The inspection took place on 16 January 2017 and was unannounced. At the last comprehensive inspection in December 2014, this service was rated Good. At this inspection we found the service remained Good.

31, Egmont Road provides care and accommodation for up to six people with moderate to severe learning disabilities. On the day of the inspection six people lived at the home.

The service 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.

Relatives told us they felt people were well cared for and safe living at 31, Egmont Road. This view was confirmed by the health and social care professionals we spoke with. Staff knew how to help protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed. Staff knew how to minimise risks and manage identified hazards in order to help keep people safe from harm or injury.

There were sufficient numbers levels of staff to meet people’s needs. This was endorsed by the relatives of people we spoke with.

People received their medicines appropriately and staff knew how to manage medicines safely.

Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure people are only deprived of their liberty in a safe and correct way. There were policies in place in relation to this and appropriate applications were made by the provider to the local authorities for those people who needed them. Staff supported people to make choices and decisions about their care wherever they had the capacity to do so.

People had a varied and nutritious diet and choice of meals. They were supported to stay healthy by staff who were aware of people’s healthcare needs and through regular monitoring by healthcare professionals. Relatives and professionals told us staff were consistently kind and caring and established positive relationships with people and their families. Staff valued people, treated them with respect and promoted their rights, choice and independence.

Staff understood family and friends were important to people and ensured they were appropriately involved in people's care, as required. People and their relatives were informed and supported to access independent advocacy services if they needed someone to speak up about their care on their behalf.

Comprehensive care plans were in place detailing how people wished to be supported and had been produced jointly with relatives and where possible people using the service. Relatives told us they agreed the care plans and were fully involved in making decisions about their family member’s support.

People participated in a range of activities within the home and in the community and received the support they needed to help them to do this.

There was a complaints procedure in place and relatives felt confident to raise any concerns either with the staff or the registered manager if they needed to. The complaints procedure was available in different formats so that it was accessible to everyone.

There were systems in place to monitor the care provided and people's views and opinions were sought regularly. Suggestions for change were listened to by the provider and actions were taken to improve the service provided.

This was an unannounced inspection and took place on 23 December 2014. At our previous visit on 16 July 2013, we judged that the service was meeting all the regulations that we looked at.

31 Egmont Road is a care home providing personal care and support for up to six people with learning disabilities. There were six people with moderate learning disabilities living at the home at the time of our inspection.

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 were kept safe. We saw that policies and procedures had been put in place to help to ensure the safety and wellbeing of people using the service. Staff knew what to do if people could not make decisions about their care needs.

People were involved in making decisions about their care and about how their needs would be met. People had risk assessments and risk management plans. Staff knew how to use the information to keep people safe.

Staff knew about the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS), which care homes are required to meet. There were procedures in place that could be used if they were needed. We found that staff sought people’s consent before providing care. DoLS refers to the framework of safeguards under the Mental Capacity Act 2005 for people who need to be deprived of their liberty in a hospital or care home in their best interests for care or treatment and who lack the capacity to consent to the arrangements made for their care or treatment.

There were enough staff on duty to help meet people’s needs and the home had safe recruitment procedures to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.

Appropriate arrangements were in place in relation to obtaining, storing, administering and the recording of medicines which helped to ensure they were given to people safely.

The provider supported and made guidance available to staff through induction and one to one supervision meetings with their line manager and in team meetings and they were supported to access further relevant qualifications. Staff received training in areas of their work identified as essential by the provider and in some specialised subjects, all of which helped staff provide support to people more effectively and efficiently.

We observed that people's experience of the service was a positive one. Discussions we had with people’s relatives supported this. We saw staff treated people with respect and dignity and people were helped to make decisions about how they lived their lives and about their care and support. Appropriate methods were used to help people communicate and make choices, for example, we saw the pictures used to help people choose what activities they wanted to take part in and the food they would like to eat.

Staff respected people’s privacy and treated them with respect and dignity. Staff understood people’s preferences, likes and dislikes regarding their care and support needs. Care was planned and delivered in ways that enhanced people’s safety and welfare according to their needs and preferences.

