Bentinck Crescent is registered to provide accommodation and personal care to a maximum of seven people. Nursing care is not provided. Care is provided to younger people who have learning disabilities including some people who have a physical disability.

At the last inspection in February 2015 we had rated the service as 'Good'. At this inspection we found the service remained 'Good' and met each of the fundamental standards we inspected.

Due to their health conditions and complex needs not all of the people who used the service were able to share their views about the support they received.

People appeared safe and comfortable with the staff who supported them. There was a relaxed and friendly atmosphere around the home. There were sufficient staff to provide safe and individual care to people. People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

The staff team knew people well and provided support discreetly and with compassion. People’s privacy was respected and people were supported to maintain contact with relatives. Staff had a good understanding of the Mental Capacity Act 2005 and Best Interest Decision Making, when people were unable to make decisions themselves.

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. Care plans were in place detailing how people wished to be supported. Information was made available in a format that helped people to understand if they did not read. This included a complaints procedure. Complaints were taken seriously and records maintained of the action taken by the service in response to any form of dissatisfaction or concern.

People had access to health care professionals to make sure they received appropriate care and treatment. Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks. Staff followed advice given by professionals to make sure people received the care they needed. Systems were in place for people to receive their medicines in a safe way. People received a varied and balanced diet to meet their nutritional needs.

People were provided with opportunities to follow their interests and hobbies and they were introduced to new activities. They were supported to contribute and to be part of the local community. They had the opportunity to give their views about the service. There was regular consultation with people and/ or family members and their views were used to improve the service. People had access to an advocate if required. Staff said the management team were approachable. Appropriate training was provided and staff were supervised and supported.

Further information is in the detailed findings below.

We saw people's needs were assessed and care was planned and delivered in line with their individual care plans. One person said, "I like being here, the staff look after me."

We found that people were provided with a choice of food which was suitable and nutritious to meet their needs.

Appropriate arrangements were in place to ensure the premises were well maintained to provide people with a pleasant and suitable place to live.

An effective recruitment procedure was in place to help ensure people were cared for by staff who were qualified and trained to meet their needs.

We found that records contained accurate and appropriate information. People’s care records were held securely in an office but were easily accessible for reference.

People who used the service had complex needs which meant they were not able to tell us about their experiences.

Six people who lived at the home were there on the day we visited. We saw they were relaxed and engaged well with staff. People had detailed care plans covering a range of care aspects. These plans were signed by the person's next of kin, indicating they agreed to the care being given to their relatives.

We found people's needs were assessed and care was planned and delivered in line with their individual plan. We saw people looked well cared for and were wearing clean clothes. One staff member told us, "It is our job to try and make the best life possible for people."

We noted signatures were in place to indicate medicines had been given with no gaps in the records. Plans were in place to deal with medicines taken occasionally or 'as necessary' and for homely medicines. We saw staff had completed a medicine administration course and copies of certificates confirmed this.

Staff told us they felt there were enough staff on duty. We examined the staff rota and confirmed there were usually three or four staff on duty. We established there was a mix of care workers and senior staff across the week. This meant there was a range of suitably experienced staff available to offer support.

The home had a written complaints procedure with a process to follow in the event of a complaint. We noted no complaints had been received by the home recently.

The views of the people who used the service were not obtained at this review. However family comments from a recent survey included 'Parties for birthdays are great' 'A very well ran and happy establishment. We are always made very welcome and X is as happy as a sand piper'.

We carried out an unannounced visit on 25 February 2015 and a further announced visit was made on 2 March 2015.

Bentinck Crescent consists of two adjoining bungalows and is registered to provide accommodation for up to seven adults with learning disabilities who require personal care and support. There were six people living at the home at the time of our inspection.

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.

We saw staff administer medicines to people and this was done safely and appropriately. Staff had received training and the registered provider had policies and procedures in place for dealing with medicines.

The staff told us, and records confirmed that staff had undergone training related to safeguarding vulnerable adults. The registered provider had policies and procedures in place to help keep people safe and to prevent abuse happening and staff were aware of the different types of abuse. The personnel records showed checks were carried out prior to staff being employed at the home to help ensure they were suitable to work with vulnerable people.

The premises were well maintained and regular health and safety checks were carried out. One person who lived at the home and relatives we spoke with told us they always found the home was clean and very well maintained.

Due to their health conditions and complex needs not all of the people were able to share their views about the service they received. One person was able to tell us they were well cared for and enjoyed living at the home. During our visits people were relaxed and staff engaged with them. Staff told us they enjoyed their work and had sufficient time to complete their duties.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005 (MCA). These safeguards aim to make sure that people are looked after in a way that does not inappropriately restrict their freedom. The registered manager was in touch with the local authority to ascertain whether applications were required for people.

There were four weekly menus in place which were varied and staff on duty were aware of people’s likes, dislikes and special diets that were required.

Staff on duty told us they were provided with good training to meet people’s individual needs and they received supervision and support from the manager.

Staff were able to describe people’s individual needs and how they met them. They cared for people in a sensitive way and respected people’s privacy and dignity.

A care professional told us the staff met people’s needs very well and provided activities and outings which they enjoyed.

A complaints procedure was in place and relatives were aware of this and felt confident to use it if necessary. One person who lived at the home told us they knew how to complain if they needed to. No complaints had been recorded since the last inspection.

We examined four care records and found people’s individual needs had been assessed prior to them moving into the home. Care plans had been developed to provide staff with information and guidelines about how needs should be met.

Surveys had been issued to relatives and health and social care professionals that asked for their opinion of the service and comments were positive. Audits and checks were carried out by the registered manager to ensure standards were met and maintained.