White Acres 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. White Acres is registered to accommodate 12 people with learning disabilities; at the time of our inspection there were 12 people living in the home.

At the last inspection in January 2017, this service was rated as requires improvement. A breach of legal requirements was found. The provider was asked to provide an action plan to tell us what they would do to meet legal requirements in relation to a breach in Good governance. At this inspection, we found that improvements had been made and sustained and the service was rated overall good.

The service had 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.

Improvements had been made to the premises in order to meet people's needs and ensure the environment was clean and well decorated. There was a plan for refurbishment and continued improvements to the environment.

People received care from staff that knew them and were kind, compassionate and respectful. There were sufficient staff to provide the care and support people required.

People’s needs were assessed prior to moving into home, care plans based on their individual needs and preferences were in place and were kept under review. Risks to people had been identified and measures put in place to mitigate any risk. The premises were maintained to support people to stay safe.

There were appropriate recruitment processes in place and people felt safe in the home. Staff understood their responsibilities to keep people safe from any risk or harm and knew how to respond if they had any concerns.

Permanent staff were supported through regular supervisions and undertook training, which helped them to understand the needs of the people they were supporting. Staff who did not work at the service regularly had not attended training to update their skills and knowledge. People and where appropriate their relatives were involved in decisions about the way in which their care and support was provided.

Systems were in place to ensure the premises were kept clean and hygienic so people were protected by the prevention and control of infection. There were arrangements in place to make sure action was taken and lessons learned when things went wrong, to improve safety across the service.

Staff understood the need to undertake specific assessments where people lacked capacity to consent to their care and / or their day-to-day routines. However, these had not always been completed for a specific decision. They did not always include information about how the person had been supported to make their own decision. People’s health care and nutritional needs were carefully considered and relevant health care professionals were appropriately involved in people’s care.

People were cared for by staff who were respectful of their dignity and who demonstrated an understanding of each person’s needs. Relatives spoke positively about the care their relative received and felt that they could approach management and staff to discuss any issues or concerns they had.

There were comprehensive systems in place to monitor the quality and standard of the home. Regular audits were undertaken and any shortfalls addressed.

The registered manager was approachable and people felt confident that any issues or concerns raised would be addressed and appropriate action taken.

The service strived to remain up to date with legislation and best practice and worked with outside agencies to continuously look

An unannounced inspection of the service took place on 23 January 2017.

White Acres is a residential care home providing accommodation for 12 people who have needs associated with a learning disability. Accommodation is on two floors. There are nine bedrooms on the ground floor and three on the first floor. All bedrooms have a wash basin. People using the service have access to a large recreational garden. The service has its own transport which is used to support people to access community day centres and activity centres. Eleven people were using the service at the time of our inspection.

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.

People using the service were protected from abuse and avoidable harm. Staff understood and practised their responsibilities for keeping people safe. People’s care plans included risk assessments which included information for staff about how to support people safely.

The provider had recruitment procedures that ensured as far as possible that only people suited to work at the service were employed. There were enough care workers to meet the needs of people using the service.

People were supported to have their medicines at the right times. The arrangements for the storage of medicines were safe.

The provider’s ‘estates department’ maintained the premises and equipment. They carried out annual audits of the premises and responded to requests from staff to attend to repair and maintain items. We identified items requiring repair or attention that had not been reported to the estates department.

People were supported by staff with the right skills and knowledge. Staff were supported through training and supervision. Staff were aware of their responsibilities under the Mental Capacity Act 2005.

People were supported with their nutritional needs. They told us they enjoyed their meals. People were supported with their health care needs and were supported to access health care services when they needed them.

Staff were kind and caring. We saw staff being attentive to people’s needs and ensuring their comfort. Staff respected people’s privacy and dignity.

People were involved in decisions about their care and were provided with information about the service and independent advocacy.

People received care that was personalised because the staff understood people’s needs and preferences. People were provided with social activities at the home and outside. People had personal aims and objectives which they were supported to achieve.

People knew how to make a complaint and raise a concern. They had opportunities to contribute suggestions and ideas at residents meetings. If people wanted to they participated in reviews of their care plans.

The registered manager regularly monitored the quality of the service and sought the views of people using the service to identify improvements. Their monitoring activity was verified by the regional director who carried out their own checks and reported findings to the provider’s board of directors. The service had not been effectively supported by the provider’s estates department and consequently the premises were not well maintained. We had pointed this out following our previous inspection on 31 May 2016, but not all improvements had been made.

We found one breach of regulation. You can see what action we told the provider to take at the back of the full version of the report.

