This inspection took place on 26 November 2015 and was unannounced.

Avenues South East – 87 Westbrook Avenue provides residential care for up to three people with a learning disability, autistic spectrum disorder or physical disability. At the time of the inspection there were three people living at the service.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager was present on the day of the inspection.

People looked comfortable with other people, staff and in the environment. Staff understood the importance of keeping people safe. Staff knew how to protect people from the risk of abuse.

Risks to people’s safety were identified, assessed and managed appropriately. People received their medicines safely and were protected against the risks associated with the unsafe use and management of medicines. Accidents and incidents were recorded and analysed to reduce the risks of further events. This analysis was reviewed, used as a learning opportunity and discussed with staff.

Recruitment processes were in place to check that staff were of good character. There was a training programme in place to make sure staff had the skills and knowledge to carry out their roles effectively. Refresher training was provided regularly. People were consistently supported by sufficient numbers of staff.

People were provided with a choice of healthy food and drinks which ensured that their nutritional needs were met. People’s health was monitored and people were referred to and supported to see healthcare professionals when they needed to.

The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLS applications had been made to the relevant supervisory body in line with guidance.

People and their loved ones were involved with the planning of their care. People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. Staff knew people well and reacted quickly and calmly to reassure people when they became agitated. Staff were kind, caring and compassionate. People were supported by staff to keep occupied and there was a range of meaningful social and educational activities available to reduce the risk of social isolation.

The registered manager coached and mentored staff through regular one to one supervision. The registered manager worked with the staff each day to maintain oversight of the service. Staff were clear about what was expected of them and their roles and responsibilities and felt supported by the registered manager and deputy manager.

Services that provide health and social care to people are required to inform CQC of important events that happen in the service. CQC check that appropriate action had been taken. The registered manager had submitted notifications to CQC in an appropriate and timely manner in line with CQC guidelines.

We used a number of different methods to help us understand the experiences of people who used the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. These included observing the interactions between people and staff. There were two people using the service at the time of our inspection. We observed how people reacted and responded to see if people indicated they were happy, bored, discontented, angry or sad.

We found records to show how people's health needs were supported and that the service worked closely with health and social care professionals to maintain and improve people's health and well-being.

People using the service were supported to have adequate nutrition and hydration.

We found that medicines were given to people when they needed them in a safe way.

People using the service were protected from infection because the provider maintained appropriate standards of cleanliness and hygiene.

Systems were in place to monitor the service that people received to ensure that the service was satisfactory and safe.

We used a number of different methods to help us understand the experiences of people who used the service, because some of the people using the service had complex needs which meant they were not able to tell us their experiences. These included observing the interactions between people and staff. There were three people using the service at the time of our inspection. We observed how people reacted and responded to see if people indicated they were happy, bored, discontented, angry or sad.

We found that people, their relatives or advocates were asked to give consent and were involved in the decisions about the care and support they received.

We found evidence to show how people's health needs were supported and that the service worked closely with health and social care professionals to maintain and improve people's health and well-being.

We observed that the provider had provided an environment that was suitably designed and adequately maintained. The home was clean and free from offensive odours.

There were enough skilled, qualified and experienced staff to meet people’s needs. All staff spoken with demonstrated experience and knowledge to enable them to support people who lived at the service with their needs.

Systems were in place to monitor the service that people received to ensure that the service was satisfactory and safe.

We made an unannounced visit to the service and spoke the registered manager and staff members. There were three people using the service at the time of our visit.

We used a number of different methods to help us understand the experiences of people using the service. This was because the people had complex needs which meant they were not all able to tell us their experiences.

We observed the interactions between people and staff. We observed how people reacted and responded to see if people indicated they were happy, bored, discontented, angry or sad.

We saw staff engage with people in a warm and positive way. Each person had a support plan which showed their likes and dislikes and how and how best to communicate. The staff we spoke to understood each person’s individual needs and how they liked to be supported.

On the day of our visit there were different activities taking place for each person. For example one person went to the hairdressers and another was taken shopping.

The company gained people's view using different methods. For example an annual survey.

Staff told us that they received the suppport they needed to carry out their jobs effectively and safely.