This inspection took place on 6 and 14 November 2017 and was announced. The provider was given 48 hours’ notice because the location was a small service for people who are often out during the day; we needed to be sure that someone would be in. West Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. West Lodge accommodates 6 people in one building.

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.

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.

At the last inspection in August 2015, the service was rated Good. At this inspection we found the service remained Good.

People told us they were happy living at West Lodge. The service had a happy and relaxed atmosphere. Sufficient experienced and trained staff were deployed to ensure people’s needs were met. Staff were knowledgeable about the people they supported, their likes and dislikes and interests. Appropriate arrangements were in place for the safe administration and storage of medicines.

People were protected from abuse and harm. The provider had a safeguarding campaign called 'Speak Out' to promote and encourage staff, people using the service and relatives to tell someone if they had any concerns. An effective recruitment and selection process was in place. The provider carried out monthly health and safety checks to ensure people lived in a safe environment.

Training was up to date and staff received support via supervision and appraisal. Relatives and people were involved in the planning of their care. Information was provided in easy read format to assist people in understanding the care available to them. The provider had an effective complaints procedure in place and people who used the service and relatives were aware of how to make a complaint.

People had maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported in maintaining a healthy and balanced diet. People were involved in the preparation of meals. People were supported to maintain good health and had access to health and social external professionals.

Activities were developed around people’s interests. People were supported to maintain relationships, access the local community and go on holidays.

Staff were compassionate and kind. An experienced registered manager was in place and understood the importance of monitoring the quality of the service and reviewing systems to identify any lessons learnt. The service regularly consulted with people, relatives and staff to capture their views about the service.

We inspected West Lodge on 26 August 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.

We last inspected the home on 9 February 2014 and found it met the five outcomes we reviewed.

West Lodge is a care home providing accommodation and personal care for six people with learning disabilities. It is a purpose build house situated close to local shops and amenities.

The home had a registered manager in place and they have run the home for over a year. 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.

At the time of the inspection six people lived at the home and we met all of the people who used the service. Two of the people were able to discuss their views about the home at length. They told us they found that the service was well-run and the support from staff had enabled them to develop many of the skills they needed to lead more independent lifestyles. People told us that they really liked the staff and the home met all of their needs.

We saw there were systems and processes in place to protect people from the risk of harm. We found that staff understood and appropriately used safeguarding procedures.

We observed that staff had developed very positive relationships with the people who used the service. Staff were kind and respectful. Throughout our visit there were lots of conversations between the people who used the service and staff. We saw that people were very comfortable in each other and staff presence and there was lots of laughter.

We saw that they were aware of how to respect people’s privacy and dignity. People told us that they made their own choices and decisions, which were respected by staff but they found staff provided really helpful advice. People discussed how they were fully involved in the development of their care records.

People told us they were offered plenty to eat and assisted to select healthy food and drinks which helped to ensure that their nutritional needs were met. We saw that each individual’s preference was catered for and people were supported to manage their weight and nutritional needs.

We saw that people were supported to maintain good health and accessed a range of healthcare professionals and services. We found that staff worked well with people’s healthcare professionals such as consultants and community nurses.

We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. The people we spoke with discussed their support plans and how they had worked with staff to create them. We were in agreement with the registered manager that it would be beneficial if these were produced in accessible formats so used pictorial images as well as the words.

We found that staff had worked well with people and enabled them to develop skills they needed to live more independently. One of the people told us that because of staff support they had now developed to the point whereby they would be living more independently.

People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments. We saw that people had hospital passports. The aim of a hospital passport is to assist people with a learning disability to provide hospital staff with important information they need to know about them and their health when they are admitted to hospital.

Staff had received a range of training, which covered mandatory courses such as fire safety, infection control and first aid as well as condition specific training such as working with people who have learning disabilities. Staff had also received training around the application of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. The staff we spoke with fully understood the requirements of this Act and were ensuring that where appropriate this legislation was used.

Staff shared with us a range of information about how they as a team worked very closely with people to make sure the service enabled each person to reach their potential. We found that people who used the service had been involved in producing the annual development plan and they could readily discuss whether staff and the home had met the goals that had been set.

People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that a senior staff member and two staff were on duty during the day and one person was on duty overnight. We found that the registered manager oversaw another home. The provider had therefore employed an additional senior support worker who worked at the home when the registered manager was working in the other home.

Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

We reviewed the systems for the management of medicines and found that people received their medicines safely.

We saw that the provider had a system in place for dealing with people’s concerns and complaints. People we spoke with told us that they knew how to complain and felt confident that staff would respond and take action to support them. People we spoke with did not raise any complaints or concerns about the service.

We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. We found that all relevant infection control procedures were followed by the staff at the home.

The registered provider had developed a range of systems to monitor and improve the quality of the service provided. We saw that the registered manager had implemented these and used them to critically review the service

We found that one of the people who used the service had become a service user representative for the home and regularly went to meetings at the provider’s headquarters. The person who used the service and undertook the role told us they were the voice of the people in the home and felt their views were listened to and acted upon. They told me how they had, with staff support, argued that the home should remain in the cluster of services with the other home the registered manager oversaw. We found that the provider had listened to this argument and agreed to not changing the current cluster arrangements.

We observed people in their recreation spaces, spoke to two people who lived there, reviewed records and spoke to staff. We viewed private living spaces and all of the communal areas in the home and found a safe, inviting and friendly atmosphere throughout. There was a large, bright and airy communal lounge that could be used at all times of the day. There was also a large outdoor space which people could use whenever they wished and the kitchen had a dining area. We spoke to four members of staff who all spoke positively regarding local training.

We reviewed the comments and complaints file kept in the office and found that the new registered manager had acted on previous issues to improve the service.

Some of the people who lived at West Lodge had physical and learning disabilities that limited their communication and verbal skills. This meant some people could not tell us their views about the service. One person told us, “I’m very settled here. I’ve been here for a few years and I do things that I like to do.”

We spent time with people during a lunchtime meal and observed how staff supported them. We saw people were encouraged to make their own choices and decisions. We saw staff understood each person’s different needs, for example when they could manage independently and when they might require some support. There were sufficient staff on duty to support people to lead active and individual lives.

People had lots of activities and were involved in the local community. One staff told us, “I think it’s a really good service for people. They get out and about all the time.”

The home provided a good standard of accommodation that suited the lifestyles and needs of the people who lived there. Each person had a good sized room which had recently been decorated to people’s individual tastes. One person told us, “I like my bedroom. I chose the colours myself. It’s big enough so I can keep all my things in it.”

We saw the provider had a quality monitoring processes in place to check the quality of the service, which included the views of people and their relatives.