About the service:

The service is in a rural setting in Lincolnshire near Spilsby.

The service provides accommodation and personal care to people with learning disabilities or autistic spectrum disorder. The care home can accommodate 14 people in one building. At the time of our inspection there were 14 people living in the service.

People's experience of using this service:

• People told us that they liked living in the service.

• The service provided a safe service.

• People were protected against abuse, neglect and discrimination. Staff members were aware of ensuring people's safety and acting when necessary to prevent any harm.

• Heating levels kept people warm in cold weather.

• Staff members knew people well and people appeared to enjoy the attention from them.

• People had a say in how the service was operated and managed.

• People's care was personalised to their individual needs.

• People were largely assisted to have choice and control over their lives and to choose their own lifestyle, though poor practice was identified with regard to how some staff dealt with behaviour that challenged the service.

• Audit processes were not comprehensively in place to ensure quality care. They had not identified poor staff practice or whether the service needed to always replace staff absence. Questionnaires had not recently been supplied to people’s representatives, staff and external professionals for their views of the service to see whether improvements were needed.

• We had not been informed of a potential safeguarding incident as required, to help us determine whether we needed to carry out an inspection at that time.

• A registered manager was in place, which is a condition of registration.

• The service met the characteristics for a rating of "Good" in key questions except well led, where it was rated Requires

Rating at last inspection:

• At our last inspection, the service was rated "Good". Our last report was published for the inspection of 29 June 2016.

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

• We will continue to monitor the service to ensure that people received safe, high quality care. Further inspections will be planned for future dates.

The inspection took place on 29 June and was unannounced.

Welham House is situated on the outskirts of Spilsby. It is registered to provide accommodation and personal care for 14 people with a learning disability or autism. There were 12 bedrooms in the house and separate flats. The flats were occupied by people who were able to be more independent but still liked the security of having staff close by. These were used by people as a step along the way to being independent. There were 14 people living at the home on the day of the inspection.

There was a registered manager for 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 had identified the number of staff needed to meet people’s needs and ensured that the correct number of staff were available at all times. Appropriate checks had been completed to ensure that staff were safe to work with the people living at the home. Staff were supported to develop their skills needed to care for people safely through training and supervision.

Staff had received training in how to keep people safe from harm and knew who to contact to report any concerns. People living at the home were also supported to raise concerns about their safety. Risks to people were identified and appropriate plans were in place to keep people safe. Where people needed to be restrained for their own safety this was clearly recorded in their care plans and the person had agreed to the restrain. Risks around medicines were identified and medicines were safely stored and administered in a person centred way.

Where people faced restrictions on their liberty that they were unable to make a decision about they were appropriately referred for assessment under the mental capacity act deprivation of liberty safeguards. People’s abilities to make decisions were assessed and where needed people were supported with decisions made in their best interest.

Staff were kind and caring and supported people’s choices about their everyday lives and to be involved with their care planning. People’s privacy was respected and they were able to choose who they wanted to support them with their personal care. People were able to engage in activities both at the home and at the day centre and were supported to develop any hobbies.

There were effective systems in place to monitor the quality of care people received. People were encouraged to raise any concerns they had about the home and the care they received as well as any ideas on any improvements they wanted to see. People’s views of the service were gathered and used to identify areas for improvements.

There were fourteen people living at the home at the time of our inspection. We reviewed the provider’s policies and procedures; spoke with three people who lived at the home and with three members of staff. We also reviewed the care records of three people.

The care records contained individual care plans and risk assessments which had been regularity reviewed and the provider’s policies provided staff with detailed guidance.

One person who lived at the home told us, “I like living here. I can do my own thing. They take me to the shops when I want to go. There are plenty of things to do. I like the holidays. I talk with the staff about my goals and how I can get them.”

A member of staff told us, “I think that there are enough staff on duty to care for people, we do increase numbers to cover for trips out. I have undertaken a full induction and there are plenty of training packages available to us.”

We found that the provider was meeting all of the standards that we inspected.

During our visit to the service we saw that support workers interacted with people in a caring, respectful and professional manner. People responded to the support workers by smiling or laughing,

Care workers responded to peoples' requests for assistance promptly, which showed that they were knowledgeable about people’s diverse communication needs.

People told us that they like living in the home and they like the staff. One person said, "I like the food and the staff." One staff member said, "We know the residents very well and the standard of care is high."

People were seen in various places throughout the home including their own rooms where people had stated this was their preference. We were told, "Staff are very obliging." People told us they could have visitors when they wished and that they were made welcome by staff.