Insight Walderslade

The home provides care and support for up to six people with learning disabilities and/or autism. Some were at higher risk of presenting challenging behaviours which may harm themselves or others. However, staff had the skills and training to support people to participate as equals in their community, living within an ordinary home. At the time of our inspection there were six people living at the home. The accommodation was split over two floors with bedrooms on the ground floor and first floor.

A registered manager was employed at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. The manager understood when an application should be made. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.

The provider's operational policy about planning for emergencies was not specific to the home. It was generic and did not ensure that managers and staff in the home would understand how to continue people's care, should the home be evacuated in an emergency. We have made a recommendation about this.

Incidents and accidents were recorded and checked by the registered manager and the provider's to see what steps could be taken to prevent these happening again. Staff were trained about the safe management of people with behaviours that may harm themselves or others. However, reportable incidents had not been appropriately reported. We have made a recommendation about this.

People were kept safe by staff who understood their responsibilities to protect people living with learning disabilities and autism. Each person had a key worker who assisted them to learn about safety issues such as how to evacuate the building in an emergency and to speak to if they felt unsafe. The registered manager had plans in place to ensure that people who may not understand what to do would be individually supported by a member of staff if there was an emergency. Staff had received training about protecting people from abuse. The management team had access to and understood the safeguarding policies of the local authority and followed the safeguarding processes.

The manager and care staff used their experience and knowledge of caring for people with learning disabilities and complex needs effectively. Staff assessed people as individuals so that they understood how

they planned people's care to maintain their safety, health and wellbeing. Risks were assessed within the home, both to individual people and for the wider risk from the environment. Staff understood the steps to be taken to minimise risk when they were identified. The provider's policies and management plans were implemented by staff to protect people from harm.

There were policies and procedures in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely. Where people could retain the information, they had been supported to understand what their medicines were for and when they needed to take them. This was reinforced by staff who administered medicines.

People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell. Good quality records were kept to assist people to monitor and maintain their health. Staff had been trained to assist people to manage the daily health challenges they faced from conditions such as epilepsy and diabetes. People had been supported to understand their health conditions and had been given information to help them manage their own health and wellbeing.

We observed and people described a home that was welcoming and friendly. Staff provided friendly compassionate care and support. People were encouraged to get involved in how their care was planned and delivered. Staff were deployed to enable people to participate in community life, both within the home and in the wider community.

Staff upheld people's right to choose who was involved in their care and people's right to do things for themselves was respected. We observed people being consulted about their care and staff being flexible to request made by people to change routines and activities at short notice.

The manager involved people in planning their care by assessing their needs when they first moved in and then by asking people if they were happy with the care they received. Staff knew people well and people had been asked about who they were and about their life experiences. People could involve relatives or others who were important to them when they chose the care they wanted. This helped staff deliver care to people as individuals.

Recruitment policies were in place. Safe recruitment practices had been followed before staff started working at the home. The manager recruited staff with relevant experience and the right attitude to work well with people who had learning disabilities and autism. New staff and existing staff were given extensive induction and on-going training which included information specific to learning disability services.

Staff received supervisions and training to assist them to deliver a good quality service and to further develop their skills. Staff had specialised, on-going training about managing behaviours and physical interventions to protect themselves and others from harm. Staffing levels were kept under constant review as people's needs changed. The manager ensured that they employed enough staff to meet people's assessed needs.

Staff understood the challenges people faced and supported people to maintain their health by ensuring people had enough to eat and drink. People were supported to make healthy lifestyle choices around eating and drinking.

The manager produced information about how to complain in formats to help those with poor communication skills to understand how to complain. This included people being asked frequently if they were unhappy about anything in the home. If people complained, they were listened to and the registered

manager made changes or suggested solutions that people were happy with. The actions taken were fed back to people.

The registered manager and the deputy manager had demonstrated a desire to deliver a good quality service to people by constantly listening to people and improving how the service was delivered. People and staff felt that the home was well led. They told us that managers were approachable and listened to their views. The registered manager of the home and other senior managers provided good leadership. The provider and registered manager developed business plans to improve the service.

The five questions we ask about services and what we found