The inspection took place on 18 November 2016 and was unannounced.

Cotswold Lodge is registered to provide accommodation and personal care for up to seven people who live with complex learning disabilities. There were seven people accommodated at Cotswold lodge at the time of this inspection. There were plans in place to refurbish and carry out some required maintenance at the home in the coming months. This was being planned in accordance to people’s needs and wishes.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

When we last inspected the service on 23 January 2014 we found the service was meeting all the standards of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People who lived at Cotswold lodge were kept safe by staff who understood and had been trained on how to keep them safe. Risks were assessed and actions put in place to reduce or mitigate them to reduce the risk of harm. There were sufficient staff on duty at all times.

The provider used a robust recruitment process and pre-employments checks were undertaken to help make sure staff were suited to working in a care home setting.

People received their medicines safely by staff who had been provided with training and had their competency checked.

Staff were supported through supervision and an annual appraisal. Staff felt supported and valued by the manager. People received the support they needed to eat and drink and healthy and balanced diet. Health needs were taken care of and people were assisted to attend health appointments if required.

People and their relatives were positive about all aspects of the home, in particular the management and staff who were kind, caring and inclusive. Staff knew people’s needs and wishes very well and involved them in the planning and review of their care where possible. Visitors were always welcomed.

The provider had processes in place to obtain feedback from people who used the service and used feedback to improve the quality of care people received. There was an open, honest and respectful culture in the home and the team worked well together to ensure people who lived at Cotswold lodge enjoyed the best quality of life they could. There were quality monitoring systems in place to monitor and improve the service.

We were unable to speak with most of the people who use the service as they had limited verbal communication. One person told us “I like it here; I chose the colours in my bedroom”. We observed care given to four people, and noted the positive and warm interactions between staff and people who use the service.

We found that people’s capacity to consent was assessed and documented, and there was access to local advocacy services for people who were unable to make their own decisions. We saw that care plans had been written and regularly reviewed based on assessments of people’s individual needs and contained detailed information. We saw evidence of monitoring and regular evaluations of the support that was provided.

We found that records were maintained which demonstrated that medicines were dispensed accurately and stored safely. Staff told us that they received regular training and assessment in medicines handling and administration.

We saw that there were suitable recruitment and selection procedures in place, and found that personnel files contained current information on the suitability of a staff member for their role. We found that staff were supported through the induction process, and had access to a programme of regular training.

We found that there was information on how to complain in formats which enabled the people who used the service to make their views on the service known. We saw that where people complained, the service’s own procedures were followed, and documented appropriately.

The provider told us they carefully assessed the care and support needs of people living in the home. All the people, their relatives, representatives and health care professionals, where necessary were involved in this process. The arrangements for supporting people to make decisions about their daily lives and preferences were recorded in their care plans.

We spoke with one person who used the service. They told us they had monthly meetings with their key worker to review their care plan and discuss their activities. We reviewed three care plans and saw they were individualised and identified people's needs. The person we spoke with said, "I chose my bedroom colour because I like green colour and this makes me happy”.

Our observations of the service showed that staff spoke and interacted with people who used the service in a patient and pleasant manner. An individual told us "Staff are friendly, helpful and supportive”.

We saw that the home was clean and tidy, and there were records to show that regular cleaning was carried out.

People told us this was a lovely place to live and that they were well supported by the provider. One person said, “I have been here for several years and I have a key worker whom I like and able to tell what I want and how I want it done”.

There were effective recruitment and selection processes in place.

We saw that the provider had systems in place to assess and monitor the quality of the service provided.