This unannounced inspection took place on 7 December 2018. At our last inspection on 6 and 8 June 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Cabrini House 3 is one of three small separate care homes run by the provider in the same road that provides accommodation care and support to eight people with learning difficulties. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both aspects were looked at during this inspection. At the time of the inspection there were eight people living at the home.

The service 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. So that people with learning disabilities and autism using the service can live as ordinary a life as any citizen

The service had a registered manager. They were aware of their responsibilities and had submitted notifications as required. They were aware of their legal requirement to display their current CQC rating which we saw was on display at the service and on the provider’s website.

At the inspection we found systems to monitor the quality of the service were being reviewed and changed following a recommendation in our recent inspection report about one of the other homes.

There were enough staff at the service to meet people’s needs. Effective and safe recruitment processes had been established. The environment had been adapted to meet people’s needs. Staff received sufficient training supervision and support to meet their responsibilities and carry out their roles.

Safeguarding procedures continued to protect people from the risk of abuse or neglect. Staff were knowledgeable about different types of abuse and who to report any concerns to. There were processes in place to respond to accidents and incidents and identify learning. Individual risks to people were assessed and written guidance provided to staff to reduce the likelihood of these risks occurring. Medicines remained safely managed. The service was clean and staff understood how to reduce the risk of infections.

People's needs were assessed in partnership with people, their families and health and social care professionals where relevant before they started at the service.

Staff understood their responsibilities under MCA 2005. 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.

People’s dietary needs were met. The service worked with health and social care professionals to help maintain the health of people they supported. The service supported people when they used other services through regular communication to ensure their care and support needs were well coordinated.

People and relatives told us staff treated people with kindness and care. Staff respected people’s individuality and promoted their independence. People were involved as far as possible in decisions about their care and staff treated them with dignity and respect.

People’s diverse needs were respected and supported. People received support that was personalised to their needs. Information was available to people in a range of accessible formats. People and their relatives knew how to complain about the service should they need to.

People were supported to engage in the community, gain employment, learn new skills and in activities that they enjoyed for their well-being. Pe

This inspection took place on 06 and 08 June 2016 and was unannounced. This was the first comprehensive inspection for this provider of this service. It had previously been run by another provider.

3 Diagrama Healthcare Services provides personal care and support for up to eight adults who have a range of needs including learning disabilities. At the time of our inspection there were eight people living at the home.

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 and their relatives told us they were safe and well looked after at the home. People were happy and relaxed and told us they liked living at the home. Staff were aware of how to recognise signs of abuse or neglect and what to do if they had any concerns.

Care was planned and delivered to protect people’s safety and welfare. Risks to people were identified and plans were in place to reduce the likelihood of risk occurring. People had detailed plans of care for their health and support needs, these included their likes and dislikes and were updated when needed. People and their relatives told us they were involved in reviewing the plan of care and support.

Checks were carried out on the premises and equipment to ensure these were safely maintained. There were enough staff on duty to meet people’s needs and the home had safe recruitment procedures to help protect people from the risks of being cared for by unsuitable staff. Medicines were safely administered.

People received enough to eat and drink and their preferences and any cultural needs were taken into account. People’s health needs were closely monitored and the service worked closely with health professionals to ensure people got the right support. Staff received enough training to support people adequately and told us they felt well supported to do their job.

Staff understood the importance of obtaining consent where possible before they provided care. They told us how they looked for signs from people that they were happy with the support they provided. Staff knew what to do if people could not make decisions about their care needs and relatives were involved in best interest meetings with professionals when required to make specific decisions. Staff knew about the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) and applications for authorisations had been made appropriately. People were supported where possible to take up employment and or skills training to build on their skills and independence.

People were supported as far as possible to make decisions about their care and support. They were encouraged to take part in a range of activities they enjoyed. Staff knew people well and knew people’s preferences regarding their care and support needs. Appropriate methods were used to help people communicate and make choices, for example, we saw staff understood gestures and body language to understand what people wanted to do. There were easy read notices displayed to aid understanding. Staff respected people’s privacy and treated them with respect and dignity.

People, their relatives and staff felt there had been positive changes at the home since the new provider had taken over. There was a visible management structure in the home and staff and relatives felt the manager was approachable and helpful. Staff told us that they worked well as a team to meet people’s needs and felt the new provider and manager listened to their views and were driving improvements. There were systems in place to monitor the safety and quality of the service provided and to obtain feedback from professionals and relatives to consider any