The inspection took place on 22 and 26 January 2018. It was unannounced on the first day and announced on the second day and was carried out by one adult social care inspector. This was the first comprehensive inspection at the service since it was registered in December 2016.

Charlotte House is a care home registered for two adults that provides support to adults with learning disabilities, autism and complex needs. The home is located in a residential area of Warrington, close to shops, transport links and other local amenities. There was one person living at the home at the time of the inspection supported by staff on a 24 hour basis.

Charlotte House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care 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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.'

A registered manager was 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.

At this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered providers audit systems had not identified the areas for development and improvement found during the inspection process. Incident and accidents were not consistently reviewed and analysed to identify trends and patterns.

The policies and procedures did not all include current best practice guidelines. The recruitment procedures were not consistently robust. You can see what action we told the provider to take at the back of the full version of the report.

Medicines were ordered, stored and administered safely by competent and trained staff. Medication administration records (MARs) were fully completed and signed by staff in accordance with good practice guidelines. PRN 'as required' medicines did not have protocols in place for their safe management. We have made a recommendation in relation to this.

The person supported had a comprehensive care plan and selection of risk assessments. The documents had not been reviewed or updated and held out of date and incorrect information. This meant staff did not have up to date guidance to support the person and mitigate any risks identified. We have made a recommendation regarding this.

Staff had all completed an induction and undertaken mandatory training. Not all staff felt competent to support the person living at Charlotte House. Due to the complexities of the person supported the registered manager was reviewing staff training to ensure staff had sufficient skills and knowledge to undertake their role.

All staff had completed safeguarding training and demonstrated a good understanding of abuse and what they would do if they had any concerns about a person. The registered provider had a safeguarding policy and procedure in place to protect people from abuse.

Sufficient staff were available to meet the needs of the person supported.

The person was supported with their food and fluid intake. The person prepared some of their own meals and snacks. They made their own food and drink choices.

Activities were available to meet the needs of the person supported. The person was supported to maintain regular contact with their family members.

The home was clean and decorated to a good standard. There were hand washing facilities at the home and it was free from