This inspection took place on 10 October 2016 and was unannounced.

Decoy Farm is a service that provides accommodation and nursing care for up to nine people with a learning disability or autistic spectrum disorder. There were eight people living at the service when we visited.

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.

Staff had been trained to recognise signs of potential abuse and to keep people safe. People felt safe living at the service. Processes were in place to manage identifiable risks within the service and to ensure people did not have their freedom restricted unnecessarily. The provider carried out recruitment checks on new staff to make sure they were suitable to work at the home. There were systems in place to ensure people were supported to take their medicines safely and at the appropriate times.

The staff recruited had the right values and skills to work with people who lived at the home. Staffing levels remained at the levels required to make sure every person's needs were met and helped to keep people safe. The registered manager planned staffing resources flexibly and responsively so that people were able to enjoy a varied but well-structured day.

Staff had received essential training to keep their skills up to date and the registered manager supported them with regular supervision. Staff sought people’s consent to care and support in line with the Mental Capacity Act (MCA) 2005. People were supported to eat and drink and to maintain a balanced diet. People were registered with a GP and were supported by staff to access other healthcare facilities.

There were positive and caring relationships between people and staff. People were encouraged to maintain their independence and staff promoted their privacy and dignity. Pre-admission assessments were undertaken before people came to live at the service. This ensured their identified needs would be adequately met. There was a strong caring culture in the care and support team.

People were able to contribute to the planning of their care. People participated in a wide and varied range of activities. Regular outings were organised and staff encouraged people to pursue their interests and hobbies. The registered manager and staff planned for these in detail to ensure the maximum amount of enjoyment would be had. People were able to partake in activities and opportunities that were previously thought to be unachievable.

There was a complaints procedure in place to enable people to raise concerns if they needed to. Complaints were responded to an acted upon in a timely way.

There was a positive, open and inclusive culture at the service. There was good leadership and management demonstrated at the service, which inspired staff to provide a quality service. There were systems in place to monitor the quality of the service provided and to drive continuous improvements.

Not all of the people who used the service were able to communicate verbally. But we were able to talk with four of the people. They told us that they liked living at Decoy Farm and that they got on well with the staff who supported them to go out to do their personal shopping, to follow their favourite activities and to be part of the local community. This was substantiated by the records we looked at.

People also told us that their bedrooms and apartments were comfortable and that they had everything they needed. One person told us that the staff, “Are all good, except this one…” while they pointed at a staff member and smiled broadly.

We observed that the staff were attentive to people’s needs. Staff interacted with people in a friendly, respectful and professional manner. We saw that staff had a good understanding of the way people communicated their needs.

We found that the service supported the people to eat healthily and to take their medication at the right time and to manage it safely. One person said, “The food is great, I do the cooking.”

We assessed the staffing levels in the service and found that people’s needs were met by sufficient numbers of appropriate staff. We also saw that the provider had systems in place to deal with complaints made about the service and that people who used the service were supported to make a complaint if they wanted to.

During the inspection we spoke with four people who used the service. They told us that they were happy with the care and support they were given. People were supported to carry out tasks such as cooking their own breakfast.

One person told us about the small farm attached to the property and the work they did. They were very proud of the farm, and told us, "I really enjoy the animals."

They were aware of the need to respect the dignity of other people who used the service, telling us it, "Isn't right to go into other people's rooms."

The service had a high number of well trained staff working at the time of the inspection This meant that people could undertake individual activities of their choice with the necessary support. While we were carrying out the inspection, people went out individually shopping, out for lunch, bowling and to the bank.

The premises were clean and well maintained, and offered self contained flats as an option for people who wanted more independence.

We spoke with two people who uses the service. They both told and showed us that they were happy with the service provided. Both were very relaxed, comfortable and proud of their individual progress. One person had just been promoted to the captain of a local disability football team on the day we visited. He told us that his active life and many various interests were promoted and he was helped to fulfil his aspirations. We observed how care workers were interacting with two more people who were having limited verbal abilities.

We observed the care process for two people who uses the service and saw how they experienced staff support and help. We saw how these two people interacted with staff and from their body language concluded that they were relaxed and comfortable with staff. Our observation showed that people were clean, shaven, appropriately dressed and generally well looked after.

We spoke to one person who uses the service. Although having limited verbal abilities, the person stated that they were very happy with the service they received.

We used the quality review questionnaires filled in by people who use the service and their relatives. The quality review process showed that people were satisfied with the service they received and that their relatives were very satisfied with all aspects of care. Individual questionnaires provided some very positive comments about the service.

They told us that they were happy with the service. All comments praised the staff for good work and progress that people made while at Decoy Farm.

We observed the care process for a person who uses the service and saw how he experienced staff support and help. We saw how two people interacted with staff and from their body language concluded that they were relaxed and comfortable with staff. Our observation showed that people were clean, shaven, appropriately dressed and generally well looked after.

A single inspector for adult social care carried out this this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

As part of this inspection we spoke with people who used the service. However, most were busy engaged in activities or were unable to comment about their care because of their communication difficulties. We spoke with a visiting health professional, a member of the quality monitoring team for Norfolk County Council, the registered manager and three other members of staff. We also observed how staff engaged with people. We reviewed records relating to the management of the service which included three care plans, daily records, policies and procedures, staff records and quality assurance monitoring records.

Below is a summary of what we found. The summary describes what the staff told us, what relatives said in their surveys, what we observed and the records we looked at.

Is it safe?

Risks to which people were exposed were assessed and guidance was provided about how these were to be managed. Staff knew that they needed to report promptly any concerns about safety or that people may be being abused. The manager had further training planned to improve the knowledge of staff about safeguarding referrals.

Recruitment practices ensured that staff were properly checked before they started work, to ensure they did not present a risk to vulnerable people. Where the conduct of staff may have placed people at risk, disciplinary processes were in place. Staff had regular training in 'safe holding' techniques so that people were not placed at risk of excessive or unlawful restraint.

There were proper procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager was aware that levels of supervision and restrictions for people leaving the home without staff support meant that applications needed to be made and there had been completed.

Is it effective?

People's needs had been assessed with them and there was clear guidance for staff about how people's needs were to be met. Where people were not able to communicate verbally, there was information about how they expressed content or distress and how staff were to respond. Where appropriate, the advice of other health professionals had been incorporated into people's plans of care.

Staff were able to tell us clearly about people's needs and the information they gave us was consistent with what we found in people's plans of care. This showed that staff were aware of how to support people effectively.

Is it caring?

We observed that people approached staff freely during our inspection. One person showed they were comfortable with staff by sitting with them, smiling and making eye contact. Staff spoke respectfully to people during our inspection.

Is it responsive?

We found that people's needs were kept under review so that changes to their care could be made if this was needed. Named members of staff supported people and understood how they would communicate whether they were happy, content or in distress. We observed that staff responded promptly to defuse and distract people who became agitated or anxious.

Is it well led?

The service had a robust quality assurance system. Records seen showed that any shortfalls were identified and followed up. There were regular checks on the quality and safety of the service so that standards could be maintained and address if this was required.

Records seen showed that people and their representatives were asked for their views and these were responded to. Staff told us they felt well supported by the manager and could make suggestions about how to improve the care that people received.