ABI Homes - Tolcarne Avenue is a three bedded terrace house situated in a residential area of Fishermead in Milton Keynes. It provides residential care for three people with Learning Disabilities and Autistic Spectrum Conditions. At the time of our inspection there were three people using the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and felt confident in how to report them.

People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and these were followed by the service. Staff were not offered employment until satisfactory checks had been completed. Staff received an induction process and on-going training. They had attended a variety of training to ensure they were able to provide care based on current practice when supporting people. They were supported with regular supervisions.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people.

People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.

People were supported to access a variety of health professionals when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place which was accessible to all. Complaint had been responded to appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

Further information is in the detailed findings below

Abi-Homes Tolcarne Avenue is a three bedded terrace house situated in a residential area of Milton Keynes. It provides residential care for three people with Learning Disabilities and Autistic Spectrum Conditions.

The inspection took place on 26 March 2015.

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 felt safe living in the service. There were systems in place to protect people from the risk of harm and through our discussions with staff; we found that staff knew how to recognise abuse.

Systems were in place to ensure that risks to people were assessed and reviewed on a frequent basis, in order that people were kept safe.

Staff were recruited safely and checks were made before staff were employed to ensure that they were considered suitable to work with people who used the service.

There was sufficient staff with appropriate skills and knowledge on duty to meet the needs of the people who used the service.

We found medicines were managed appropriately ensuring that people received their medication safely.

There was a full training programme in place and staff reported that they were able to access appropriate mandatory and additional training. Staff received supervision from more senior staff which enabled them to discuss any matters relevant to their work and to develop personally.

Staff understood the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

People were able to make choices about what they did on a daily basis; about what they ate and about how their care was provided.

People were referred to appropriate health care professionals to ensure their health needs were maintained.

There were systems in place to make sure changes in people’s care needs were managed and responded to, including regular care plan reviews with people’s involvement. Staff were aware of people’s individual health needs and supported people appropriately.

Staff treated people with respect and preserved their dignity. They knocked on doors and waited for an answer before they entered. They were attentive to people’s needs and aware of possible triggers for people who had behaviour that may challenge others.

There was a complaints procedure in place and staff and people knew who to speak to if they wanted to raise a concern. There were effective systems in place for responding to complaints.

The registered manager monitored all safeguardings, incidents and accidents and told us that they learnt from incidents and concerns.

There was an effective quality assurance system in place which helped in the development of the service and making changes and improvements.

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; 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, speaking with people who used the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were cared for in an environment which was clean and safe.

People who used the service had risk assessments in place to enable them to be as independent as possible.

There was an effective recruitment process in place to ensure that staff employed were suitable for this work.

Is the service effective?

People’s needs were assessed and care planned and delivered to reflect this.

Documentation was available in a pictorial format to aid understanding.

An advocacy service was available to access additional support, if people needed it.

Is the service caring?

We observed that the people appeared happy in their environment; staff knew them well and were seen to offer reassurance and support.

One person gave us the ‘thumbs up’ sign when asked if they were having a good day, and used sign language to say they were going out for a walk.

Is the service responsive?

We saw that care plans had been reviewed and updated when people’s needs changed, and had accessed other relevant health professionals when required.

People were supported to enjoy activities of their choice, both within the home and in the wider community.

Is the service well led?

There was a registered manager for the service, supported by an area manager and director of operations. This gave robust support for staff and people who used the service.

Quality assurance processes were in place to ensure people received a quality service.

Three people are supported to live at Tolcarne Avenue. One person we spoke with told us that the “staff have helped me and I have got better at some things”.

Not all of the people we met with were able to talk to us about their care so we also spoke with family members. One relative told us that they would like to see their family member engaging in more community based activities. Another relative told us that their family member had done well since being at Tolcarne Avenue.

We looked at records which showed that peoples care needs were up to date and had been reviewed regularly. We saw that people’s day to day cultural needs had been met.

We spoke with staff that demonstrated a good knowledge of the needs of people they supported. We saw that staff interacted with people with warmth and respect.

We noted that staff had received regular supervision and appraisal which ensured they had the knowledge, skills and support to do their job

We spoke with two people who used the service. When we asked what it was like living at Tolcarne Avenue one person told us "It's nice" and another person told us "It's not bad, I feel safe".

We spoke with two staff members who worked at Tolcarne Avenue they both told us that they felt well supported. One staff member told us "It's a very person centred service" and another told us "It's a good home".

We found that people who used the service had their needs assessed and care and support plans were put in place to meet their needs. We saw that people were provided with daily timetables to enable them to have structure to their day. We found that medication was administered and recorded correctly. We saw that the provider had a complaints policy in place that was available in different formats to meet people's needs.

Generally people using the service chose not to talk to us during the visit. Although, one person said that he liked to access a computer daily. He also said that he goes to McDonalds restaurants on Fridays.