5 Elcot Close is registered to provide accommodation and personal care for up to five adults with learning disabilities and associated health needs. At the time of our inspection there were five people living in the home. The service is one of many, run by the White Horse Care Trust, within Wiltshire and Swindon.

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

A registered manager was employed by the service and was present during our inspection. 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.

There were systems in place which ensured the quality and safety of the service was monitored. An internal quality assessment tool (IQAT) was used to identify actions required to improve the quality of service people received. Checks and audits of the service were routinely undertaken which included medicine administration, fire safety and infection control.

People were happy and relaxed in the home. During our visit we observed people approaching staff for support and laughing and sharing jokes. Staff spoke with people in a caring and considerate manner responding to requests for support without hesitation.

People were encouraged to take part in activities both outside and in the home. This included going to weekly day services as well as going out for lunch and day trips. People were also supported to be involved in day to day living skills such as cooking, cleaning and shopping if they wished to.

Staff understood their responsibilities to keep people safe and were able to describe what actions they would take if they had any concerns. Staff told us they would not hesitate to report any concerns to senior staff. Where required any concerns raised had been reported to the local authority and CQC.

Assessments had been completed to identify risks to people’s safety and guidance put in place to minimise these risks. People’s care and support needs were fully described in people’s care plans. Care records were regularly reviewed and updated as necessary. Where necessary health professionals had been contacted by staff for support and guidance to ensure people received on-going health care.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Care plans included detailed information on the least restrictive options to support people.

Medicines were stored securely and audits were undertaken weekly to ensure that stocks of medicines and medicines records were accurate. People received their medicines as prescribed. Where people required ‘as necessary’ medicines, the protocols for these were written specifically for the person.

People were supported to eat a varied diet to include their food preferences. Where required people had access to specialist diets and their fluid intake was also monitored to ensure they drank enough. People we spoke with said they liked the food choices.

There were sufficient numbers of staff available to meet people’s needs. During our visit we observed that staff took time to support people with no one being rushed. The service followed safe recruitment practices. People were supported by staff who access to a range of training to ensure they had the correct knowledge and skills to meet people’s needs. Staff we spoke with said they felt supported and were positive about working within the service.

5 Elcot Close provides accommodation for up to five people with a learning disability. The service is one of many, run by the White Horse Care Trust within Wiltshire and Swindon. At the time of our inspection five people were living in the home.

The inspection took place on 13 August 2015. This was an unannounced inspection. During our last inspection in October 2013 we found the provider satisfied the legal requirements in the areas that we looked at.

The previous registered manager had recently left the service and the provider was in the process of recruiting a new manager. The home was being overseen by two area care managers and an interim manager who was supported by a deputy 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.

Whilst there were arrangements in place for keeping the home clean and hygienic to ensure people were protected from the risk of infections, we observed that dining room seating was worn down to the cushion. This meant that if there were any spillages the seating could not be wiped clean to prevent cross contamination.

Throughout the day we saw staff interacting with people with kindness and in a friendly manner. Staff always informed people about what was going to happen next, seeking consent before proceeding with any care or support. People who were unable to express their views verbally appeared comfortable with the staff who supported them. We saw people smiling and laughing with staff when they were approached.

Care staff demonstrated a good understanding of people’s care needs. Staff were knowledgeable of people’s daily routines and preferences.

People were supported to eat a balanced diet. There were arrangements for people to access specialist diets where required. There were snacks and drinks available throughout the day during our inspection.

People’s medicines were managed appropriately so people received them safely.

The interim manager and staff had knowledge of the Mental Capacity Act 2005. The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, and Deprivation of Liberty Safeguards (DoLS).

There were enough staff deployed to fully meet people’s health and social care needs. The provider had systems in place to ensure safe recruitment practices were followed.

There were systems in place to respond to any emergencies or untoward events. The interim manager and provider had systems in place to monitor the quality of service people received.

Not all people who used the service used verbal speech but communicated by using gestures, body language and facial expression. Due to this, we were only able to gain limited verbal feedback about people’s experiences of the service. We observed people's overall wellbeing and their interactions with staff as a means to make a judgement about service provision.

People looked well supported in relation to their personal care needs. They were involved in the day-to-day running of the home and enjoyed varied leisure activities. People had access to a range of health care services to meet their health care needs. Staff were aware of people’s nutritional requirements and there was an emphasis on people receiving healthy, balanced meals of their choice.

The home was spacious and light. All areas were homely, clean and well maintained. Bedrooms were personalised and reflected people’s individual interests and preferences. Systems were in place to maintain the safety of the environment.

Staff interacted with people well and positive relationships were evident. Staff felt well supported by each other and the manager. They were positive about the training in place and felt it equipped them to do their job effectively.

People had detailed support plans, which identified their needs and the support they required. Other records demonstrated the range of management systems within the home. Records were organised, up to date and stored appropriately.

Five people live in the home. We spoke to three people and observed the care of everybody during the course of the day. We spoke with three members of staff, the deputy manager and the manager.

We saw that wherever possible people were asked for their consent before care was given. Where people were unable to give consent verbally, staff looked for indications of consent based on their knowledge of their likes and dislikes. We saw that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. All of the records we saw were highly person-centred, putting people at the heart of care.

Arrangements were in place to ensure that medication practice was being carried out safely and that people were encouraged to take responsibility for their own medication as far as possible.

Staff were suitably experienced and skilled to support people living in the home, who had benefited from a stable staff team who have come to know them well. One member of staff said it was “an honourable job” and all staff we spoke with talked with respect and affection about the people they cared for.

There was an effective complaints procedure that was available in alternative presentations. This meant that it was more understandable for people who cannot understand the written word. A relative had written in the complaints and compliments log, complimenting staff for all their hard work.

We spent time with the people who lived at the home and asked them how they enjoyed living there. Most people had limited capacity to provide meaningful feedback about the service but they told us they were happy and that the staff were kind. We observed that people were clean, well presented and appropriately dressed, and they were happy and relaxed in the company of staff that they knew. We joined them for lunch and witnessed friendly and informal banter which helped to make the mealtime a pleasurable experience.

We spoke to three relatives on the telephone. One person told us: “It is a very good home. X is very happy there and has built up very good relationships with the staff. They told us that they had had some concerns about issues of personal hygiene but they had spoken to staff and had been assured that the concerns would be acted upon. Another relative said “Staff have been absolutely wonderful; I cannot praise them enough. Y’s life has been totally transformed since they moved there. We are eternally grateful and we wouldn’t want Y to be anywhere else.” They spoke very positively about the staff, saying “the way that they interact with people is amazing”.