United Response - 14 Lingwell Approach

The service is registered to provide accommodation and personal care for up to four people who have learning disabilities and or physical disabilities.

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.

This inspection took place on 24 and 25 September 2018. The inspection was unannounced on the first day. This meant the staff and provider did not know we would be visiting. The second day was announced.

There was a registered manager. A registered manager is a person who has registered with the CQC 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 our last inspection we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We observed people living in the home were safe and relatives told us staff kept people safe. Staff received training on safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.

Risk assessments were carried out, reviewed and updated when people's needs changed. We found the provider monitored risk effectively and in the least restrictive way. Accidents and incidents were recorded and appropriate action taken to reduce the risk of reoccurrence.

Medicines were managed safely. They were checked regularly and audits carried out to ensure people received their medicines as prescribed. 'As required' medicines were managed appropriately with guidance in place for staff to follow.

Safe recruitment processes were in place and had been followed. Pre-employment checks on employees were completed that helped to minimise the risk of unsuitable staff from working with adults at risk. Records

confirmed staff received induction training when they were new in post.

Staff received training which helped them to meet people's needs and staff told us there was enough training to meet people's needs.

We checked and found the provider was working within the principles of the MCA and all people using the service had a DOLs in place. Best interest decisions also took place and were documented in care plans.

People were supported with their nutritional needs and specific dietary requirements. If requiring support from health care professionals, this was arranged for people and they were supported to attend hospital if needed.

We observed positive interactions between staff and people living in the home. We saw people were encouraged to maintain relations with their family and friends.

Care plans recorded people's preferences, likes and dislikes to ensure staff met their individualised needs. These were reviewed regularly with people and their relatives. Due to people's complex needs staff ensured detailed communication plans were in place to support people to consent and make choices about their care.

Staff protected people's rights for privacy and respected these. People were encouraged to remain as independent as possible and relatives confirmed this.

The provider had not received any complaints since our last inspection. The registered manager understood the importance of how these would be managed in line with their policy.

Staff and people using the service all had positive relationships with the management. They felt supported and said the registered manager was always present in the home.

Surveys were carried out to gather people's views and to monitor the quality of the service being provided. The provider completed audits to monitor standards and to ensure they were maintained.

The provider was continuously looked at ways to improve care and monthly summaries had been devised to show impact of people's care and areas for improvement.

They ensured people were involved within the local community and initiatives had been taken to make sure this happened. For example, arranging a local fayre and taking people to hairdressers in the local community.

The five questions we ask about services and what we found