The inspection of Whitwood Hall took place on 14 January 2019 and was unannounced. Whitwood Hall is a ‘care home’, known locally as “The Hall”. 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.

Whitwood Hall accommodates 16 people across three separate units, each of which have separate adapted facilities. The home supports people with autism, learning disabilities, complex needs and behaviours which may challenge. On the day we inspected 13 people were living at Whitwood Hall.

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.

There was a registered manager at the service. 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 drove the service with a strong vision to enable people to live fulfilled lives as independently as possible. There was a transparent culture and staff were confident in discussing issues or incidents in an open culture which promoted improvement. Excellent teamwork and communication was embedded across the home, with all staff having a clear understanding of each person’s role.

People were supported to take positive risks and be as independent as possible. People were enabled through encouragement and incentives to be as independent as possible and undertake as much as possible for themselves. All risk assessments were detailed and ensured people faced the minimal level of restriction. We found numerous examples where people had been supported out of their usual routines and encouraged to try new experiences.

People were enabled to participate in their preferred daily living activities at the times they wanted due to the exceptional staffing levels, which gave ample capacity to ensure people could go out whenever they wished. The service had actively sought to obtain mobility vehicles to ensure people who enjoyed car rides could do so at their preferred time rather than having to wait for the company vehicle.

Staff’s skills ensured hospital admissions due to people’s complex behavioural needs had been minimised. The service provided effective advocacy to support people receiving access to treatment.

The number of success stories shared with us showed people were at the heart of the service and celebrated achievements. Care documentation reflected people’s needs thoroughly and were constantly reviewed to reflect changes to people’s needs.

Staff were highly empathetic and knew people really well. Staff were extremely attentive, kind and compassionate. They also demonstrated how much they liked working with people in the service and had a strong focus on providing an atmosphere like any family home. Staff were calm and unobtrusive, allowing the person to be the focus of attention and promoting their equality. Staff were extremely knowledgeable and confident in ensuring better outcomes for people.

We found staff promoted privacy and respected dignity as this was embedded practice. The registered manager took an innovative approach to training in this area.

The quality assurance systems in place encouraged continual reflection and review of support provision, all with the ultimate goal of improving people’s lives. Holistic assessments of people ensured all aspects of support were in the best interests of the person and staff knew how to provide

The inspection of Whitwood Hall took place on 11 May 2016. The inspection was unannounced. We previously inspected the service on 18 and 19 February 2015 and at that time we found the provider was not meeting the regulations relating to safeguarding people from abuse. On this inspection we checked and found improvements had been made.

Whitwood Hall is a residential care home for adults who have a learning disability and behaviour that challenges. It consists of three units, each one providing care and support for individuals with different levels of need.

The service is required to have 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. The service did not have a registered manager. The manager had applied to register with CQC, but at the time of the inspection the application had not been finalised.

People who used the service told us they felt safe at Whitwood Hall. Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

Effective recruitment and selection processes were in place and medicines were managed in a safe way for people.

There were enough staff to provide a good level of interaction. Staff had received an induction, supervision, appraisal and role specific training. This ensured they had the knowledge and skills to support the people who used the service.

People’s capacity was always considered when decisions needed to be made. This helped ensure people’s rights were protected in line with legislation and guidance.

People were supported to eat a balanced diet and meals were planned on an individual basis.

Staff were caring and supported people in a way that maintained their dignity and privacy.

People were supported to be as independent as possible throughout their daily lives.

The service was led by each individual’s goals and aspirations. Individual needs were assessed and met through the development of detailed personalised care plans and risk assessments.

People and their representatives were involved in care planning and reviews. People’s needs were reviewed as soon as their situation changed.

People engaged in social activities which were person centred. Care plans illustrated consideration of people’s social life which included measures to protect them from social isolation.

Systems were in place to ensure complaints were encouraged, explored and responded to in good time and people told us staff were always approachable.

The culture of the organisation was open and transparent. The manager was visible in the service and knew the needs of the people who used the service.

People who used the service, their representatives and staff were asked for their views about the service and they were acted on.

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of the people were met and that the service provided was to a high standard.

We saw that residents were encouraged to make decisions for themselves wherever this was possible. Assessments of mental capacity, and best interest decisions, were being made. We saw that the views of residents were taken in to account, and that relatives also felt included in decision making.

We saw that a range of care needs assessments had been carried out, and both appropriate and up to date care plans were in place. We saw care assessments which considered a broad and holistic range of needs. Each of the three staff members we spoke with would recommend Whitwood Hall to family and friends.

We were told all staff members had received safeguarding training. The three staff members we spoke with confirmed this and each could explain to us different types of abuse, and what they would do if they had concerns about a person's safety and welfare. All three staff were confident that if any safeguarding concerns were brought to the attention of managers they would be taken seriously.

We found evidence that Whitwood Hall worked with a range of other services and professionals to ensure the needs of its residents were being met.

We saw that an appropriate staff recruitment process was in place to ensure only persons fit and appropriate were employed.

We saw that Whitwood Hall had a range of up to date records, not only relating to the care needs of residents, but to the overall management and safety of the home.

This inspection took place over two days on 18 and 19 February 2015. The first day of the inspection was unannounced and the second day was announced. At the last inspection in May 2013 we found the provider was meeting the regulations we looked at. At this inspection we found the provider was in breach of regulation relating to safeguarding people from abuse.

Whitwood Hall is registered to provide accommodation and personal care for up to 16 people with a learning disability. The service is divided into three units. 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.

People we spoke with told us staff were caring. People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. They engaged in social activities which were person centred. Professionals told us the service provided very good care and support.

People told us they felt safe and didn’t have any concerns about the care they received. However, there was a risk to people’s safety because safeguarding procedures were not always followed.

Some incidents between people who used the service had not been reported to the appropriate agencies. Other safeguarding incidents were reported and staff had a good understanding safeguarding processes that were relevant to them. The provider had systems in place to manage risk so people felt safe and also had the most freedom possible.

There were enough staff to keep people safe. Robust recruitment and selection procedures were in place to make sure suitable staff worked with people who used the service. Staff were skilled and experienced to meet people’s needs because they received appropriate training, supervision and appraisal.

The home’s management team promoted quality and safety and had good systems in place to help ensure this was achieved. They worked alongside everyone so understood what happened in the service. The provider did not always check everything was in place. People’s feedback about the service was not always sought. The provider told us they were going to improve some of their systems to ensure they were monitoring the service effectively.

You can see the action we have told the provider to take at the end of this report.