Whitworth Lodge is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Whitworth Lodge accommodates up to six people with a learning disability in one adapted building. 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. At the time of this inspection there were six people using the service.

This inspection took place on 2 October 2018. At our last comprehensive inspection of the service in August 2017 we gave the service an overall rating of ‘requires improvement’. This was because the provider did not always make records relating to people's capacity to consent to or agree to the care provided. The provider had not always notified CQC or other external organisations, as required, of significant events or incidents involving people and staff. And, systems were not in place to record accidents and incidents consistently. As a result, we identified that arrangements to monitor the service were not always robust as they had not identified the issues we found during that inspection.

At this inspection we found the provider had used the learning from the previous inspection to make improvements at the service. People’s capacity to make decisions about their care had been documented in their records. People’s relatives and relevant healthcare professionals had been involved in making decisions in people's best interests, where people lacked capacity to do so, and these decisions were also documented. Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and supported people in the least restrictive way possible. The policies and systems in the service supported this practice.

The service continued to have a registered manager in post who was fully aware of their registration responsibilities particularly with regards to submission of statutory notifications about key events that occurred at the service. Our records showed these had been submitted when required and in a timely way.

The provider had introduced a standardised reporting system for accidents and incidents to ensure clear and consist records were maintained as well as support the service to improve from any lessons learnt. When things went wrong the provider acted to make improvements. We saw improvements had been made following an incident involving a person to help reduce the risk of a similar incident reoccurring.

The provider had enhanced their arrangements for monitoring and assessing the safety and quality of the service. Senior manager’s audits were now recorded which gave a clear picture of any improvements that were needed. The registered manager undertook regular checks of key aspects of the service and acted to make improvements when required. Records relating to people, staff and to the management of the service were accurate, up to date and well maintained

Staff knew how to safeguard people from the risk of abuse and how to report any concerns about people to the appropriate person and agencies. Staff understood the risks posed to people and followed current guidance about how these should be minimised to keep people safe from injury or harm.

Risks posed by the premises were appropriately managed. The provider maintained a servicing programme of the premises and the equipment to ensure areas covered by these checks did not pose unnecessary risks to people. Since our last inspection they had improved arrangements relating to checks of water hygiene to prevent legionella accumulating in the water system. The premises were clean. Staff followed good practice to ensure risks to people were minimised from poor hygiene and cleanliness when providing personal care, c

This inspection took place on 31 August 2017 and was unannounced. At our last announced comprehensive inspection of this service on 9 June 2015 we rated the service ‘good’.

Whitworth Lodge provides care and accommodation for up to six people with a learning disability, some of whom also have autism. Some people had behaviours which challenged the service in various ways. There were six people using the service at the time of our inspection.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

The provider did not always enable bodies, including CQC, to carry out their regulatory duties in monitoring the service provided to people. This was because the provider did not always notify external bodies of significant events as required by law. The provider did not have systems in place to ensure all relevant information about accidents and incidents were consistently recorded as they had no template in place. The provider had systems in place to assess, monitor and improve the service, although these had not identified the issues we found during out inspection.

Staff understood their responsibilities to provide care to people in line with the Mental Capacity Act (MCA) 2005. However, the provider had not always recorded their assessments for significant decisions to evidence they followed the code of practice. In addition, the provider did not always formally record discussions held with family members and others involved in people’s care in relation to best interests decision making, in accordance with the MCA. The provider told us they would review their processes in relation to MCA as soon as possible. People were only deprived of their liberty when this was required as part of keeping them safe and authorisation was granted from the local authority.

Risks to people were mitigated because the provider identified and assessed risks and put suitable management plans in place for staff to follow in caring for people safely.

People were safeguarded from abuse and neglect by the provider as staff received relevant training and understood how to identify and respond to allegations appropriately.

People lived in a service which was maintained by the provider. Staff and external contractors carried out regular checks relating to the safety of the premises. The provider agreed to contract a specialist to carry out a risk assessment to further mitigate the risks of Legionella accumulating in the water system.

The provider recruited staff following robust procedures to check they were suitable to work with people. In addition there were enough staff deployed to meet people’s needs. Medicines management was safe and the provider carried out sufficient audits to check medicines safety.

People received care from staff who were supported with a suitable programme of training, support and supervision. People received the support they required in relation to eating and drinking and the provider supported people to access the healthcare services they needed.

People were treated with kindness, dignity and respect by staff. Staff understood the needs of the people they were caring for as well as their interests, preferences and the best ways to communicate with them. Staff supported people to maintain their independence. People were involved in decisions about their care and were supported to maintain relationships with people who were important to them.

People were cared for in a way that was responsive to their needs. In addition people were involved in planning and reviewing their care. People were supported to access activities they were interested in. The provider encouraged feedback from people and the

This inspection took place on the 9 June 2015 and was unannounced. There had been a change of ownership since our last inspection and the new provider registered with us in October 2014.

Whitworth Lodge provides care and accommodation for up to six people who have learning disabilities. The service also supports people who have behaviours that may challenge the care services that they require. There were five people using the service at the time of our inspection.

There was a registered manager in post who had worked in the home for over five years. 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 and their relatives told us they felt safe at Whitworth Lodge. Staff knew the correct procedures to follow if they considered someone was at risk of harm or abuse. They received appropriate safeguarding training and there were policies and procedures to support them in their role.

People’s rights were protected because the provider acted in accordance with the Mental Capacity Act 2005. This is legislation that protects people who are not able to consent to care and support, and ensures people are not unlawfully restricted of their freedom or liberty. The manager and staff understood the requirements and took appropriate action where a person may be deprived of their liberty.

People’s needs were regularly assessed, monitored and reviewed to make sure the care was current and relevant. The care records were person centred and descriptive, ensuring staff had specific information about how they should support people. Care records included guidance for staff to safely support people by reducing risks to their health and welfare.

People were supported to keep healthy. Any changes to their health or wellbeing were acted upon and referrals were made to social and health care professionals to help keep people safe and well. Accidents and incidents were responded to quickly. Medicines were managed safely and people had their medicines at the times they needed them.

Staff recruitment practices helped ensure that people were protected from unsafe care. There were enough qualified and skilled staff at the service and staff received ongoing training and management support. Staff had a range of training specific to the needs of people they supported. This included managing behaviour that might challenge the services people require.

People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff.

Staff were patient, attentive and caring in their approach; they took time to listen and to respond in a way that the person they engaged with understood. They respected people’s privacy and upheld their dignity when providing care and support.

People were provided with a range of activities in and outside the service which met their individual needs and interests. Individuals were also supported to maintain relationships with their relatives and friends.

There was an open and inclusive atmosphere in the service and the manager showed effective leadership. People, their relatives and staff were provided with opportunities to make their wishes known and to have their voice heard. Staff spoke positively about how the registered manager worked with them and encouraged team working.

The provider completed a range of audits in order to monitor and improve service delivery. Where improvements were needed or lessons learnt, action was taken.