This inspection took place on 19 and 21 July 2017 and was unannounced. This was the first inspection of the service since it was registered in January 2016.

42 East Wonford Hill is registered to provide accommodation and personal care for up to six people with learning disabilities, autistic spectrum disorders, physical disabilities or sensory impairment. At the time of this inspection there were five people living there. People had lived together for a number of years and knew each other well.

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 2008 and associated Regulations about how the service is run.

People living at 42 East Wonford Hill had limited verbal communication skills and were unable to answer questions about the care and support they received. Therefore we relied on our observations of staff interaction with each person, and our conversations with the staff team to enable us to form a judgement on the quality of the service people received.

People received a service that met their needs safely. There were sufficient staff employed to make sure people were safe, and to enable them to focus on the individual needs of each person. The staff team were stable, positive and caring and there was good teamwork. Comments from staff included, “It’s like home. It’s warm, friendly. It’s like one big family. We are a close team.” Staff expressed a determination to ensure each person experienced a good quality of life. For example, a member of staff talked about their colleagues saying, “They all have people’s best interests at heart and ask ‘What can we do for them? How can we make things better for them?’”

Staff had been carefully recruited to ensure they were entirely suitable for the job. Appropriate checks had been completed to ensure they were safe to work with vulnerable people. Staff were vigilant and knew how to recognise and report any possible signs of abuse. Staff told us they would not hesitate to speak out if they had any concerns. All new staff had received training at the start of their employment to ensure they had the basic skills to meet people’s needs safely. The provider had identified a range of essential training topics which all staff were expected to complete, and they received regular updates to ensure their skills and knowledge were continuously updated. Staff were also supported to gain relevant higher qualifications in care. Comments included “I have done so many training courses since my induction I could not name them all!” and, “We are all constantly learning.”

There were safe systems in place to ensure medicines were stored and administered safely. Staff had received training on safe administration procedures. Detailed information had been drawn up to ensure staff had full information on the medicines prescribed for each person and how they should be administered. Audits were carried out regularly to ensure medicines had been administered and recorded safely.

People lived in a home that was well maintained and safe. Each person had their own spacious bedroom with en-suite facilities. Bedrooms were personalised and had been decorated and furnished to reflect the personality and tastes of the person. All areas of the home were clean, bright and comfortable. Equipment had been serviced, checked and maintained. There were procedures in place to ensure people were safe in the case of an emergency such as fire.

People received care and support in line with their individual care plans. Risk assessments identified individual risks to people’s health and safety and there was information in each person’s support plan showing how they should be supported to manage these risks. The management team and staff had sought advice and inp