Candover House

Candover House is a residential care home that provides personal care to six people with a learning disability. At the time of the inspection six people were using the service.

People's experience of using this service:

Most of the people who used the service were not able to tell us about their experience, but one person and three relatives we spoke with were positive about the service. Risks to people's health and safety were assessed and staff had guidance on how to manage any identified risks. Adult safeguarding procedures were in place and staff knew how to recognise and report incidents of abuse. Staff recruitment processes were robust which meant that staff employed at the service were checked to ensure they were safe to work with people who used the service. There were enough staff to meet people's needs. The registered manager had systems in place to ensure any errors in medicines were addressed and lessons learnt to avoid similar errors.

People and relatives told us staff had knowledge and skills to meet people's needs. Arrangements were in place to ensure staff received supervision and appraisal. Staff supported people to eat and drink. They also supported people to access healthcare. Staff received induction and training and felt supported by the registered manager. We have made a recommendation about staff supervision.

Staff supported people to live as independently as possible by giving them choices and encouraging them to make decisions about their care.

Staff were kind and caring. Relatives told us they listened to them and communication with the service was good. The service was inclusive, and staff had good awareness about equality, diversity and human rights.

Each person had a care plan which identified their needs and how they wanted staff to support them. People benefitted from a range of activities available to them within and outside the care home. The service’s complaints procedure was available to people and their relatives.

The registered manager carried out a range of audits to ensure the service was running well, and areas of improvements were identified and acted on. Relatives and staff gave positive feedback about the registered manager. The registered manager confirmed that they were developing a new survey questionnaire to enable people and relatives to give feedback anonymously.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

At the last inspection on 15 September 2016, (report published on 27, October 2016), the service was rated 'Good'.

Why we inspected:

This was a planned inspection based on their previous inspection rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our reinspection programme. If any concerning information is received, we may inspect sooner.

Candover House provides accommodation and personal care for up to six people with a learning disability. At the time of our inspection there were six people living at the home.

There was a registered manager 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 and associated regulations about how the service is run.

Staff supported people to maintain their interests in the service and in the community. There were different activities for people to engage in. The service also provided enough staff to ensure that people were well cared for and were safe. We noted that the staff were skilled, experienced and trained. The registered manager also provided support and supervision for staff so that they were able to meet people's needs. The service's robust recruitment system meant that people were supported by staff who were appropriately checked and suitable to provide safe care.

The registered manager was outstanding in the ways they worked with healthcare professionals and universities which undertook research activities in areas related to the service. People were involved in research projects relating to epilepsy and positive behavioural management. The findings of these projects were expected to further improve the outcomes people experienced at the service.

The relationships staff established with relatives and advocates ensured that people’s interests were represented in the provision of the service. Staff were knowledgeable about the Mental Capacity Act 2005. We saw that people were offered choices and were supported to make their own decisions.

Care plans and risk assessments were completed and regularly reviewed. These ensured that the service people received reflected and met their current needs. The registered manager had a hands-on approach which meant that people's care was closely monitored. Relatives and staff were satisfied with the management of the service. The auditing processes in place meant that care plans, menus, risk assessments, people's monies, and the health and safety of the premises and equipment were monitored to ensure the service was run appropriately. People and relatives could be confident staff would listen to them and act on their feedback to improve the service.

During the inspection we spoke with one person using the service and observed staff communication with five other people using the service. We spoke with a relative of one person using the service. We also interviewed staff and checked people's care files and the home's various records.

Below is a summary of what people using the service, their relatives and the staff told us and what we observed and what we found in the records we looked at.

If you want to see evidence that supports our summary please read the full report.

Is the service safe?

People who used the service and their relatives felt that the staff treated them well. They told us staff treated people with respect. Records and the manager indicated that there was a robust recruitment system which ensured that staff were vetted before starting work at the home. We noted that there were sufficient number of trained staff to provide care. Records and interviews with staff showed that staff had a good understanding of Mental Capacity Act (2005) and were aware of the home's policies and procedures including the policy on safeguarding.

Is the service effective?

People who used the service and their representatives were involved in the assessment of needs and review of care plans. Staff had a good understanding of people's care and support needs and knew them well. The staff handover and the key working systems enabled staff to be aware of people's ongoing needs and to provide appropriate care and support.

Is the service caring?

We noted that staff were attentive to people's needs. We saw that staff encouraged people to do as much as possible for themselves thus promoting independence. A relative told us that staff were always present and supportive when people attended medical appointments. We noted that the home worked closely with various social and healthcare professionals to meet people's needs.

Is the service responsive?

People's progress was monitored closely. Written notes about people's behaviour, health and care were completed by staff during each shift. Review of care plans included detailed guidance about how to respond to the identified needs of people using the service. A relative of a person told us that there was an improvement in a person's wellbeing since they moved to the home.

Is the service well-led?

Staff and a visitor told us that the manager was approachable and supportive. We also saw that there were auditing systems in place and the views of the stakeholders were sought. We noted that meetings took place regularly and that appropriate support was available for staff to provide care that people needed.

There were systems in place to ensure that people received their prescribed medication appropriately. We found that there were sufficient staff on duty to meet people's needs and both staff and relatives confirmed this. A relative told us 'there are always plenty of staff and they know what they are doing.'

People had confidence that if they were not happy about anything the manager would address this. One relative said "I can approach the manager about anything." Another said "I have raised minor things and the manager has dealt with them." People were protected from the risks of unsafe or inappropriate care because accurate and appropriate records were maintained.