About the service: • 28 Stamford Avenue provides accommodation and personal care to adults with learning disabilities or autism spectrum disorder. The care home accommodates nine people in one adapted building.

People’s experience of using this service:

• Since our last inspection the service had made improvements.

• People liked living at the service and got on well with staff who knew them well.

• People were able to choose how to spend their time and were encouraged to make decisions about their care.

• People were supported to be more independent.

• People told us they had enough to do and enjoyed going out.

• People were supported by enough staff at the time of inspection, previously staffing had impacted on people’s activities.

• Staff delivered care that was safe and met people’s needs.

• The provider had systems in place to keep people safe, provide good quality care and ensure staff were trained.

• New systems had been implemented to ensure the service was meeting the standards.

• People’s risks were assessed and mitigated in the least restrictive way as possible.

• The service met the characteristics for a rating of "good" in all key questions.

• More information about our inspection findings are in the full report.

Rating at last inspection: At our last inspection the service was rated as requires improvement.

Why we inspected:

• All services rated "requires improvement" are re-inspected within one year of our previously published inspection report.

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor the service to ensure it provides safe and effective care. We will plan further inspections in the future.

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. However, the right support and best practice was not always promoted.

28 Stamford Avenue is a residential care home for nine people who have a learning disability and some who have a mental health diagnosis. There were nine people living at the home at the time of this inspection.

The home consisted of four flats. Three of the flats were shared and people had their own personalised bedroom with shared bathrooms/shower facilities, lounge, dining area and kitchen. The registered manager’s office is located on the ground floor.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Infection control measures were not always followed by staff to ensure people were safe.

There were not always enough staff to support people’s needs.

People were not always supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community.

Audits did not always have action plans and some audits were not always accurate.

Records in care plans had not always been updated and did not reflect accurately people’s needs.

Staff received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally.

The provider had safe and effective recruitment practices to help ensure that all staff were suitably qualified and experienced.

Staff had developed positive and caring relationships with the people they cared for and knew them very well.

Plans and guidance had been drawn up to help staff deal with unforeseen events and emergencies.

Trained staff helped people to take their medicines safely and at the right time.

People and relatives were positive about the skills, experience and abilities of staff who worked at the home. They received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary.

Staff obtained people’s consent before providing personal care and support, which they did in a kind and compassionate way.

The confidentiality of information held about people’s medical and personal histories were securely maintained throughout the home.

Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs.

Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances.

Complaints were recorded and responded to in line with the service policy.

People, relatives and staff were complimentary about the registered manager and how the home was run and operated.

The inspection took place on 12 November 2015 and was unannounced. At our last inspection on 11 April 2013, the service was found to be meeting the required standards in the areas we looked at. 28 Stamford Avenue is a residential care home for people who have a learning disability. At the time of our inspection seven people lived at the home.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

The Mental Capacity Act (2005) provides a legal framework for making particular decisions on behalf of people who may lack mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. Where they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. We checked whether the service was working in line with the principles of the MCA and whether any conditions on authorisations to deprive a person of their liberty were being met.The manager had submitted DoLS applications to the local authority for people who needed these safeguards.

People told us they felt safe, happy and well looked after at the home. Staff had received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally. Safe and effective recruitment practices were followed to ensure that all staff were suitably qualified and experienced to carry out their duty safely. Arrangements were in place to ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.

Plans and guidance had been drawn up to help staff deal with unforeseen events and emergencies. The environment and equipment used were regularly checked and well maintained to keep people safe. People were helped by trained staff to take their medicines safely.

Relatives were positive about the skills, experience and abilities of staff who worked at the home. They received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.

Staff had developed positive and caring relationships with the people they cared for and knew them very well. People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained throughout the home.

Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances.

People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community. They felt that staff listened to them and responded to any concerns they had in a positive way. Complaints were recorded and investigated thoroughly with learning outcomes used to make improvements where necessary.

Relatives and staff very were complimentary about the manager and how the home was run and operated. Appropriate steps were taken to monitor

During our inspection on 11 April 2013, we talked with five out of the nine people who live at 28 Stamford Avenue. During the day some people went out with staff to walk to the shops and other activities of their choice.

We observed that people were very happy talking with the staff who were on duty and staff listened when people made choices about what they wanted to do that day. Some of the people we spoke with said they made lots of their own decisions, which included activities and visits outside the home and housework they undertook within the home. Guidance relating to the Mental Capacity Act 2005 had been followed to record people’s ability to make decisions about their lives.

Support plans gave staff enough guidance on the ways in which each person preferred to be supported. Assessments of risks to people were carried out so that people were supported to be independent and kept as safe as possible. Each person’s healthcare needs were met. Medicines were managed safely and given as prescribed.

Staff undertook a range of training so that they could meet the needs of those living in the home.

The provider had a complaints procedure in place that was in easy read language and pictures so that people could understand it better. During the inspection, we spoke with an independent advocate who visits the home regularly who said the home had made improvements for the people living there.