Say when the inspection took place and whether the inspection was announced or unannounced. Where relevant, describe any breaches of legal requirements at your last inspection, and if so whether improvements have been made to meet the relevant requirement(s).

Improvement action plan issued following the previous inspection

Where we asked the provider to complete an improvement action plan following the last inspection, include the text below, adapting where necessary:

'Following the last inspection, what they would do and by when to improve the key question(s) to at least good.' Then describe at a high level what you found, adding detail in the detailed findings section for the relevant key question(s).

Focused inspection

'We undertook an announced / unannounced focused inspection of on . This inspection was done to check that improvements to meet legal requirements planned by the provider after our inspection had been made. The team inspected the service against of the five questions we ask about services: is the service well led, , (more as needed)? This is because the service was not meeting some legal requirements.

No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection'

Comprehensive or focused inspection

Where breach topic has moved to a different key question in Next Phase

When we completed our previous inspection on DD/MM/YYYY we found concerns relating to . At this time this/these topic area(s) was/were included under the key question of . We reviewed and refined our assessment framework and published the new assessment framework in October 2017. Under the new framework this/these topic area(s) are included under the key question of . Therefore, for this inspection, we have inspected this key question and also the previous key question of to make sure all areas are inspected to validate the ratings.

Provide a brief overview of the service (e.g. Type of care provided, size, facilities, number of people using it, whether there is or should be a registered manager etc).

Service Types and descriptions

Care at Home services

Domiciliary care agency

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community [and specialist housing]. It provides a service to [older adults], [younger disabled adults], [children].

Provider of care to people living in specialist housing

Location proving care to people housed under supported living arrangements

This service provides care and support to people living in [a] [insert number of] 'supported living' setting[s], so that they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Location proving care to people living in extra care housing

This service provides care [and support] to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is [bought] [or] [rented], and is the occupant’s own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at peop

The service supported four people to live as independently as possible. The people were unable to tell us about their views due to limited verbal capacity. We observed staff interacting with people and found that they were respectful and friendly. We also reviewed people’s records and spoke with staff and the manager. The staff and manager had good knowledge of people’s preferences, likes and dislikes and the best ways to meet their care and support needs.

During our visit we spoke with one relative who told us the home had consistently provided the highest quality of care and support. They said the staff and the manager were well trained and this ensured they were able to meet their relative’s needs. The relative told us “we greatly appreciate our monthly emails with information about what our relative has been doing. This ensures we feel part of our relative’s day to day life”.

We found that people had individual risk assessments and support plans related to these which were reviewed regularly. Staff coordinated care and support with other professionals in order to ensure people’s needs were met.

Staff records evidenced that they had regular training, supervision and appraisals. Staff told us they felt well supported working at the home and loved supporting people who lived there.

There were four people living in the home at the time of the visit. Three people were out at day care activities. One person that we spoke with indicated to us that they were happy living in the home.

The person told us that they liked the staff, the other people they lived with and the meals.

Each person living in the home had a detailed plan of care in place that included people’s individual needs and wishes and also recorded people's physical and emotional healthcare needs.

The home’s staff worked with a variety of healthcare professionals including learning disability teams. We were shown that advocates and specialist consultants were used where appropriate.

We spoke with staff and reviewed records which showed us that people were protected from abuse and their care was planned and delivered in a safe manner.

People attended a variety of day care and social activities that were tailored to their individual choice.

People were protected by their being a robust staff recruitment and selection process in place.

A family member told us. “The home is very good and we are very pleased. We have a good relationship with the staff team and are kept informed by monthly updates from our son's keyworker or the manager. We can call in any time and have a chat about any worries."

There were quality audits undertaken and recorded in order to ensure that the home was kept under regular review.

This inspection took place on 29 October 2015 and was unannounced.

102a Brockhurst Road is registered to offer support and accommodation for up to four people with learning disabilities. At the time of our inspection there were four people living at the home. People were accommodated in single rooms, with a shared lounge, kitchen, quiet room, dining room and an enclosed garden. 102a Brockhurst Road is situated next to 102b Brockhurst Road and has the same manager and provider for both services, staff can be called upon from either house to assist if needed.

There was no registered manager in place, however the person in charge of the day to day running of the home has made an application to register and were registered until recently with us for another service run by the same provider. 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.

There were appropriate processes and risk assessments in place to protect people from risks to their safety and wellbeing, including the risks of avoidable harm and abuse. Staff were aware of their responsibilities to recognise and report signs of abuse. Arrangements were in place to keep people safe and comfortable in the event of an emergency evacuation.

The manager made sure there were enough staff with the skills and knowledge to support people safely. Staff stored and administered medicines, including skin creams and ointments, safely. Medicines records, including for medicines prescribed “as required” were accurate and complete.

Staff had the knowledge they required to support people but the training and skills needed were not up to date. The manager had recognised this and a plan was in place to ensure all staff received training to update them.

Staff were aware of the need to obtain people’s consent. When people lacked capacity to make decisions staff were guided by the principles of the Mental Capacity Act 2005.

The service provided individualised, varied and nutritious meals which were prepared and served according to people’s individual needs. People had access to their GP and other healthcare providers when needed.

Staff and the management team had received safeguarding training and they were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

People and staff told us they felt the service was well-led and were positive about the management team. The provider was proactive in promoting good practice, through supervisions and team meetings.

People told us and our observations confirmed that they felt the home was caring. Staff were enthusiastic about working with the people who lived at the home. They were sensitive to people’s individual needs treating them with dignity and respect, and developed caring and positive relationships with them. People were encouraged to maintain their family relationships.

People received care and treatment that met their needs and took into account their wishes and preferences. Staff delivered care and treatment in line with plans and assessments. The service had a procedure in place to manage complaints, but people had not felt the need to use it.

Staff supported people in a variety of individual activities, including trips outside the home and day care services.

People, their families and staff were all complimentary about the atmosphere and culture in the home. People expressed affection for the home and its staff. Staff expressed pride in the service provided, and described it as homely and well run.

The manager had an effective and organised management system. They had completed an audit of the home when they started work there and had developed an action plan. The service manager who oversaw the work of the day to day manager, had also completed an audit and action plan and had found similar issues to be worked on. Work was underway to maintain the quality of the service and to communicate the priorities and values.

There was a thorough and wide ranging system of checks and audits to monitor and assess the quality of service. Actions arising from these checks were followed up.