An unannounced inspection of the service took place on 31 May 2016.

White Acres is a residential care home providing accommodation for 12 people who have needs associated with a learning disability. Accommodation is on two floors. There are nine bedrooms on the ground floor and three on the first floor. All bedrooms have a wash basin. People using the service have access to a large recreational garden. The service has its own transport which is used to support people to access community day centres and activity centres. Eleven people were using the service at the time of our inspection.

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.

People using the service were protected from abuse and avoidable harm. Staff understood and practised their responsibilities for keeping people safe. People’s care plans included risk assessments which included information for staff about how to support people safely.

The provider had robust recruitment procedures that ensured as far as possible that only people suited to work at the service were employed. There were enough care workers to meet the needs of people using the service.

People were supported to have their medicines at the right times. The arrangements for the storage of medicines were safe.

The premises required repairs and refurbishment in places. Work on this had started after a local authority inspection which took place shortly before our own inspection identified areas that required attention.

People were supported by staff with the right skills and knowledge. Staff were supported through training and supervision. Staff were aware of their responsibilities under the Mental Capacity Act 2005.

People were supported with their nutritional needs. They told us they enjoyed their meals. People were supported with their health care needs and were supported to access health care services when they needed them.

Staff were kind and caring. We saw staff being attentive to people’s needs and ensuring their comfort. Staff respected people’s privacy and dignity.

People were involved in decisions about their care and were provided with information about the service and independent advocacy.

People received care that was personalised because the staff understood people’s needs and preferences. People were provided with social activities at the home and outside. People had personal aims and objectives which they were supported to achieve, but some people's objectives required review. The registered manager was introducing new and fresh activities for people, including for those living with dementia.

People knew how to make a complaint and raise a concern. They had opportunities to contribute suggestions and ideas at residents meetings which were well attended by people using the service. If people wanted to they participated in reviews of their care plans.

The registered manager regularly monitored the quality of the service and sought the views of people using the service to identify improvements. Their monitoring activity was verified by the regional director who carried out their own checks and reported findings to the provider’s board of directors. Monitoring of the state of the premises was not as effective.

We spoke with six people who used the service and four members of staff. We also reviewed three care records, one staff record and two training records.

One member of staff we spoke with explained to us: “People have different ways of expressing their views. We do our very best to understand how each person communicates their preferences”. We saw the use of picture books, signs and symbols and easy read documentation to support people to communicate.

We also spoke with a number of people who used the service and asked them their views in relation to the care they received. All spoke with high regard for the quality of care and kindness displayed by the staff.

There was enough equipment to promote the independence and comfort of people who use the service. One person told us “I use a wheelchair. It always works well”.

We asked the staff we spoke with to describe to us how supported they felt. Their responses indicated that they were very well supported. One member of staff told us: “The manager has an open door policy. We are all able to discuss any issues we may have.”

We asked one person who used the service what they would do if they were unhappy. They told us: “I would just tell them and they would put it right.”

People told us they felt safe and well cared for. They also told us that the staff were always supportive and helped them with their needs. We observed the staff patiently interact with people using the service and found them to be caring and supportive, the activities they arranged for people were well attended and from what we saw people took part enthusiastically and enjoyed themselves.

We found all care plans to be people centered and evidence of people using the service being involved in all decisions about their care.

We found evidence of the manager and their staff being proactive in managing people's care and respecting and supporting their choices. The service was reviewed on a regular basis and any issues identified and addressed, this ensured people's needs were always met in such a way that best supported them.

Some people we spoke with have limited and specialised communication, therefore we were unable to directly ascertain what people felt about their experiences in this outcome area.

Comments from the annual Quality Assurance questionnaire from a relative included, “Under the new management the care has improved – I observed that all the residents are treated with the greatest respect and care. The staff are a credit to their employer.” Another relative stated (a person using the service) “appears to be content here, being as her family are unable to care for her needs it is nice to know she is being cared for and her needs met.” “(The registered manager) has always made us feel very welcome and her devotion to the residents is obvious. Although she is young she demonstrates experience beyond her years and with this brings fresh ideas to Whiteacres”.

A social care professional indicated “lovely home very friendly.”

We spoke with the staff group and found they were aware of how to safeguard people and how to recognise different forms of abuse. We spoke to one member of staff who confirmed that the recruitment process included checks to enable them to work with vulnerable people. Staff said they have access to individual supervision, appraisal and general staff meetings. The staff spoken with stated they felt supported throughout this process and felt they could raise any issues in the privacy of supervisions or in the public forum of a meeting.