Wilton House provides residential care for up to 26 adults with learning disabilities. The service comprises of three houses and two bungalows on the same site. The service is situated in the Kimberworth area of Rotherham, with some local facilities such as shops and pubs nearby. It is within easy access to Rotherham town centre. At the time of the inspection 20 people were using the service.

At the last inspection, in June 2015 the service was rated ‘Good’ across each of the five key questions. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Wilton House’ on our website at www.cqc.org.uk’.

At this inspection we found the service remained Good.

Why the service is rated Good.

The service had a registered manager in post at the time of 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.

The service continued to assess, plan for and meet people’s individual and changing needs and people were involved in making decisions about their care and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The service continued to provide safe care. There were sufficient numbers of staff available to keep people safe and there was an effective staff recruitment process in place. Staff were appropriately trained and supervised to provide care and support to the people who used the service.

Staff had a clear understanding of safeguarding adults and care and support was planned and delivered in a way that ensured people were safe, without restricting people’s freedom.

People were supported to receive a healthy diet and were supported to have access to relevant healthcare services to support their health needs.

People's privacy, dignity and independence were maintained by staff who were caring and respectful. Staff knew the people they were supporting and provided a person centred, personalised service.

There were systems in place to continuously assess and monitor the quality of the service, with a strong emphasis on promoting and sustaining improvements.

Further information is in the detailed findings below.

The inspection took place on 23 June 2015 and was unannounced. Our last scheduled inspection at this service took place in April 2014 when one breach of legal a requirement was identified. This was in relation to medicine management. The provider sent us an action plan and we completed a follow up inspection to check actions had been completed. This took place in September 2014 and the service was meeting requirements.

Wilton House – Steps Residential Care provides residential care for up to 26 adults with learning disabilities. The service comprises of three houses and two bungalows on the same site. The local park can be accessed from the rear of the properties by a garden gate. The service is situated in the Kimberworth area of Rotherham, with some local facilities such as shops and pubs nearby. It is within easy access to Rotherham town centre.

The service had a registered manager in post at the time of 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.

We spoke with staff who had a clear understanding of safeguarding adults and what action they would take if they suspected abuse. Staff we spoke with were confident the manager would act appropriately to safeguard people from abuse. Posters were displayed around the service with contacts for the local council safeguarding team.

Care and support was planned and delivered in a way that ensured people were safe. The support plans we looked at included risk assessments which identified any risk associated with

people’s care. We saw risk assessments had been devised to help minimise and monitor the risk.

We spoke with staff and people who used the service and found there were enough staff with the right skills, knowledge and experience to meet people’s needs. This was flexible to support the activities and interest’s people took part in.

People were supported to have their assessed needs, preferences and choices met by staff who had the necessary skills and knowledge. Staff we spoke with told us they received appropriate training which made them confident to do their job.

We found the service to be meeting the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had some knowledge of this and said they would speak to the registered manager for further advice.

People were involved in menu planning, shopping and meal preparation. We saw snacks were available throughout the day and people had access to drinks as they wanted them.

People were supported to maintain good health, have access to healthcare services and received on-going healthcare support. We looked at people’s records and found they had received support from healthcare professionals when required.

People who used the service were supported to maintain friendships. Support plans contained information about their family and friends and those who were important to them.

We saw staff were aware of people’s needs and the best ways to support them, whilst maintaining their independence.

People’s needs were assessed and care and support was planned and delivered in line with their individual support plan. The support plans were person centred and some contained pictures to assist the person to understand their plan. Support plans included information about healthcare, communication, personal hygiene, mobility and activities.

The service had a complaints procedure and people knew how to raise concerns.

Staff we spoke with felt the service was well led and the registered manager was approachable and listened to them. Staff confirmed they knew their role within the organisation and the role of others. They knew what was expected of them and took accountability at their level.

Our inspections look at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? This was a follow up inspection which looked at whether the service was safe.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, relatives, and the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that people were protected from the risks associated with medicines

because the provider had appropriate arrangements in place to manage medicines. We saw that some medication was recorded on the Medication Administration Record (MAR). Audits were in place to ensure any issues were identified and rectified.

Our inspection looked at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations, speaking with people who used the service, speaking with staff supporting them and looking at records.

If you want to see the evidence supporting our summary, please read the full report.

Is the service safe?

People were cared for and supported in line with their assessed needs. We spoke with people who used the service and they felt able to raise any concerns with the staff or the manager. They were confident that they would resolve any issues.

We observed staff and saw they respected people and offered choices suitable to their needs.

We saw that audits were in place to monitor the service. We found that medication audits did not reflect our findings.

We saw that medication was not always stored or administered in a safe way.

Is the service effective?

People’s health and care needs were assessed and care plans were designed to meet the needs of people who used the service. People felt that they were involved in their care.

Each person had a key worker who was responsible for their care. They ensured the care plans were still relevant to meet people’s needs.

Is the service caring?

We observed staff interacting with people who used the service and saw that they were caring and kind in their approach. Care plans included people’s interests, likes and dislikes. This ensured that people’s preferences were considered as part of their care and that life history had been used effectively.

We spoke with people who used the service who told us that they felt they were cared for appropriately. One person said, “I get on well with the staff, I can tell them about anything.”

Is the service responsive?

Social events and daily activities for people who used the service were planned on a daily basis and in conjunction with their commitments. Activities were based on people’s likes and interests. We spoke with people who used the service and they said they had enjoyed Easter Sunday lunch at a local pub.

We spoke with people who used the service who told us they felt able to discuss anything with the manager or the staff. One person said, “I can talk to the staff and they know what I like. We have chats about my care and how to help me.”

Is the service well-led?

The manager sought the views of people who used the service in order to improve. House meetings took place on a regular basis and people felt able to contribute.

There was a quality assurance system in place which was completed on a six monthly basis. The registered manager acted on suggestions made and discussed the outcome of the survey with people who used the service and their relatives.

Although audits took place and actions were identified we could not always see where the actions had been achieved. Some audits did not reflect our findings.

Before people received care and treatment they were asked for their consent and the provider acted in accordance with their wishes. The appropriate procedure was followed where people were not able to give consent.

People who used the service had a care plan which was person centred and relevant to their individual needs. We spoke with three people who used the service, three relatives and four staff. One person who used the service said, “It’s lovely here, I really do enjoy it.” A relative said, “I am totally at ease with my relative living at Wilton House, it’s one big happy family.”

People were supported to be able to eat and drink sufficient amounts to meet their needs. People we spoke with said that the food was really nice and they enjoyed helping to prepare it.

People were cared for in a clean and hygienic environment.

We found that the provider had an effective recruitment procedure in place. Appropriate checks were undertaken before staff began work.

The provider had an effective system in place to regularly assess and monitor the quality of service that people receive.

We spoke to people who used the service but their comments were not in relation to this outcome.

We found that people who used the service had a clear care record which identified their individual needs. Care records were person centred and available in an easy read format.

We found that the provider had records in place to record staff training and supervision.

There were also records in place which were used to record quality audits regarding the service. The manager and the senior staff were completing these records on a regular basis.

We spoke to three people who used the service and they told us that staff were very kind and supportive. They told us that staff had supported them to go on several outings and they particularly enjoyed a zumba class. One person said “I go to bed late so that I can spend time with my family”. Another person said “I enjoy menu planning and going to the shops for food”. People who used the service felt that staff gave them space and respected their privacy.

We spoke with two relatives who were very satisfied with the service and felt that the staff were very approachable.