Chessel Avenue is a residential care home which provides care and support for adults with learning disabilities, mental health or acquired brain injury. The service can accommodate up to 5 people, and 5 people were living at Chessel Avenue at the time of the inspection.

At our last inspection 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.

People who live at Chessel Avenue were kept safe, their risks were assessed and staff planned care with people to manage these risks. Staff knew about possible signs of neglect or abuse and felt supported to report any issues. People’s medicines were managed safely.

The premises were suitable, clean and well maintained.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People’s goals and independence was prioritised when planning care and people were supported to gain skills and confidence. Information was provided for people in a way they could understand.

Staff at Chessel Avenue cared for the people they supported. People were treated with respect and dignity and staff respected people’s privacy and right to personal space. Staff knew people well, including their preferences and personal histories.

People received support which was responsive to their needs. People were supported to feedback and make complaints if they wished to. People had been supported to stay in the home at the end of their life. The service was working to improve advanced care planning for people at the end of their lives and to support their families after they die.

The service was well led by a skilled and knowledgeable registered manager. There was a clear set of values for the service which guided development and improvement in the service. The service had good processes for reviewing and improving the quality and safety of care. The registered manager developed links and relationships with the local community and other providers and organisations. Further information is in the detailed findings below.

This inspection took place on 4 November 2015 and the provider was given 48 hours’ notice because the location was a small care home for younger adults with learning disabilities, who are often out during the day.

At the time of the inspection there were five people using the service. The registered manager was also the operational manager of the service. 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.

This inspection was of the residential side of the service as the Domiciliary Care Agency (DCA) and Supported Living; were in the process of being registered as a separate location which will be assessed once registered. As well as the operational manager, there were two managers, one who was to be the registered manager for Chessel Avenue and the other who was to be registered manager for the DCA and supported living. There were two team leaders and 9 other support staff.

The people were well cared for and there were enough staff to support them effectively. The staff were knowledgeable about the complex needs of the people and knew how to spot signs of abuse. People appeared to be safe and supported by the care staff and registered manager.

Care records and risk assessments were person-centred, up to date and were an accurate reflection of the person’s care and support needs. The care plans were written with the person, so they were fully involved in the planning and identifying of their support needs. The care plans included the person’s likes and preferences and were reviewed regularly to reflect changes to the person’s needs.

The service showed flexibility and responded positively to people’s request. People who use the service were able to make requests and express their views. The registered manager used the feedback as an opportunity to make changes and improve the service.

Staff received regular supervision and on-going training which was appropriate to their role. There were regular resident meetings as well as staff meetings, which supported people and staff and allowed them to explore areas which mattered to them.

The managers and staff were caring. They spoke to people in a kind, respectful and caring manner. There was an open, trusting relationship between them, which showed that staff and managers knew people well.

People were supported to be part of the local community and were able to attend activities both within the home, as well as in the local community. They made choices about how they spent their time and where they went each day.

Staff worked well as a team and said the manager provided support and guidance as they needed it. There was an open and transparent culture which was promoted amongst the team. This allowed them to learn from incidents and changes were made to the service following feedback from people and staff.

The manager demonstrated a good understanding of the importance of effective quality assurance systems. There was a process in place to monitor quality and to understand the experiences of the people who used the service. The manager demonstrated a desire to learn and implement best practice throughout the service.

We spoke with two people at Chessel Avenue, two people being supported to live in their own home, four members of staff and the manager. We observed support given to people using the service during our inspection. The people spoken with told us they were happy with the support they received from the service. One person told us everything was “all alright,” and another person told us their keyworker was “the nicest one ever.” Care and support were observed to be respectful and responsive to individuals’ needs.

People supported by the service and staff knew and got on well with each other. Staff ensured people were enabled to give their consent to care and support whenever possible. Where people did not have capacity to consent, effective systems ensured their rights and well-being were protected in line with legal requirements.

People were supported to be able to eat and drink sufficient amounts to meet their needs, and were protected from the risks of inadequate nutrition and dehydration. The provider had appropriate arrangements in place to manage medicines, so people were protected against the risks associated with medicines. The service’s systems for the return and disposal of unused medicines were not completely effective, but the provider had identified this and was taking action to address the issue.

The provider’s recruitment and selection processes ensured staff employed were suitable and sufficiently skilled to provide effective care and support to vulnerable people.

People were given opportunities to feedback about the service, and their complaints and comments were taken account of to improve the service. Regular audits helped maintain standards as part of an ongoing quality assurance programme.

This was a follow-up inspection, to check the provider’s progress against areas where we found non-compliance on our previous inspection visit on 6 December 2012. We spoke with the registered manager and staff about staff support. The manager explained how they had implemented a comprehensive support structure for the staff team, and we viewed records which confirmed regular supervision was taking place. Staff told us they “definitely” felt supported and that their manager was “always there” when they needed support. They had had sufficient training to do their work properly, and there were opportunities for them to complete further training as required and requested. We found people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

We spoke with the registered manager about the service’s policy and systems for the handling of complaints. They told us that all people at the service had been taken through the service’s complaints procedure. They explained the steps they had taken to ensure service users with communication difficulties also understood and were able to access the complaints process. We spoke with a person living at the service and they told us that staff were good at listening, and that if they wanted to complain about anything they would speak directly to staff. We found an effective complaints system was now available and comments and complaints people made were responded to appropriately.

We inspected against the regulated activity of ‘Accommodation for persons who require nursing or personal care’.

We spoke with three of the four people using the service and four members of staff, and observed support given to all four people. People said they were happy at the service, were supported to do what they wanted, and were involved in decisions made about their care and support. Support was observed to be person-centred, respectful and responsive to individual needs.

We reviewed care plans for three of the four people using the service and they were detailed, up-to-date and person-centred. Staff also demonstrated the importance of developing positive relationships and gaining personal knowledge of the people in their care.

Staff had received adequate training to be able to carry out their work effectively and inductions were thorough and service-specific. However, staff raised a number of issues regarding the support they receive from the provider and management team, including that supervision had not taken place on a regular basis and it had been difficult to raise issues or concerns with the senior management team.

We found there was not a satisfactory complaints process in place, and the service did not have adequate systems for the recording and responding to complaints.

The service had effective procedures in place for safeguarding vulnerable adults and followed the appropriate local safeguarding process.