The inspection took place on the 6 and 12 December 2016 and was unannounced.

Aveley House is a registered care home providing 24 hour support to seven adults with a learning disability. The service does not provide nursing care.

The service had 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 were treated with dignity and respect and staff interacted with people in a kind, caring and sensitive manner. Staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to protect people.

There was a regular and consistent staff team. The provider had appropriate recruitment checks in place which helped to protect people and ensure staff were suitable to work at the service. There were sufficient numbers of skilled, well trained and qualified staff on duty. Staff told us that they felt well supported in their role and we saw that staff had received training and formal supervision had been regularly provided.

We found that detailed assessments had been carried out and that the care plans had been developed around each individual’s needs and preferences. There were risk assessments in place and plans on how the risks were to be managed. We saw that appropriate assessments had been carried out where people living at the service were not able to make decisions for themselves; to help ensure their rights were protected. People were supported with taking every day risks and encouraged to take part in daily activities and outings.

People were happy and relaxed with staff. Systems were in place for people to raise concerns and they could be confident they would be listened to and appropriate action would be taken.

People’s medication was well managed and this helped to ensure that they received their medication safely. They were supported to be able to eat and drink sufficient amounts to meet their needs and were offered choice. We found that people’s healthcare was good and they had access to a range of healthcare providers such as their GP, dentists, chiropodists and opticians.

The provider had effective quality assurance systems in place. People and their relatives were encouraged to feedback on their experiences and staff tried to involve people where possible in day to day decisions and the running of the service. The service was well managed.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection. Aveley House was last inspected 17 January 2014. There were no concerns found at this inspection.

Aveley House provides accommodation for persons who require nursing or personal care for up to seven people. There were five people living at the home when we carried out our inspection. The home provides care and support to people with complex emotional and behavioural needs.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Health and social care professionals we spoke with were all positive in their comments about the support provided to people at Aveley House.

The home had robust systems in place to keep people safe. Assessments of risk to people from a number of foreseeable hazards had been developed. These had been signed and reviewed by staff. We saw that staff followed these guidelines when they supported people who used the service, for example when people became agitated and displayed behaviour that could cause others harm.

Relatives we spoke with told us that the staff including the registered manager were approachable and supported people with kindness and compassion. Our observations confirmed this.

We found that people had been encouraged to make decisions for themselves. However, where people were unable to do this the service had considered the person’s capacity within the guidelines of the Mental Capacity Act 2005. Where there was potential for people to be deprived of their liberty in order to safeguard them from harm, the manager had referred to the local safeguarding authority. This ensured that decisions were made in people’s best interests.

There were systems in place to manage concerns and complaints. No formal complaints had been received in the last year. Informal concerns received from people using the service had been recorded and included the action taken in response. This included how the outcome was fed back to the person who raised the concern.

The home had sufficient staff to meet people’s needs. Staff had been provided with a range of training which included opportunities for professional development.

As part of this inspection process we spoke with two senior managers from Meadowview Care Limited and one senior member of support staff. We also spoke with two out of the three people who used the service.

Our observations suggested that people living at the service were happy, that they felt safe and were well cared for. It was evident that the people who used the service had a good relationship and rapport with the staff who supported them.

People's health and personal care needs were assessed and there were detailed support plans in place for staff to follow so as to ensure that people were supported safely and in accordance with their individual preferences and wishes. Staff spoken with demonstrated a good understanding of individual's health and personal care needs and how each person wished to be supported.

The provider was able to demonstrate that a robust staff recruitment policy and procedure was in place and followed to ensure that people living at the service were kept safe. We found that improvements had been made in relation to staff training. There was evidence to show that staff had received appropriate training in core subject areas. An effective quality assurance system was in place to monitor the quality of the service provided. We also found that appropriate systems were in place so as to ensure that people who used the service received their medicines at the time they needed them and in a safe way.

The purpose of this inspection was to check that improvements had been made with compliance actions set following our inspection in October 2012.

We found that improvements had been made by the provider to ensure that suitable arrangements were in place to assess the needs of people who may lack capacity to make day to day decisions. We found that a daily log had been introduced for each person detailing activities undertaken and the one to one hours provided on any given day. On the day of the inspection people who use the service were noted to participate in community activities.

Discussions between the provider and the Local Authority remain on-going in relation to specific one to one hours commissioned for individual people as there continues to be a disparity between what has been agreed.

We did not speak with anyone who used the service about the way their medicines were managed. People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Improvements to staff inductions, training and supervision had been made by the provider. We will continue to monitor this so as to ensure that improvements are sustained.

We directly observed care within the service, so as to help us determine what it was like for people living at Aveley House. We found that staff interactions with people who live at the home were positive and staff were seen to have a good rapport with individuals. Staff on duty at the time of our visit were observed to have a good understanding and awareness of people's support needs. In general people told us that they liked living at Aveley House and found the majority of staff to be nice. Staff confirmed to us that they liked working at the service and that staff morale was good.

Our findings showed that as a result of non-compliance with the regulations or part of a regulation, people who use the service did not always experience care and treatment that met their needs. Our evidence showed that the impact of this means that people's health and wellbeing was on occasions compromised and significant improvements by the provider to become compliant was required. We found that none of the outcome groups inspected were compliant with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

People told us that they were involved in their care. They said that they were treated well and that staff were respectful to them. They told us that they regularly go out locally. One person told us about their college sessions and another person told us about their work in a local charity shop.

People told us that they were happy with the care provided at Aveley House. They said that they had been fully involved in their care and support plans. One person told us that staff had supported them in all of their healthcare appointments. People were very positive when they were interacting with members of staff.

People told us that they felt safe living at Aveley House. One person said that they felt that the staff protected them when they were out in the local community as well as in the home. People told us that they liked the staff. They said that the staff always treated them well and spoke to them respectfully and we observed this on our recent visit.

People told us that they liked living at Aveley House. One person showed us around the home and they were very proud of their surroundings. They told us that the home was always kept nice and clean and that they helped to keep it that way. They also said that things had been fixed quickly.