There was a clear management structure in the home and staff, relatives and people using the service felt comfortable talking to the manager and staff about their complaints, concerns and ideas for improvements. There were systems in place to monitor the safety and quality of the service provided. People were supported effectively with their health needs.

On the day of our inspection there were four people living at 31 Egmont Road on a permanent basis. One person was on holiday. We used a number of different methods to help us understand the experiences of people using the service because most of the people who lived at this care home had complex needs. This meant they were not always able to communicate with us.

We were able to observe that people's experience of the service was a positive one. During our inspection we saw staff always treated people with respect and dignity and people were supported to make informed decisions about how they lived their lives. We saw the methods used to help people communicate and make choices, for example, we saw the pictures used to help people choose what activities they wanted to take part in and the food they would like to eat.

We also gathered evidence of people's experiences of the service by speaking to the new manager and other staff who worked in the home and reviewing various records the provider was required to keep. Staff we spoke with told us they liked working at 31 Egmont Road, one staff member told us “I love it, I like to spend time with people and let them know I am there for them”.

We saw that policies and procedures had been put in place to ensure the safety and well-being of people using the service and we saw evidence of a quality assurance system regularly monitored by the provider.

There were four people living at the home at the time of this inspection. The house was coming to the end of major refurbishment and building works. We found that the provider had strived to minimise disruption to the lives of people using the service, including ensuring they were out doing activities for most of the day when work took place internally.

People living at the home had limited communication abilities and were unable to tell us their views. However, we were able to observe one person using the service throughout the inspection, how she interacted with staff and with her relative who was visiting.

We were unable to see if care staff at the home had a qualification such as NVQ Level 2 relevant to their work. However, the provider did ensure that all staff had proper induction training, and other training to enable them to deliver care to an appropriate standard. We found that staff were not receiving adequate levels of individual supervision to support them in their role.

A relative told us that the manager had improved care at the home since coming into post. She said "I trust him" and that she hoped the service would continue improving. The proprietor might like to note that she felt it would help to meet other relatives of people using the service.

We found that support plans were person centred and focused on people's needs and preferances.

We met all four people who currently reside at 31 Egmont Road during our visit, but we did not speak at length to any of them because of peoples complex communication needs. We did observe how care staff interacted with everyone.

During our visit we always observed staff treating the people who use the service with the utmost respect and courtesy.

Furthermore, care staff were always observed taking their time to actively listen and respond to the non-verbal signs and gestures the people who live at 31 Egmont Road used to communicate their needs and wishes. All the staff we met demonstrated very good understanding of peoples preferred and often unique methods of communicating. For example, we saw a person using an audio/pictorial communication passport to tell staff that they wanted a cup of tea, while another individual used their own form of sign language to express their desire to change their clothes.

We also observed staff actively encouraging and supporting people to do as much for themselves as they were willing and able to do so safely. For example, we saw staff verbally prompting people who use the service to take their dirty cups back to the kitchen after they had used them and support others to make their own lunch with minimal staff assistance.

When we arrived everyone who lives at 31 Egmont Road was out participating in a variety of social and occupational activities in the wider community. It was evident from all the comments we received from staff that people who use the service lead very active and fulfilling lives and are always encouraged to participate in all manner of interesting occupational and recreational activities, both at their home and in the local community. Typical comments we received from staff about activities, included: "Some people like to go to the pub so we try and make sure that happens every week", "I would say the activities people participate in reflects their social interests", and "I do not think people get bored here...If they did we would certainly know about it by their behaviour".

On balance 31 Egmont Road looked like a relatively homely and comfortable place to live. All the bedrooms we viewed had their own en-suite toilet and shower facilities and were suitably furnished. These rooms also contained lots of pictures, family photographs, ornaments that seemed to reflect the individual tastes and interests of the people who occupied them. We are aware that a plan to totally refurbish the care home has been agreed, which all the staff we met were confident would have been completed by the summer of 2012.

The care home is also kept very clean and was free from any malodours when we visited.