We carried out a comprehensive inspection of Bramshaw House on 27 September 2018.

Bramshaw House is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Bramshaw House is registered to provide accommodation for people requiring personal care for up to 10 people, older people and younger adults with learning disabilities or autistic spectrum disorder, physical disabilities, sensory impairments and mental health support needs. Bramshaw House is a large detached premises in a residential street that is split across two floors. At the time of the inspection, 10 people were living in Bramshaw House.

Bramshaw House has 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 this service can live as ordinary a life as any citizen.

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.

This was the first inspection of the service since it was registered with the Care Quality Commission (CQC) in June 2017.

People felt safe and there were systems and processes in place to keep people safe from abuse. Staff and people had support to knew how to recognise and report abuse. Any concerns were reviewed by the registered manager and reported to the local authority safeguarding team. People were helped to understand what discriminatory abuse was and who they could speak with to get help to prevent this. People said this was useful and made them feel safe.

People had assessments that identified potential risks to their safety. People, or people acting in their best interests, were involved in deciding how to take appropriate actions to manage these risks and made sure people’s personal freedom, independence and choices were respected. Accident and incidents were responded to quickly to keep people safe and reviewed to look at how to prevent them happening again.

There were safe recruitment processes and the service had enough staff to meet people’s needs. Staff had regular medicine administration training and competency assessments and there were systems and processes to help make sure that people received their medicines safely. Infection control risks were well managed and the premises were clean and hygienic. Staff had received food hygiene training to know how to safely support people with any food preparation and handling support they needed.

People told us the service was effective and they had a good quality of life. One person said, “They look after me very well, they know what they are doing”. Another person said, “I am happy”. People were supported to achieve the outcomes they needed and wanted support with. Staff received equality and diversity training and did not focus on people’s disabilities when supporting them to achieve their choices. One person said, “They help me do everything that other people do.”

Staff worked well with each other and with other organisations to co-ordinate people’s support to help make sure people’s needs and choices were met consistently. Staff had a comprehensive induction and probation programme and on-going training and supervisions to give them the necessary skills and knowledge to deliver effective care and support. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the poli