2 Windsor Avenue 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. 2 Windsor Avenue is registered to accommodate five people with learning disabilities; at the time of our inspection there were five people living in the home.

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.

At the last inspection in March 2016 this service was rated good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff followed the procedures for safeguarding people from the risks of harm or abuse. Risk management plans were in place to safeguard people's personal safety and manage known environmental risks.

Staffing arrangements met people's individual support needs. The recruitment procedures ensured only suitable staff were employed to work at the service. Medicines were appropriately managed and staff followed infection control procedures to reduce the risks of spreading infection or illness.

Staff had comprehensive induction training and on-going refresher training that was based on following current best practice. Staff supervision and appraisal systems ensured staff had regular opportunities to discuss and evaluate their learning and development needs and their work performance.

Staff supported people to follow a nutritious, varied and balanced diet. The staff supported people to access health appointments as required so that people's continuing healthcare needs were met.

Staff understood the principles of the Mental Capacity Act, 2005 (MCA) and ensured they gained people's consent before providing personal care. People were encouraged to be involved in decisions about their care and support and information was provided for people in line with the requirements of the Accessible Information Standard (AIS).

People had their privacy, dignity and confidentiality maintained at all times. People experienced positive relationships with staff and received care that respected their diversity as staff supported people to maintain relationships with family and friends and make new friends. The care people received from staff was kind, caring and compassionate.

The provider operated an open and transparent culture. Quality assurance processes checked all aspects of the service. Events such as safeguarding matters, accidents and incidents had been reported to the CQC and other relevant agencies as required. Complaints brought to the provider's attention had been dealt with in accordance with the complaints procedure.

This unannounced inspection took place on 15 January 2016. This residential care service is registered to provide accommodation and personal care support for up to five people with learning disabilities. At the time of the inspection there were five people living at the home.

There was a registered manager in post at the time of our inspection. 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 felt safe in their own home. Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required at the times they needed. There was sufficient staff to meet the needs of the people and recruitment practice protected people from being cared for by staff that were unsuitable to work at the home.

Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe but also enabled positive risk taking. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

Staff were highly skilled; plans were in place for new staff to complete the Care Certificate which is based on best practice. The provider’s mandatory training was updated annually.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People felt safe and there were clear lines of reporting safeguarding concerns to appropriate agencies and staff were knowledgeable about safeguarding adults.

Care plans were written in a person centred approach and focussed on empowering people; personal choice, ownership for decisions and people being in control of their life. They detailed how people wished to be supported and people were fully involved in making decisions about their care. People participated in a range of activities both in the home and in the community and received the support they needed to help them do this. People were able to choose where they spent their time and what they did.

People had caring relationships with the staff that supported them. Complaints were appropriately investigated and action was taken to make improvements to the service when this was found to be necessary. The manager was accessible and worked alongside care staff to monitor the quality of the service provided. Staff and people were confident that issues would be addressed and that any concerns they had would be listened to.

The registered manager was passionate about people receiving person centred care and people and staff being involved and included in decisions about the future.

Our inspection was carried out by one inspector who visited the service unannounced. During the inspection we sought answers to five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found:-

The summary is based on our observations during the inspection, speaking with staff supporting people who used the service, speaking with the manager and looking at records. Because of the nature of the disabilities of people living in the home they were not able to tell us in detail about their experiences. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with dignity and respect by the staff. Most of the staff had worked with people for many years and knew them well. We saw that people were relaxed and comfortable in the presence of staff.

Staff received regular training and support which helped them to provide safe care. Staff training included the safeguarding of vulnerable adults. Staff knew who they should contact, should they have any concerns about the treatment of people who used the service.

Risk assessments were in place which identified any specific risks for people who used the service. Measures including bed rails and lap straps on wheelchairs were in place to reduce the risk of falls and injury. However records were not sufficiently detailed to explain the decision making process and confirm the correct process had been followed.

Is the service effective?

People’s health and care needs were assessed and plans of care developed according to their needs. Information about how people communicated their needs and wishes was clearly identified in care plans which helped ensure that new staff were able to provide appropriate care.

Is the service caring?

We saw that a questionnaire giving feedback about the service from a professional who visited the service referred to people being cared for with kindness and compassion.

We saw staff approach people who used the service in a caring manner. People’s preferences, interests, and needs had been recorded and care and support had been provided accordingly.

Is the service responsive?

We saw that staff were available to support people who used the service and that they were responsive to signs that they may need assistance.

Is the service well-led?

We found that the service was well managed and systems were in place to identify and make improvements where necessary. Staff received regular training and support from the manager which helped them to provide safe and effective care.

We spoke with two people who told us they were happy living at 2 Windsor Avenue. We saw that people were happy and relaxed and enjoyed each other’s company and the company of staff. We spoke with three members of staff who all had a good knowledge of people's care needs and spoke positively about their roles in the staff team.

We saw that care plans included details about how staff encouraged people’s independence and their involvement within their local community. People talked with us about places they had been out to recently and enjoyed.

We saw that there were systems in place to monitor care records; the care people received; medication; risk assessments and health and safety. We saw that the manager had a programme of audits and checks that she undertook and that the area manager also carried out checks on people’s care, the environment and on the record keeping.

We spoke with two people who live at 2 Windsor Avenue. The both told us that they were happy living in the home. We spoke with three members of staff who all had a good knowledge of people's care needs. We saw that staff spoke with people living in the home respectfully, gave explanations and offered people choices. Staff explained how they assist people to make choices by using visual aids, being aware of people’s non verbal communication and by offering choices in a way that people can understand.