said they would, “Discuss with my manager, or go straight through to adult social care”. People who used the service had access to information suitable for their needs and knew who to contact. One told us, “I’d go straight to the office and talk to them about it”.

All staff at the home had appropriate checks before starting work. People who used the service were involved in staff recruitment and had confidence in the staff’s abilities. One person said, “I like to think they’ve all got a conscience”.

The provider used a range of methods to gather the views of people who used the service and staff. They also monitored quality and had measures in place to ensure the home was safe.

Webb House provides accommodation for up to 20 people. There were 17 people living at the home at the time of the inspection. People living at Webb House had range of learning and physical disabilities including multiple sclerosis, stroke and acquired brain injuries following accidents. Some people had lived with learning and/or physical disabilities since birth and a number had lived in institutional care all of their adult lives. Most people required help and support from two members of staff in relation to their mobility and personal care needs.

Accommodation was provided over two floors with a passenger lift that provided level access to all parts of the home. The home was built on a slope which meant both floors had direct access outside. People spoke well of the home and visiting relatives confirmed they felt confident leaving their loved ones in the care of the staff at Webb House.

There is a registered manager at the home. 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 registered manager is also the registered manager for two further homes and spends her time at each location during the week. The deputy manager was responsible for the day to day running of the home and was present throughout the inspection.

This was an unannounced inspection which meant the provider and staff did not know we were coming. It took place on 16 and 17 December 2015.

People were looked after by staff who were kind and caring. They knew people really well and had a good understanding of people’s individual care and support needs. Staff supported people to make choices and respected their right to make decisions. People were supported by staff who treated them with dignity and demonstrated an interest in their welfare and views. However, care plans did not always reflect the support people needed or received. There was an audit system in place however this had not identified all the shortfalls we found in relation to people’s records.

There were risk assessments in place and staff had a good understanding of risks and what steps they should take to mitigate the risks. Although people were supported to maintain a healthy diet and were involved with the planning of menus there were no nutritional assessments to identify people who may be at risk of malnutrition.

There was a robust recruitment procedure in place which people were included people who lived at the home. They were involved in interviewing prospective staff which helped to ensure staff with the appropriate experience, skills and character were employed to work at the home. There were enough staff to meet people’s individual care needs however staff did not always have enough time to spend with people on a one to one basis. We saw the provider was currently recruiting volunteers to support people.

There was an open and relaxed atmosphere within the home, where people were encouraged to express their feelings, whilst respecting others. People told us that when they had a problem or were worried they were happy to talk with any of the staff. Whenever people had raised concerns or issues prompt action had been taken to address them.

Information was available for people throughout the home in a format that they could understand and was easily accessible. For example there was information about the risk of abuse and what people could do if they felt this had happened to them.

People were involved in the day to day running of the home through meetings and discussions about the food, refurbishment of the home and what they done each day. Some people represented others at regular provider meetings to discuss the development both of the home and the organisation. We saw people had been involved in developing the feedback surveys that were due to be sent out following our inspection.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.