About the service: Apple Blossom Court is a residential home registered to provide accommodation and support to up to 17 adults who have learning disabilities. The home is situated in a residential area of Wallasey with shops and local transport links nearby. We inspected the home 20 and 21 February 2019. The home was providing support to 11 people with one person staying on a short-term basis at the time of inspection.

The home had a registered manager. 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 experience of using this service: At the last inspection in November 2017 we had rated the service as Requires improvement. This was in relation to the environment, health and safety checks, lack of staff supervision and lack of induction documentation. At the last inspection we also identified that systems and processes did not operate effectively to enable the service to assess, monitor and improve the quality and safety of the services provided.

During this inspection we found improvements had been made. However, we found improvements were needed to the ‘grab file’ that held emergency information for people and the water temperatures were not being regularly checked. This was brought to the registered managers attention that was actioned immediately.

The home had been decorated and refurbished so that the environment was brighter, cleaner and more welcoming. The health and safety checks on the home was regularly completed by the manager and staff were receiving regular supervision. The manager had implemented regular audits of the service and these were completed monthly. The staff induction was in the process of being improved.

At the last inspection in November 2017, we found the provider to be in breach of Regulation as systems to monitor the quality and safety of the service were not always effective. During this inspection we looked to see if improvements had been made and found that they had. The registered manager and staff had a good understanding of their roles and responsibilities within the

service. Systems were in place to monitor the quality and safety of the service. Any issues identified were addressed to ensure quality of care was maintained.

Feedback received during the two days of inspection was all positive from people using the service, relatives and staff.

Staffing were deployed in suitable numbers and staff had time to spend with people and were not rushed. Medication needs were assessed and medication was only given by staff who were trained to do so. Staff were recruited safely, and incident and accidents were analysed for patterns and trends. Risks to people were assessed safely, care plans were person centred and regularly updated.

The care service had not 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.

Registering the Right Support gives guidance surrounding the maximum amount of people a home providing support to people with learning disabilities should have. Guidance states this should be six however Apple Blossom Court had been registered since October 2016 to provide a service to 17 people. We saw that the home itself was situated in a residential area and that people with learning disabilities who were using the service were able to live as ordinary a life as any citizen. People were able to make their own decisions about their lives for example what they wanted to do and eat.

Rating at last inspection: Apple Blossom Court was pre

This comprehensive inspection took place on 08 November 2017. Apple Blossom Court 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.

The home is registered to provide accommodation and personal care for a maximum of 16 adults with a learning disability. The home is a three storey, detached property located in a residential area of Wallasey, Wirral. It is close to local shops and transport links to all parts of Wirral, Chester and Liverpool. At the time of our visit the service was providing support to 15 people.

The care service had not 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. However, we saw that people with learning disabilities and autism using the service were able to live as ordinary a life as any citizen.

The service had a registered manager. 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.

During our inspection, we identified a breach of the Health and Social Care Act 2008 in respect of Regulation 17 good governance. You can see what action we told the provider to take at the back of the full version of the report.

The service did not have effective quality assurance systems such as audits in place and other checks did not operate effectively to ensure people received a safe, effective, caring, responsive and well led service.

Monitoring information was not clear in regards to maintenance, people’s weights and daily checks that were meant to be carried out by the staff.

A formal, fully completed application process and checks in relation to criminal convictions and previous employment had been completed when new staff were employed. However we did not see evidence of any risk assessments being carried out on staff whose DBS checks identified past convictions.

We saw that monthly or weekly checks such as fire alarms, fire extinguishers, emergency lighting and water temperatures had not been regularly completed.

We looked at safety certificates that demonstrated that utilities and services, such as gas, electric had been tested and were safe. Fire evacuation plans had been reviewed and updated. Personal emergency evacuation plans (PEEPS) had been completed for all of the people who lived in the service

Staff said they felt supported and that they could approach the registered manager with any concerns, however there was no evidence of a formal supervision and appraisal process.

We found that the Mental Capacity Act 2005 and the Deprivation of Liberty (DoLS) 2009 legislation had been followed by the home. The registered manager told us about people in the home who lacked capacity and that the appropriate number of Deprivation of Liberty Safeguard (DoLS) applications had been submitted to the Local Authority.

People's GPs and other healthcare professionals were contacted for advice about people’s health needs whenever necessary. The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place and training to guide staff in relation to safeguarding adults.

The people living in the home were able to express themselves and were able to choose the way they spent their day and were taken to activities outside the home. Each of the people’s bedrooms had been personalised by them and those who were able to choose who entered their rooms and go in and out of the front door freely.

People