This was an unannounced comprehensive inspection that took place on 15 November 2016.

Cosy Lodge is a care home registered to provide accommodation for up to six people who have a learning disability or who are on the autistic spectrum. The home is located on two floors. Each person had their own individual room. The home had a communal lounge, kitchen and dining room where people could spend time together. The home had a large garden that people had been involved in developing including an area to grow rhubarb. At the time of inspection there were six people using the service.

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.

People and their relatives told us that they felt safe while they received support from staff at Cosy Lodge. Staff understood their responsibilities to protect people from abuse and avoidable harm. There were procedures in place to manage incidents and accidents.

Risks to people’s well-being had been assessed. Where risks had been identified control measures were in place.

There was a suitable number of staff to meet people’s needs. Staff had been checked for their suitability before starting work with the provider. Staff received support through an induction and regular supervision. There was training available for staff to update them on safe ways of working and how to meet people’s needs.

The provider had plans to keep people safe during significant events such as a fire. The building was well maintained and kept in a safe condition. Evacuation plans had been written for each person, to help support them safely in the event of an emergency.

People’s medicines were handled safely and were given to them in accordance with their prescriptions. People’s GPs and other healthcare professionals were contacted for advice whenever necessary. Staff had been trained to administer medicines and had been assessed for their competence to do this safely.

People chose their own food and drink and were encouraged to maintain a balanced diet. They had access to healthcare services when required to promote their well-being.

People were supported in line with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff and the registered manager had an understanding of the MCA. We found that appropriate DoLS applications had been made. Staff told us that they sought people’s consent before delivering their support.

People received support from staff who showed kindness and compassion. Their dignity and privacy was protected including staff discussing people in a professional and discreet manner. Staff knew people’s communication preferences and used these to support people effectively.

People were involved in decisions about their support. We saw that people’s records were stored safely.

People were supported to develop skills to maintain their independence. People and their relatives had contributed to the planning and review of their support. People had care plans that focused on them and what they wanted. Staff knew how to support people based on their preferences and how they wanted to be supported. People took part in activities and hobbies that they enjoyed.

People and their relatives knew how to make a complaint. The provider had a complaints policy in place that was available for people and their relatives.

People, their relatives and staff felt the service was well managed. The service was led by a registered manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009. Staff felt supported by the registered manager.

Systems were in place which assessed and monitored the quality of the se

At our inspection on 8 January 2014 we found that there was a lack of effective systems for making sure that people who used the service were protected from the risk of abuse. This was because the systems in place for recording and reporting unexplained marks or injuries to people’s bodies were not always being followed effectively by staff.

The provider wrote to us on 14 January 2014 to tell us about action they were taking to address this matter. At this inspection we found that the registered manager had put systems in place to make sure that any incidents, accidents or unexplained marks to people’s bodies were clearly documented by staff. The information was then reviewed by the manager or senior staff so that any necessary action could be taken.

We did not speak to people using the service on this occasion.

We used a number of different methods to help us understand the experiences of people using the service, because some of the people who lived there had complex needs which meant they were not able to tell us about their experiences. We observed how people spent their time during the day, how staff met their needs and how people interacted with staff. We spoke with two people who used the service and three members of staff.

People had individual care and support plans that they had been involved in developing and that reflected their current needs.

The service had systems in place to make sure that people were kept safe. However, we found that not all of the systems in place for staff to report and identify possible abuse were being used effectively.

We saw that there were enough staff on duty to give people the support they needed. We saw that people were comfortable with staff and interactions between staff and people were positive and respectful. Staff did not rush people when supporting or speaking with them and respected when people wished to exercise their independence and do things for themselves

The provider had systems in place to monitor the quality of the service provided. These included internal audits and systems for consulting people who used the service.

People told us they were happy with the service. One person said “I love my home” and people told us they felt safe. Staff knew how to recognise the signs of abuse and what to do to keep people safe from harm.

People told us that they were supported to make decisions in their lives and we saw that the staff treated them with respect. People had been involved in writing their care plan and were encouraged to be as independent as possible. There were meetings for people to talk about their care and have a say in how the service was being run.

People were asked about the social activities they enjoyed and had a plan for meeting their social needs. However, there was not an effective system in place for monitoring the activities that people did to ensure they were doing what they had said they wanted to. People told us about the activities they enjoyed doing and we saw that this reflected what their plans said they should be supported to do. One person said “I went to the disco last night, I love dancing”. We saw that people were busy doing various activities in the service during our visit.

The staff who supported people were qualified and received the training and support they needed to care for people effectively. There were systems in place for checking the quality of the service and this included asking people that used it for their views. The manager checked the safety of the service and took action quickly when changes needed to be made.

People told us they enjoyed living at the home. They said that staff supported them to make decisions, and listened to them if they were worried about something. People said they felt safe and well cared for.