Larwood

people. At the time of the inspection there were five people living in the service.

We found the following examples of good practice.

A visitor’s protocol was in place, this included a health questionnaire, personal protective equipment (PPE) to put on and a test for COVID-19.

Testing was carried out for both people living in the service and staff on a regular basis. If anyone had symptoms of COVID-19 they were tested immediately and isolated until the results were received.

The provider was following national guidance for anyone moving into the service and admissions were carried out safely.

There were good supplies of PPE which we observed staff wearing appropriately.

Staff had completed infection prevention and control training including the correct use of PPE. The registered manager had implemented infection control leads and accessed additional training to support this role.

Cleaning of the home, including frequently touched surfaces, had increased to reduce the risk of transmission of infection. Staff breaks were staggered so they could maintain social distancing.

The service had developed ways to safely support visits in line with the latest guidance.

Larwood is a registered care home providing 24 hour care for eight adults with severe or profound learning disabilities and those with additional mobility or physical difficulties. The care home is a large, detached purpose built house in a residential cul-de-sac. It has a very large garden housing two large summerhouses, one of which is used as a sensory room and the other an activity room where people do activities including music, arts and crafts and games. Each person has a single room and there is a communal bathroom, shower room, kitchen, dining room and lounge. There is a rear-enclosed garden at the back of the house with level access. At the time of our inspection there were eight people using the service.

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.

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.

The service was safe. The recruitment process ensured that appropriate checks were carried out before staff commenced employment. There were sufficient staff on duty to meet the needs of people and keep them safe from potential harm or abuse. The service assessed people's health and wellbeing needs and carried out risk assessments to minimise risk to health. The registered manager and staff kept people's medication records up to date.

The service was effective. People were cared for and supported by staff who had received training to support people and to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to health and social care services was made when required.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people's preferences of care. Staff worked hard to promote people's independence through encouraging and supporting people to make informed decisions.

The service was responsive. Records we viewed showed people and their relatives were involved in the planning and review of their care. Support plans were reviewed on a regular basis and when there was a change in care needs. People were supported to follow their interests and participate in social activities. The service responded to complaints in a timely manner.

The service was well-led. Staff and people spoke very highly of the registered manager and the provider who were supportive and worked hard to provide an exceptional service. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis.

Larwood provides accommodation and personal care without nursing for up to eight people who have a physical disability or learning disability. There were eight people using the service on the day of our inspection.

The service did have a registered manager. 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.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

People were safeguarded from the potential of harm and their freedoms were protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).

People had sufficient amounts to eat and drink to ensure that their dietary and nutritional needs were met. The service worked well with other professionals to ensure that people's health needs were met. Support and guidance was sought from health care professionals where required, including a doctor and district nurse.

Staff were attentive to people's needs. Staff were able to demonstrate that they knew people well. Staff treated people with dignity and respect.

People were provided with the opportunity to participate in activities which interested them. These activities were diverse to meet people’s social needs. People knew how to make a complaint and complaints had been resolved efficiently.

The service had a number of ways of gathering people’s views including using surveys and by talking with people, staff and relatives. The manager carried out a number of quality monitoring audits to help ensure the service was running effectively and to make improvements.

We found that the service had a robust recruitment process in place that was followed and audited. All members of staff had to be cleared by an occupational health department prior to starting. There was evidence that the service had procedures in place regarding people's capacity to consent

The service demonstrated that they co-operated with other providers by regular communication, attendance at external meetings and reports for external meetings.

We found that the service had a comprehensive complaints system in place although not all of the supporting forms were available on the unit at the time of the inspection.