The inspection took place on 4 and 14 December 2017 and was unannounced.

Yockleton Grange Residential Home is a 'care home' which provides accommodation and personal care for up to 30 older people, some of whom have a learning disability. At the time of our inspection visit, 21 people were living at the home. People in care homes receive accommodation and nursing or 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.

The service is required to have a registered manager and there was a registered manager in post. 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.

At the last inspection on 18 August 2015, the service was rated Good. At this inspection, we found the service remained Good.

People still felt safe living at Yockleton Grange, and staff understood their individual responsibilities to protect people from abuse, discrimination and avoidable harm. The risks to people had been assessed, recorded and plans were in place to manage these. Staffing levels at the home were monitored and adjusted to ensure people's individual needs could be met safely. People received their medicines safely and as prescribed from trained senior care staff. Appropriate measures were in place to protect people from the risk of infection.

People’s care needs were assessed with them and effective care plans developed. Staff received induction, training and ongoing management support to enable them to work safely and effectively. People had enough to eat and drink and any associated risks were assessed and managed with appropriate specialist input. People had support to access healthcare services whenever needed. People were involved in decision-making about the home environment, and adaptations had been made to keep them safe. People's consent to care was sought and their rights under the Mental Capacity Act 2005 promoted.

Staff adopted a kind and compassionate approach to their work. People were supported to share their views and participate in care planning and reviews. People's rights to privacy and dignity were understood and promoted by staff.

People received care and support that reflected their individual needs and requirements. They had support to participate in stimulating and enjoyable activities. The provider had procedures in place to ensure concerns and complaints were dealt with in a fair and consistent manner. People’s wishes and choices in relation to their end-of-life care were assessed, recorded and acted upon.

The management team promoted an open and inclusive culture within the home, and consulted with people, their relatives and staff about the service. Staff felt well supported, valued and were clear what was expected of them at work. The management team completed audits and checks to assess, monitor and improve the quality of the service people received.

Further information is in the detailed findings below.

The inspection was carried out on 18 August 2015 and was unannounced. At our previous inspection on 4 September 2013 we found that they were meeting the Regulations we assessed them against.

Yockleton Grange is a care home that provides accommodation and personal care for up to 30 older people, some of whom are living with a learning disability.

A registered manager was in post. 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 provider had policies and procedures to ensure that people who could not make decisions for themselves were protected. People’s human rights were protected because staff understood the policies and legislation and how to apply them.

Systems were in place to protect people from harm. All staff had been given training in keeping people safe. Staff were clear about their responsibilities to be aware of and report any incidents of abuse or poor practice immediately.

People told us they felt safe living in the home and believed staff would not let them come to any harm. No-one shared any issues of concern. Accidents and incidents were monitored and reviewed to identify any issues or concerns. People were assessed against a range of potential risks such as poor nutrition, falls, skin damage and mobility.

The registered manager assessed people for their level of dependency and this information was used to determine the number of staff needed to meet people’s needs. The registered manager stated they would increase the number of staff to cover events as necessary.

Suitable recruitment procedures and checks were in place to ensure staff had the right skills to support people at the home. Medicines were handled safely and stored securely.

People told us they were happy with the standard and range of food and drink provided at the home. People were given a choice about what they wanted to eat at each meal. Staff kept records regarding people’s individual dietary requirements and preferences.

People told us they felt the staff knew how to look after them. Staff confirmed they had access to training and development. Regular supervision took place and staff received annual appraisals.

People told us they were very well cared for and spoke highly of the kindness and attention of the registered manager and staff in the home. Staff knew people well and used their knowledge of people’s families and life histories to engage with them. Staff were able to tell us about people’s particular needs and how best to support them. People’s health and wellbeing was monitored and staff regularly referred people to GPs and district nurses.

People and their families were encouraged to express their views and be actively involved in their own care and in the running of the home. There were frequent resident meetings and the registered manager made time to speak with people directly. Information was displayed about the services and activities on offer. Important contact details, such as advocacy services, were made available to people and their visitors to help them maintain their independence.

People told us they rarely had to formally complain about the service. No formal complaint had been raised in the previous 12 months. People were encouraged to make comments and suggestions. A suggestion box was in the foyer.

