About the service: Wheatley Lane is a care home that provides personal care and accommodation for up to six people with learning disabilities or autistic spectrum disorder. At the time of this inspection four people were using the service. The home comprises of three two-bedroom terraced houses.

People’s experience of using this service:

•The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways, promotion of choice and control, independence and inclusion. Peoples support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

• The service had improved since the last inspection. Staff were aware of safeguarding procedures and had been provided with training on recognising and reporting abuse to promote people’s safety. Care plans contained person-centred information so that individual needs were identified. Written information had been made available in accessible formats to support people’s understanding. Audits carried out were monitored to identify any issues and act on these.

• People told us the staff were “Nice” and “Good.” They were positive about how they were treated by staff. People received personalised support from staff who knew them well. Staff had built positive relationships with people living in the service. Staff supported people to retain their independence.

• People felt safe living at Wheatley Lane. Recruitment processes were robust and thorough checks were completed before staff started working in the home. We saw there were sufficient numbers of staff on duty to make sure people’s care needs were met. Staff supported people safely with their medicines.

• Risks to people were assessed and kept under review. People’s needs were assessed and support plans were developed to guide staff in how to support each person. People were involved in discussions about their support.

• Staff had received training and supervision to ensure they had the knowledge to provide people with appropriate care.

• People had access to a range of health professionals as required, to promote people’s health.

• People felt able to raise any concerns with the registered manager or provider and were confident they would be addressed. Staff felt well supported by the registered manager and we observed the staff team work well together.

• The registered manager and provider undertook a range of quality checks and audits of the service to make sure the care and support provided was of a good standard. This supported the continuous improvement of the service.

• The service met the characteristics of good in all key questions.

• More information is in the full report.

Rating at last inspection: At the last inspection the service was rated requires improvement (published 16 March 2018).

Why we inspected: This was a planned inspection based on the rating awarded at the last inspection.

Follow up: We will continue to monitor this service. We plan to complete a further inspection in line with our re-inspection schedule for those services rated good.

The inspection of Wheatley Lane took place on 18 January 2018 and was announced. We gave short notice of our inspection because we wanted to make sure we were able to meet people who used the service. The last inspection of this service was in April 2015 when the service was rated as good.

Wheatley Lane is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Wheatley Lane comprises three two bedroom terraced houses which provide people with individual bedrooms and shared bathrooms, lounges and kitchens. The home is registered to provide accommodation for up to six people but only five beds were being offered for occupancy at the time of our inspection. On the day we inspected there were two people living in one of the houses and one person in each of the other two.

There was 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.

Staff were not clear about events which needed to be reported under safeguarding procedures and we found some issues had not been reported as needed.

We found inconsistencies in risk management. We saw some risk assessments had been well completed and the risk managed well. However risk assessments had not always been put in place as needed.

Systems were in place to make sure the environment was safely maintained and infection control practices were robust.

Medicines were managed safely.

Staffing levels were appropriate to meet the needs of people. Safe recruitment procedures were followed and people who lived at the home were involved in the recruitment process.

Staff received good support and staff told us the training was effective.

People were supported to have choice and control of their lives but we found little evidence of people being involved in the development or review of their care plans and care documentation lacked the person centred approach we observed staff deliver.

Where appropriate, the registered manager had made application for Deprivation of Liberty Safeguards (DoLS) authorisations. However specific conditions documented on the authorisations had not always been met We recommended that systems be put in place to audit compliance with DoLS conditions to make sure they were met.

People told us the food was good and they had plenty of choice.

We found people accessed health and social care services as needed.

Staff were considerate, caring and friendly in their approach. People told us they were very fond of the staff and that they were respectful of their privacy and dignity needs.

We found inconsistencies in care records. For example some care plans were detailed and up to date whilst others did not fully reflect people’s needs, abilities, goals and aspirations. We also found a lack of documentation available in formats suitable to people who used the service. We recommended the approach to person centred care be reviewed to make sure care plans fully reflected people’s current needs, goals and aspirations and the involvement of people living at the home.

People had access to a range of social and recreational activities within the home and the local community. People told us about clubs and activities they attended and how they were supported to make lifestyle choices. Transport was available to support people in accessing activities of their choice.

People were supported to maintain and make friendships.

Systems to audit the quality of service were in place but we found these were not always effective in identifying issues and therefore driving improvement.

We found two breaches of regulation in rela

We visited Wheatley Lane on 16 April 2015.The inspection was unannounced.

Wheatley lane comprises of three small houses which are linked by a shared garden. Care staff provided the majority of support to people in two of the houses. Due the high level of independence of people living at Wheatley Lane, staff presence was not required all the time.

There was a registered manager in place. 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.

Safeguarding information and contact details were easy to access. Posters encouraged reporting of potential abuse and the details of who could be contacted were present on notice boards. The service had a safeguarding policy in place. Staff told us they had reported any concerns. Staff felt their concerns would be listened to and actioned. Staff received training on safeguarding and were able to tell us different types of abuse and the warning signs they looked for.

