The inspection took place on 25 July 2017. We gave the registered manager 24hours notice of the inspection to ensure that there would be staff available to talk with us. 1 Charmandean Road is a small care home registered for up to eight adults living with physical and learning disabilities, sensory impairments and complex health needs including epilepsy. People have different communication needs; some people were able to hold conversations independently and others needed support from staff to express their views, thoughts and feelings. The home is located in Worthing, close to shops and a short distance from the seafront. At the time of the inspection there were eight people living at the home.

The home had a registered manager. 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. At the last inspection undertaken on the 8 and 9 June 2015 we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) 2014 in relation to inadequate processes for assessing and monitoring the quality and safety of services provided. The provider sent us an action plan stating they would have addressed all of these concerns by 30 September 2015. At this inspection we found that the registered manager had made improvements and this breach of regulation had been addressed.

Staff understanding of their responsibilities with regard to the Mental Capacity Act 2005 was not consistent and embedded within practice. Some staff did not have a clear understanding of Deprivation of Liberty Safeguards (DoLS) and some mental capacity assessments and best interest decisions were not always completed in line with legal requirements. This was identified as an area of practice that needed to improve.

People told us they felt safe living at the home and relatives said they felt their relations were safe. One relative said, “I have seen very good, safe practice.” People were receiving their medicines safely and risks to people had been assessed and plans were in place to manage risks. There were enough staff to care for people safely and the provider had a robust recruitment system to ensure that suitable staff were employed. Staff were able to explain how they would recognise signs of abuse and knew what action to take.

Staff told us that they felt well supported and received the training and support they needed to carry out their roles effectively. Training provided was relevant to the needs of people living at the home.

People told us they enjoyed the food at the home and a relative told us, “The food is very much home cooking and it looks really good.” Risks associated with eating and drinking had been assessed and were managed effectively. Advice received from specialist, such as speech and language therapists (SALT), had been incorporated into people’s care plans and staff were following these instructions carefully. Some people were living with complex health conditions and staff were proactive in supporting them to access the health care services that they needed.

People and their relatives spoke highly of the staff and the caring relationships that had developed. Staff knew people well and supported them to be involved in planning their care and support. One person told us, “All the staff are nice, they help me.” A relative said, “The care is amazing.” People were treated with dignity and their privacy was respected.

People were leading full and busy lives. Staff supported people to follow their interests with a range of activities and people accessed the local community regularly. People were supported to maintain relationships that were important to them.

Care plans were personalised and enabled staff to provide care in a person centred w

We observed staff talking to people with respect and compassion and assisting them in making choices.

We read in care records that every person had a personalised care and support plan that was suitable to their needs and reviewed regularly. We saw from reading people's daily diaries and from observation that care plans were being followed by staff. We saw that there were regular community meetings where people's views were listened to and valued. We saw that regular audits of the service were completed by staff ensuring that people who used the service benefited from a service that constantly monitored its quality of care provided.

We spoke to and observed staff caring for people and they displayed a thorough knowledge of the people that they cared for including personal preferences.

Staff told us that that had adequate training in order to provide good quality care and were well supported in order to meet the needs of the people in the home. We inspected staff training records and saw that all staff had received safeguarding training and that their responsibility was well understood.

We observed staff talking to people with respect and assisting them in making choices. We saw people undertaking activities and displaying pleasure when doing them.

We read in care records that every person had a personalised and individualised care and support plan that was suitable to their needs and read reviews that were held with people, their representatives and external professionals. We saw, from reading people's daily notes and from observation, that care plans were being carried out by staff.

We spoke to staff about residents and they displayed a thorough knowledge of the people that they cared for. This was confirmed by our observations and by what we were told by a carer.

We saw notices around the home informing people and visitors how to complain or raise a safeguarding concern. We saw procedures and read that staff and people often discussed safeguarding matters.

We inspected staff records and we saw that staff received suitable training to undertake their roles. We observed there were enough staff to provide care and activities for people when we visited.

We read a number of audits and surveys and saw that feedback was sought from people and that the service had good quality systems in place.

We spoke with six people who live at 1 Charmandean Road. Conversation with most people was limited due to their disability. However, we spent time with them over lunch. We also observed the care they received from staff in order to understand what it was like to live at this care home.

We spoke with three members of staff who were on duty. They demonstrated they knew about the level of care that each person required. They also told us they were well supported by the manager.

We spoke with a representative of the provider who explained how the quality of service provision has been assessed and monitored.

The inspection was unannounced and took place on 08 and 09 June 2015.

Care Management Group - 1 Charmandean is an eight bed residential care home that provides support to adults with physical and learning disabilities, sensory impairments and complex health needs including epilepsy. People have different communication needs; some people were able to hold conversations independently and others needed support from staff to express their views, thoughts and feelings. The home is located in Worthing, close to shops and a short distance from the seafront. At the time of this inspection, there were eight people living at the home.

The home did not have a registered manager. 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. When we arrived at the home we were informed that the manager who was in the process of registering with us had stopped working at the home on the Friday before our inspection. A manager from another of the provider’s homes was called and came to the home to assist with the inspection process. We were informed that a new person had been recruited to manage the home and that they would be submitting an application to register with us in due course.

People said that the lack of a consistent manager was impacting on the service provided and our evidence supports this view. For example, one external professional wrote and informed us, ‘There have been a variety of managers in the service and this has led to inconsistencies of approach to and responsiveness to concerns, implementation of programmes etc’. Due to staff vacancies and sickness the deputy manager had not been able to use specific hours separate from the care staff to undertake management duties. In addition to this, the vacant manager’s hours were not all being used. A manager from another of the provider’s homes was at the home two days a week to provide support. However, it was apparent that the current situation regarding the lack of use of management hours was affecting the smooth running of the home.

Quality assurance processes were in place but these were not always being completed at the frequency stated by the provider. As a result events were not always identified and prompt action was not always taken to address areas of shortfall. Staff said that they prioritised the needs of the people that lived at the home and as a result, other aspects were not always being addressed.

At the last inspection on 18 and 26 September 2014 we asked the provider to take action to make improvements to safeguarding processes, notifications and record keeping and this action has been completed. The provider sent us an action plan that detailed steps that would be taken to achieve compliance. At this inspection we found that the provider had improved systems and processes to keep people safe. People told us they felt safe. Staff were aware of their responsibilities in relation to safeguarding. They were clear about when to report concerns and the processes to be followed in order to keep people safe.

People were able to make choices, to take control of their lives and be supported to develop their living skills. Risk assessments and support plans were in place that considered potential risks to people. Strategies to minimise these risks were recorded and acted upon. People were safely supported to manage their medicines. People were supported to access healthcare services and to maintain good health.

Appropriate recruitment checks were completed to ensure staff were safe to support people. Staff were sufficiently skilled and experienced to effectively care and support people to have a good quality of life. People told us that they were happy with the support they received from staff. Staff received training that supported them to undertake their roles and to meet the needs of people. Action was being taken to ensure they received regular formal supervision.

The Care Management Group - 1 Charmandean met the requirements of the Deprivation of Liberty Safeguards (DoLS) and people confirmed that they had consented to the care they received. Staff were kind and caring and people were treated with respect. Staff were attentive to people and we saw high levels of engagement with them. Staff knew what people could do for themselves and areas where support was needed.

People were supported to express their views and to be actively involved in making decisions about their care and support. Everyone had a key worker who was knowledgeable about the person they supported. Staff knew in detail each person’s individual needs, traits and personalities. People were supported to access and maintain links with their local community. Support plans were in place that provided detailed information for staff on how to deliver people’s care.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.