This unannounced inspection took place on 16 March 2018. At our last inspection in January 2016 the service was rated Good. At this inspection we found the service remained Good.

130 Whitworth Road is a ‘care home’ that accommodates up to four people with learning disabilities in one purpose-adapted building. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The CQC regulates both the premises and the care provided, and both were looked at during this inspection. On the day of our visit there were four people using the service.

The care service had 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.

There was no registered manager in post and for this reason the service was overseen by a registered manager from another service. 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.

Why the service is rated Good.

The home continued to ensure people were safe. There were enough suitable staff to meet people's needs. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. People received their medicines safely. Staff had attended safeguarding training and were aware of the systems in place to report any allegations of abuse. The provider followed appropriate recruitment procedures to ensure they employed staff who were suitable to provide care.

People continued to receive effective care. People who lacked capacity had decisions made on their behalf in line with current legislation. Staff received training to ensure they had the skills and knowledge required to effectively support people. People's healthcare needs were met. People were supported to eat and drink in line with their nutrition assessments. People were supported to have maximum choice and staff supported them in the least restrictive way possible.

The home continued to provide a caring service to people. We observed that staff were kind and patient. People's privacy and dignity were respected by staff. People were involved in making decisions about the care and support they received. People's choices were always respected and staff encouraged choice for those who struggled to communicate with them.

The home remained responsive to people's individual needs. Care and support were personalised to suit each person’s needs and preferences, and people were able to make choices about their day to day lives. People took part in a wide range of activities which reflected their interests and preferences. People and their relatives told us they knew how to complain and there were a range of opportunities for them to raise concerns with the management team and designated staff.

The home continued to be well-led. Relatives and staff spoke highly of the management. Regular audits and checks were carried out on the quality of care people received. Shortfalls identified were addressed in a timely manner to develop the service.

We inspected 130 Whitworth Road on the 22 January 2016. 130 Whitworth Road, is a small home in Swindon, offering accommodation and support to four people with learning disabilities.

There was a registered manager in post at the service. 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.

People’s needs were assessed and clear guidance was in place for staff to mitigate those risks. There was a good understanding of safeguarding within the service, what constitutes abuse and what action to take is abuse was suspected. There were enough suitably qualified staff deployed to meet people’s needs.

Staff received appropriate support to do their roles both day to day and through structured supervisor and appraisal. Staff were well trained and had access to further professional development. People’s dietary needs were understood and they enjoyed a balanced and healthy diet of their own choosing. The service worked well with other professionals to ensure people needs were met safely.

Staff were described as caring and this matched our own observations. People clearly appreciated their relationship which staff and we observed many trusting and warm interactions between people and the staff that were with them. People’s privacy and dignity were respected.

People benefited from a person centred culture where their needs and wishes were documented. People also had the opportunity to develop goals and were supported by a staff team who understood those goals and worked towards them. Feedback was important to the service to ensure continued improvement.

The leadership within the service was described as very good by staff and relatives we spoke with. There were effective systems in place to monitor the quality and safety of the service. There was a clear vision within the service and an open culture for people to raise their views if they felt they needed to.

One inspector visited the home and answered our five questions, is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, communicating with two people using the service, two staff, the deputy manager and a manager from another service belonging to the same provider. We reviewed four care plans and other relevant records.

Is the service safe?

Assessments of people’s needs were developed with them and shared with care managers from local authorities and other professionals. We saw that people’s mental capacity was assessed and best interests meetings were held to ensure care was provided to maintain people’s health and welfare in the safest and most appropriate way.

Care plans instructed staff how to meet people’s needs in a way which minimised risk for the individual. They were detailed and ensured staff cared for people in the safest way.

A behavioural team and special plans of care were provided to assist staff to support people whose behaviour may sometimes cause them or others harm or distress.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We saw that the home had made recent DoLs referrals to the local authority as a result of the recent Supreme Court ruling with regard to DoLS. The deputy manager had an in – depth knowledge of the most recent DoLS requirements.

We saw that medication was safely administered to people who used the service. There were guidelines in place for people who had medication prescribed to be taken ‘when required’. Only trained staff administered medication.

The home made sure that staff were safely recruited. The checks to ensure prospective staff members were safe to work with vulnerable people were completed before they started work. Staff members were well trained and supported to enable them to provide safe care to the people who lived there.

Systems were in place to make sure that the staff, the manager and the provider continually monitored the quality and safety of care offered to people.

Health and safety was taken seriously by the home and all the appropriate safety checks had been completed. This reduced the risks to the people who lived in the home, staff and visitors.

Is the service effective?

People’s health and care needs were assessed with them and they were helped to make informed decisions about their lifestyle, wherever possible. Care plans were detailed and clearly identified people’s needs and how they should be met. We saw that staff gave support as described in individual’s care plans.

People’s methods of communication were well recorded in detailed ‘communication plans’. We saw that staff followed the communication plans and understood what people were asking or telling them.

We saw that people’s health needs were met and they were referred to health professionals and specialists, as necessary.

Is the service caring?

People were supported by caring, knowledgeable and patient staff. We saw that care staff were attentive, encouraging and positive. Staff communicated and interacted with people at all times.

People's diversity, values and human rights were respected. Care plans were individualised and person –centred. We saw that people were treated with respect and dignity by the staff. We saw people confidently communicating with staff when they wanted support or interaction. Staff communicated positively and considerately with people.

Is the service responsive?

Care plans were reviewed regularly and amended, as necessary, to meet people’s current needs. We saw that people were supported to access health services in a timely way. During the inspection we observed staff responding appropriately and quickly to people’s needs.

The home had made changes and improvements as a result of ideas and discussions with people who lived in the home.

The home had received no complaints about the quality of care the home offered in 2013/2014. We saw that the one complaint received, about staff parking, had been satisfactorily resolved.

Is the service well led?

Staff members told us that they were supported to do their job well. They said they felt: ‘‘well supported by senior staff and the staff team’’.

The service had a formal quality assurance system. We saw records which showed that the home identified shortfalls and the actions to be taken to address them. Some examples of changes made as a result of the annual quality questionnaires were provided by the deputy manager. As a result the quality of the service was being maintained or improved.

There have been considerable changes since the last inspection, both in the staff group and to the group of people living at the home. This has meant some inevitable disruption, but we were told that people were coping well. This was confirmed by entries in the care records we looked at. When we inspected, there were four people living in the home. We spoke with and observed three people who used the service and spoke with four staff.

We used a number of different methods to help us understand the experiences of people using the service, because people had complex needs which meant they were not able to tell us how they felt about the service. We saw staff speaking and responding to people in a kind and respectful manner.

The care records showed us that people's health needs had been assessed before they came to live in the home. These records included information from health and social care professionals which helped ensure people got the care and treatment they needed.

We spoke with one person about the care and support provided. They told us that they had been involved in developing their support plan and their personal profile. They said that they had opportunities to choose their meals and their activities. The person told us they went out independently and they had a voluntary job. They found the staff very supportive. They told us that there were monthly meetings where people who lived in the home could give their views about the service. They said that they had also had a questionnaire and had given their views. They told us that staff listened to people and acted on what people said.