Wingfield Road

This inspection took place on 11 April 2018 and was unannounced.

At Wingfield Road staff can support five adults with learning disabilities that were also autistic. The home is registered to provide accommodation personal care for a maximum of five people.

It 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.

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. Registering the Right Support CQC policy.

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.

Safeguarding processes were in place and ensured people at the service were safeguarded from potential abuse. Staff had attended safeguarding training on how to identify the types of abuse and the actions needed where there were concerns of abuse.

Risk management systems were effective. People were supported to take risk safely which enabled them to be independent. The staff we spoke with were knowledgeable about people's individual risks and the actions needed to minimise the risks. Where risks were identified risk assessments were developed on how to minimise the risks.

There were people who expressed their anxiety and frustration using behaviours that placed them and others at risk of harm. Staff had attended training to help them manage these situations. Positive behaviour support plans gave staff guidance on how to respond to people when they expressed feelings of frustration and anxiety.

Staff documented accidents and incidents. Debrief with staff and people took place where the incidents were significant. The registered manager then analysed the reports for patterns and trends.

Steps were taken to ensure medicine systems were safe. People administered their medicines and risk assessments and support plans were in place for this. Where staff administered people's medicines there was a profile which included their photograph and essential information such as known allergies and how the person preferred to take their medicines.

People told us there was staff on duty for them to have the attention they needed. Staff told us the team was stable and people received continuity of care from staff that knew them.

Staff attended training set as mandatory by the provider and there were opportunities for vocational qualifications. Staff told us they received basic mental health training during induction but not specific to one person's medical condition. The registered manager said a staff meeting themed on this topic was to take place.

The people at the service had capacity to make decisions and told us they made all their decisions. The staff we spoke with were knowledgeable about the day to day decisions people made.

Support plans were person centred and reflective of people's preferences. However, we found them to be repetitive and not all the action plans were related to support plan for the same area of need. We saw copies of the updated support plans which included all aspects of needs.

People told us how they kept busy. There were people that had joined groups and attended clubs. One person worked at a farm everyday and another worked on building a shed. One person was in part time employment. While we were at the home one person went on a shopping trip with staff and two people went on a trip for coffee with staff.

We saw people seeking staff attention and reassurance. We observed staff approaching people in a caring manner. For some people the staff used banter to gain their attention. We observed staff support one person to express their discontent with their current situation. We saw staff use an understanding approach and supported them with unravelling their issues.

The staff were knowledgeable about the values of the organization. They knew how these values were embedded into practice. Staff told us the team was stable and they worked well together. They told us the manager was approachable.

Quality Assurance systems were in place. Governance meetings were held with the registered manager and appropriate staff such as the deputy manager, team leader and maintenance staff. At the meeting the outcomes which included audits and events were discussed. Action plans were then devised where outcomes were not met. Copies of the minutes were then sent to senior managers. The registered manager said at the quarterly meetings the reports of unmet outcome were discussed at regional level.

The five questions we ask about services and what we found