People’s care records and risk assessments were kept up to date and reflected people’s current needs. Identified risks were supported by measures to reduce or remove the risks. Staff told us about people’s care records and associated risks.

People’s medicines were administered in a safe way. People received their medicines in line with their prescription. One person managed their own medication and received a prompt from staff. Other people had their medicines administered by a member of staff. We found medication administration records were signed correctly. Medicines were stored appropriately in a cupboard. People had ‘as and when required’ (PRN) medicine. These medicines had a protocol sheet advising staff when these could be administered.

Care records were person centred and reviewed six monthly as a minimum or when someone’s needs had changed. People told us they had been involved in creating their own care records and they told us staff had a good knowledge about them. Care plans included people’s personal preferences, likes and dislikes. People and their families had signed to say they supported the care records.

We saw people were supported to maintain good health and had access to healthcare professionals. One person had regular contact with doctors. Another person attended appointments and received advice from a dietician.

People were supported to do as much as they could for themselves to improve their independence. We saw people were supported to cook their own food in a safe way. Food was balanced.

We spent time observing care and support being given. Staff were seen to treat people with respect and dignity. Staff had developed relationships with people so they appeared comfortable, at ease and shared discussion and laughter with staff. We saw staff asked people what they wanted to do before they did it. If people refused their decision was respected.

We looked at the complaints procedure for the service. Complaints were recorded, analysed, responded to and learnt from. We saw one complaint had been followed through in line with the policy. Complaints, accident and incidents were monitored to look for trends. The service sent out an annual questionnaire to people and their relatives. Responses were looked at to improve the service and quality of care.

We spoke with a staff member who told us they had confidence in the registered manager and believed any concerns would be listened to, recorded and actioned. People that used the service told us they liked the registered manager and felt issues would be looked into. The registered manager ensured a robust programme of quality assurance was in place. We saw quality audits were completed regularly. These audits fed information into a biweekly report sent to the provider’s office. This report identified trends and areas of improvement for the service.

The Care Quality Commission (CQC) monitors the operation of the DoLS (Deprivation of Liberty Safeguards) which applies to care homes. We saw referrals had been made for people that had been deprived of their liberty.

We saw evidence from the records we looked at that people's consent had been sought. We found that the people who used the service were involved in their care planning and received personalised care and support.

We spoke with five people who lived at Wheatley Lane and two staff. We also observed how staff cared for people.

We looked at care plans for the people who lived there. They covered a range of needs and had been reviewed regularly to ensure that staff had up to date information. There were also detailed assessments about the person's health so that staff could support people to keep healthy and well. All the staff we spoke with had knowledge of the needs of the people who lived there.

People who lived there were supported to make choices around the care they received. A staff member told us: "It's not about what staff want to do. It's about what people who live here want."

The home had a safeguarding adults procedure that complied with all of the relevant legislation and good practice guidelines. Staff understood their responsibilities to protect people from harm.

Staff we spoke with were happy to work for the service and told us "I'm happy here." and, "We are a good team." We saw evidence that the provider operated an effective recruitment process to ensure that only suitably qualified, skilled and experienced people were employed at the service.

We saw that accurate records were kept and that these were stored securely.

We met four people who lived at Wheatley Lane and they told us they were well looked after. They were happy to show us around the home, particularly their bedrooms which were personalised to their individual taste. The home was clean and had a welcoming atmosphere.

We spoke with two support workers who told us Wheatley Lane was a nice place to work. They explained to us the care and support they provided and it was evident they knew people well. We observed positive interaction between the support workers and people living at Wheatley Lane.

We looked at the care records of two people and it showed they were involved in decisions about their care and the running of the home. When risks to people's health and welfare were identified, we saw risk assessments detailing how to reduce the risk and what to do if the risk became an incident.

We saw appropriate arrangements were made to ensure people were protected from unsafe and inappropriate care. This included reviews of care plans to ensure they were up to date and health and safety checks of the environment.

People told us they like living at Wheatley lane, they said everyone is friendly and gets on well together. One person jokingly said “well, we get on most of the time”.

One person told us “I like living with my friend”.

People are consulted about how the house is run; we saw evidence of this in the minutes of meetings. People are asked about the menus, holidays and visits are arranged that are in keeping with individual hobbies and interests. One person told us about the concerts he had been to and told us about a visit to Manchester United football ground.

People told us about some of the activities they take part in during the week, they said they enjoyed them. A couple of people told us about their care plans; one person told us some of the things that were in his plan.

We asked people what they thought about the accommodation and they said it was “good”,” very nice and comfortable” and “I like my room”.

People told us they liked the staff and got on well with them. People were at ease chatting to staff about what they had been doing during the day. We witnessed some good humoured exchanges between people living and working there.

There are always sufficient staff on duty to meet people’s needs; this was confirmed by people living there. From talking to staff it was evident that they communicate well with each other and they can respond to any changes in people’s needs by alterations to the staffing arrangements.