Reach Vale Road Chesham

Reach Vale Road is a care home. 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.

Reach Vale Road accommodates six people in one adapted building. It is registered for people with a learning disability. At the time of this inspection five people were living there.

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.'

At the previous inspection on the 17 November 2016 the service was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had failed to act in accordance with the Mental Capacity Act 2005. Records were not up to date, accessible and fit for purpose and effective systems were not in place to audit and monitor the service. We asked the provider to complete an action plan to show what they would do and by when to improve the key questions effective and well-led to at least good. At this inspection we found the provider had made improvements to comply with those regulations.

People and their relatives were happy with the care provided. They felt their family members received safe care from staff members who were well supported by the registered manager. They described Reach Vale Road as "home from home."

We found the home provided safe, effective, caring, responsive care to people in a service that was well-led.

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.

People had care plans in place which provided detailed guidance to staff on the support people required. People's records were suitably maintained. Further improvements to records were identified and planned.

Systems were in place to safeguard people. People were provided with the information and opportunities to raise concerns. Risks to people were identified and managed. Accident and incidents were appropriately responded to and reported on which enabled trends and reoccurrences to be picked up and addressed.

People's health and nutritional needs were met. They had access to other health professionals and were

supported to take their medicines. Safe medicine practices were promoted.

People had access to activities and whilst there had been a decline in people accessing community activities this was recognised and being addressed.

Staff were kind, caring and had a positive relationship with people. They had a good understanding of people's needs. Staff were developing communication with people by use of signs and pictures to further promote people's understanding and involvement.

The home had a number of staff vacancies which they were attempting to recruit into. The required staffing levels were maintained and regular agency staff were used to cover shifts to promote continuity of care for people.

The home was clean and suitably maintained. Systems were in place to ensure equipment was safe to use and that infection control risks were minimised. People were provided with equipment to promote their safety and independence.

Staff were suitably recruited, inducted and trained to fulfil their roles. They received support from the registered manager and one to one supervision meetings with staff took place. The registered manager recognised this was not at the frequency outlined by the provider and was looking to improve the frequency of those meetings.

The provider had systems in place to gain feedback on the care provided. They had improved their auditing systems which showed issues were picked up and addressed to promote safe care to people.

The registered manager was a positive role model. They had developed in their role and confidence. They were committed to the home and to improving the service. They worked closely with staff in supporting individuals. Relatives were very complimentary of the registered manager. They told us [registered manager's name] was the best manager the home had ever had. They described the registered manager as "Always accessible, brilliant, honest, open, gentle, kind, empathic and showed compassion."

The five questions we ask about services and what we found