Options Watermill House

Options Watermill House is a care home providing accommodation and personal care for up to ten younger adults with a learning disability, autistic spectrum disorder and associated complex needs. Options Watermill House consists of two separate buildings, the house and the bungalow. Those living in the house have their own en-suites and quiet spaces. People are encouraged to personalise these areas. They share access to kitchen, lounges, and dining facilities. There is also a fully equipped single occupancy flat within the house.

The bungalow has four independent, high quality single occupancy flats. This means those who use the service have the opportunity to practice independence skills and develop these with a view to moving to more independent living at a future date, should they wish to do so. Every flat has access to a patio or garden area. People who use the service have access to the other facilities on site which include; a sports hall, an activity barn, a woodland area, sensory room, computer room, external gardening, hydrotherapy pool and specialist outdoor activity equipment.

Options Watermill House is a 'care 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. At the time of our inspection there were 9 people living at the service.

At our last inspection in November 2015 we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that showed 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.

There was a registered manager in place 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.

Options Watermill House have maintained and further developed the outstanding model of care and support provided to those who live in the service, which underpins the values of Registering the Right Support. The service is extremely committed to person-centred planning making every effort to assist people to be involved in and understand decisions about their care and support to enhance their self- esteem, quality of life and confidence.

Staff were compassionate and kind and went 'above and beyond' to ensure people received positive outcomes. Recruitment processes were robust to ensure prospective staff had the right skills and were

suitable to work with vulnerable people. Staff had regular supervision and their personal performance was evaluated at an annual appraisal. Staff were very well qualified, competent and had extensive training based on best practice and guidance, to equip them with the skills and knowledge needed to support people extremely effectively.

The service continued to support an extremely person-centred approach, care plans were comprehensive and showed people whose behaviour had previously isolated them, had been supported by the service to develop new skills and successfully become involved in their local community and achieve extremely positive outcomes. For example, one person had particularly high needs regarding their behaviour, when they first arrived at Options Watermill House other providers had stated they could not meet their complex needs. Staff had worked tirelessly with the person to improve their quality of life. Relatives and professionals told us they were amazed by how stable and content the person had become and these improvements were due to the dedicated and caring staff and the support the person receives at the home. They have recently moved to their own flat and this is working extremely well.

The strong person-centred culture continued to be a driving force in delivering an exceptionally consistent approach to support and enabled people to try new things and to make positive changes in their lives. Each person who used the service played a very active role in developing their individualised programmes of care and personal development and their individual choices were fully respected. Staff supported them in the least restrictive way possible. Positive risk taking was encouraged throughout the organisation, balancing the potential benefits and risks of choosing one action over others, to support people to live as ordinary a way of life as possible.

Staff spoke consistently and passionately about the service being a good to place to work and described working together as a team, dedicated to person-centred care, helping people to achieve their full potential. They [staff] also spoke about the support they received from their manager and colleagues, describing the registered manager as very approachable, available, and supportive and that people were at the heart of the service. Staffing flexibility allowed people to live independent, fulfilled lives and helped them to reach their full potential. The philosophy of the organisation was thoroughly embedded throughout the service.

The registered manager and the staff took the safety of people who used the service very seriously and were fully aware of their responsibilities to protect people's health and well-being. Extensive systems were in place to reduce the risk of harm including medication which was managed well and the staff had detailed knowledge of the system in place. The environment was well maintained and all required safety checks completed.

Complaints were investigated and resolved whenever possible to the complainant's satisfaction and any lessons learnt shared with staff.

The five questions we ask about services and what we found