The inspection took place on 27 April 2017 and was unannounced. Buckfield House provides accommodation and personal care for up to six adults with a learning disability or autism. There were six people living at the home at the time of our inspection.

There were two registered managers in post at the time of our inspection. 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 supported to maintain some independence and to take positive risks. Staff knew how to recognise and report any concerns about people’s safety. Staff understood risks associated with people’s needs and how to keep them safe. There were enough staff on duty to respond to people’s health needs at the times when they needed support. The provider completed checks to ensure staff were suitable and safe to work at the home.

People had good relationships with the staff. It was a relaxed atmosphere with staff spending quality time with people. People were treated with kindness, compassion, dignity and respect. People received care and support to meet their diverse needs including people who had complex health needs.

People’s health needs were responded to effectively with people being supported to access doctors and other health professionals when required. People had daily access to health professionals like speech and language therapists, occupational therapists and doctors. People were supported to have their medicines when needed. Medicines were stored and administered appropriately.

People had access to a varied diet of food and drink. People were supported to have their food and drink safely. Where recommendations had been made by other professionals regarding their diet or health needs these had been acted upon by staff.

Staff understood people’s individual communication styles and were able to communicate effectively with people. People’s permission was sought before any care or support was given. Time was taken to make sure that people could make choices and decisions about the care and support they received.

People were supported by staff that had the knowledge and skills to understand and meet their health needs. Staff were well supported and had access to additional training specific to people’s needs. Staff felt that they were able to contact the registered manager at any time if they needed support or guidance.

Relatives and staff views on the care and support provided was gathered on a regular basis. The registered managers were approachable and willing to listen to views and opinions. A range of audits and checks were completed regularly to ensure that good standards were maintained.

The people who lived in this home were unable to communicate verbally.

As we watched we saw the staff were very attentive towards them. We saw that the staff always asked them how they would like things to be done, were always mindful of their privacy and treated them with respect. We saw that staff talked with them as they provided their support.

Staff told us that they felt able to raise any issues with the manager or senior staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that the home had arranged for them to attend so that they would recognise abuse and how to report it.

We saw staff were always available when people needed help.

The provider had developed a system whereby they can monitor how well the home is meeting the needs of the people who live there.

We used a number of methods to help us understand people's experience as most people were not all able to tell us their views. We spoke with one person who said they were happy at the home, took part in activities they liked and said staff were “kind”.

We observed positive staff interaction with people who used the service during and after a mealtime. Staff supported people to make choices. People could do things when they wanted to. People ate well and their preferences were catered for. Privacy and dignity was respected. Five young adults led active lives, with suitable exercise, stimulation and personal development. Staff intervened gently when necessary to make sure people were safe.

We looked at care and health records about two people, medication records for other people, records about staff and the running of the home. We spoke with four staff, the manager and a provider manager.

Best interest decisions about care and treatment were made with relatives and other professionals. People had health checks and usually had their prescribed medication. The manager took steps during the inspection to improve the safety of the medication system. The home was clean and good hygiene standards protected people from infections.

Staff had advice from company specialists to provide a consistent approach to managing behaviour, health and safety. There were effective systems in place to investigate and learn from incidents and complaints.

Buckfield House was providing an individualised service for the three people living there at the time we did our visit. People we spoke with included the parents of two people, support workers at the home, one of the management team and health professionals who work closely with the service.

We did the visit to check what improvements had been made in the six areas outlined and found that the home was more organised and that the support and care to people living there had improved. The health and safety manager came to the home to represent the management team because the manager was on leave. He told us that they had learned a great deal from the problems that occurred in 2010 when they opened.

We were not able to have conversations with the people who live at the service due to their communication needs. We watched how they spent their day, how they were dressed and how the support workers were with them and how they responded. This showed us that the people living there were supported well by a team who knew them well and understood their needs. We saw examples of good practice where individual support workers showed respect and warmth for the people they were supporting. We observed that the people living at Buckfield House had been helped to dress well in clothes suitable for their age group and had modern haircuts. All of them went out during the day to various activities and whether they were at home or out they had enough staff with them to provide safe levels of support.

Relatives we spoke to were pleased with the care and support at the service. One of them told us that their son’s health had improved due to having an improved diet and a more active lifestyle. Another parent said that they thought their son’s care had improved and were pleased with the good communication with his keyworker.

Professionals we spoke to told us that they consider the service to be safe and providing good care.

This was an unannounced inspection on 14 October 2014. The home provides accommodation for up to five people who have a learning disability. There were five people living at the home when we visited and there was 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’.

At the previous inspection no improvements were identified as being necessary.

People were not able to talk with us about their care and treatment due to their communication needs. We observed how people interacted with staff. We saw that people were comfortable and confident when they did so. Staff showed they understood people’s needs and preferences and could talk to us about each person in detail.

Staff were able to tell us about how they kept people safe. During our inspection we observed that staff were available to meet people’s care and social needs.

We saw that people’s privacy and dignity were respected. We saw that the care provided took into account people’s preferences as well as their relative’s suggestions. The provider had taken guidance and advice from other professionals such as social workers.

The provider acted in accordance with the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS). The provisions of the MCA are used to protect people who might not be able to make informed decisions on their own about the care or treatment they receive. At the time of our inspection one person was being assessed for DoLS.

We found that people’s health care needs were assessed, and care planned and delivered to meet those needs. People had access to healthcare professionals such as doctor and dentists .

People were supported to eat and drink enough to keep them healthy. They had access to snacks and drinks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

Staff were provided with training that reflected the care needs of people who lived at the home. Staff told us that they would raise concerns with the registered manager and were confident that any concerns were dealt with appropriately.

The provider had taken steps to assess and monitor the home which took account of people’s preferences and the views of relatives and other professionals. These had been used to make changes that benefitted the people living at the home.