The provider had a wide range of activities and opportunities for social stimulation, both in the home and in the local community. People told us they were happy with the social activities available to them and said that staff made every attempt to meet individual preferences, as well as providing group activities.

The registered manager provided leadership and ensured there was an open and caring culture in the home. Staff told us they were clear about their roles and responsibilities and were proud of the quality of care they provided and were happy working in the home. They said they felt supported and listened to by the registered manager.

People living in the home spoke very highly of the registered manager and said she was always approachable, kind and had time for them. They said they felt listened to by the registered manager and the staff and were encouraged to express themselves freely. We were told the home had a happy family atmosphere.

Health professionals who supported the home commented very positively on the ability and quality of the management of the home.

There were twenty eight people living in the home on the day we visited. Eleven of these people were being supported with needs relating to their learning disabilities. We met and spoke with over half of the people who lived at the home. We spoke with three visitors, including a health care professional. We also spoke with four members of staff.

Everyone agreed they were happy to be living at the home and were satisfied with the care and support they received. People said that they had been consulted and involved in their care and treatment.

We saw effective arrangements in place which made sure people and their representatives were able to give consent for care and treatment in ways they could understand.

People said that their needs and wishes were identified and staff supported them in ways that they preferred. Our observations supported this. We saw the numerous examples of good care observed at previous inspections had been maintained.

People told us that their medical, personal and emotional care needs were met. We saw people were supported to attend regular health care appointments to keep them well.

We saw effective staff recruitment systems made sure all new employees were checked and were suitable to have contact with vulnerable people. People told us they were supported by a knowledgeable and well trained staff team who knew their care and support needs well.

We saw the service had continued to use their comprehensive quality monitoring tools to ensure that they maintained good quality and safe care. We saw they effectively sought people's views about their care, listened to them, considered their comments and responded to them. This showed they acted positively to make sure the home was run for the benefit of the people living there.

We carried out this review to check on the care and welfare of people using this service. There were 28 people living in the home on the day we visited, and 10 of these people were being supported with their needs relating to their learning disabilities. We met and spoke with over half of the people who lived at the home, three relatives who were visiting and three members of staff. We looked at selected care records, staff files and other records relating to the running of a care home.

People we met told us they were very happy living at the home. Everyone we spoke with said that they had been consulted and involved in their care and treatment. People said that their needs and wishes were identified and staff supported them in ways that they preferred. People told us that their privacy and dignity was always promoted and respected. Our observations supported this and we saw numerous examples of good care.

People's needs were fully assessed and care and treatment was planned and delivered in line with their individual care plan. People told us that their medical, personal and emotional care needs were met. Relatives told us that people received excellent care and support from the staff team. One person told us, “I am truly impressed by the professional care and patience of the staff at Yockleton Grange.”

People were supported to attend regular health care appointments to keep them well. When people’s needs increased or changed there was evidence that the home worked with health and social care professionals to safely and effectively manage the support they required.

We saw that people lived active lives with varying levels of support suited to their needs and choices. People took part in a range of leisure and social activities, both at home and in the local community. People were involved in developing independent living skills as far as they were able. Relatives said they felt included and welcomed to join in the day-to-day goings-on with their family member when they visited the home. People were unanimous that the regular visits from a labrador dog we met during our inspection were very welcome. We saw contact with the affectionate well-trained dog brought a lot of smiles and pleasure to people.

People told us that they felt safe and we saw paperwork which demonstrated how potential hazards were identified and reduced as far as possible. Risks were regularly reviewed and people were helped to be as independent as they could be. Staff were aware of risks, people's rights and their responsibilities in order to enable people to do this.

People told us that they liked the staff that looked after them and they felt safe. Many of the staff had worked at the home for a long period of time. Staff and people living at Yockleton Grange described it as being like “one big family”. We saw care and support was offered by a knowledgeable and well trained staff team who knew people’s needs.

Staff told us they were confident to recognise and report abuse. The registered manager had made sure their staff team were offered a range of training opportunities that were specifically designed to meet the needs of the people that they supported. Staff told us they appreciated the benefit of regular support from the home management because they felt valued and people received good standards of care.

We saw the home had comprehensive quality monitoring tools in use to ensure that they maintained good quality and safe care. They effectively sought people's views about their care and listened to them. Staff told us that the service was always led first and foremost for the benefit of the people who lived there.