Connington Court is a specialist residential service designed to support up to six adults with learning disabilities who may also have autism, complex needs or behaviours that challenge services. The service is provided on ground floor level and at the time of inspection there were four people using the service.

At the previous inspection completed on 24 November 2015 we found breaches of legal requirements and the service was issued five warning notices and placed in special measures. The provider did not ensure risks to people were minimised when receiving care. The service did not have suitable arrangements to manage medicines safely. Staff were not given appropriate support through regular supervision and training opportunities. The provider was not providing care in line with people’s consent and with mental capacity legislation. People’s preferences and choice of activity were not consistently accounted for when planning care and not all staff understood the principles of providing a personalised care service. The service did not document complaints made by people or their representatives. The manager did not have a system of carrying out quality checks on the service provided. The provider carried out quality audit visits of the service and found issues not addressed by the manager. People were not asked for feedback by the provider to help shape the service and were not given the opportunity to give their views through meetings. At this inspection we found the previous issues had been addressed.

This inspection took place on the 5, 9, 12, and 16 September 2016 and was unannounced. We found significant improvements had been made and so the service is no longer in special measures.

There was a registered manager at this 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.

The provider had a recruitment system in place to ensure the suitability of staff working at the service and there were enough staff on duty to meet people’s needs. Staff knew how to report concerns or abuse. Risk assessments were carried out and management plans put in place to enable people to receive safe care. There were effective and up to date systems in place to check and maintain the safety of the premises. The provider had systems in place to ensure the safe management and administration of medicines.

Staff received appropriate support through supervisions and training opportunities. Appropriate applications for Deprivation of Liberty Safeguards had been applied for and authorised. People were offered a choice of nutritious food and drink and were involved in meal preparation. People had access to healthcare professionals as required to meet their day to day health needs.

We observed staff treating people in a respectful and caring manner. Staff respected people’s privacy and dignity and were knowledgeable about assisting people to maintain their independence.

Staff knew the people they were supporting including their preferences to ensure a personalised service was provided. A variety of activities were offered which included trips outside of the home. The service dealt with complaints in accordance with their policy and timescales.

The provider held regular meetings for staff and for people who used the service. People were given the opportunity to complete satisfaction surveys. The provider had quality assurance systems in place to identify areas for improvement.

Connington Court is a specialist residential service designed to support up to six adults with learning disabilities who may also have autism, complex needs or behaviours that challenge services. The service is provided on ground floor level and at the time of inspection there were six people using the service.

We carried out this unannounced inspection on 10, 11, 12, 13, 20 and 24 November 2015 and divided our inspection time between Connington Court and the house next door, also run by the same provider. This was the first inspection of this service since its registration in October 2014.

There was no registered manager in post at the time of this inspection. 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.

The provider did not ensure that all reasonable steps were taken to ensure the risks to people were minimised when receiving care. We also found there were issues of concern around the management and safe administration of medicines. Staff were not given appropriate support through regular supervision and training opportunities. The provider was not providing care in line with people’s consent and with mental capacity legislation. People’s preferences and choice of activity were not consistently accounted for when planning care and not all staff understood the principles of providing a personalised care service. The service did not document complaints made by people or their representatives. The manager did not have a system of carrying out quality checks on the service provided. The provider carried out quality audit visits of the service and found issues not addressed by the manager. People were not asked for feedback by the provider to help shape the service and were not given the opportunity to give their views through meetings.

Staff were knowledgeable about procedures around safeguarding and whistleblowing procedures. There were enough staff on duty. The provider had safe recruitment procedures for new staff. People were offered choices from a varied and nutritious menu and special diets were catered for. Records showed that people accessed health professionals as required. Staff demonstrated they knew how to promote people’s privacy and dignity. People were assisted to maintain their levels of independence. The provider had a clear complaints policy and an accessible pictorial complaints guide for people who used the service.

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

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.