This inspection took place on the 17 and 20 November 2017 and was unannounced. The inspection team consisted of one inspector. The previous inspection took place in October 2015 and the service was rated Good overall. This service was inspected at the same time as the provider’s other service which is very similar to this service. Both services are with five minutes’ drive from each other and managed by the same registered manager. Some areas of the reports will contain some similarities as we spoke to the same staff during our inspections of both services.

Dexter close is a residential home registered to provide personal care and accommodation for two people with learning disabilities and on the autism spectrum. The service is a house located in Grays, Essex. Each person has a single room and there is a communal bathroom, shower room, kitchen, dining room and lounge. There is a rear enclosed garden at the back of the house with level access. At the time of our inspection there were two people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Registering the Right Support CQC policy.

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 service was safe. The service’s recruitment process ensured that appropriate checks were carried out before staff commenced employment. There were sufficient staff on duty to meet the needs of people and keep them safe from potential harm or abuse. People’s health and wellbeing needs were assessed and reviewed to minimise risk to health. People’s medication was managed well and records of administration were kept up to date.

The service was effective. People were cared for and supported by staff who had received training to support people and to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to health and social care services was made when required.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.

The service was responsive. Records we viewed showed people and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were supported to follow their interests and participate in social activities. The service responded to complaints received in a timely manner.

The service was well-led. Staff and people spoke very highly of the registered manager and the provider who they informed to be supportive and worked hard to provide an exceptional service. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis.

The unannounced inspection took place on the 22 October 2015.

Dexter Close provides accommodation and support for up to two people living with on-going learning disability.

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 delivered support effectively and care was provided in a way that intended to promote people’s independence and wellbeing, whilst people’s safety was ensured. Staff were recruited and employed upon completion of appropriate checks as part of a robust recruitment process. Sufficient members of staff enabled people’s individual needs to be met adequately. Qualified staff dispensed medications and monitored people’s health satisfactorily.

Staff understood their responsibilities and how to keep people safe. People’s rights were also protected because management and staff understood the framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People were given support and advice regarding purchasing and cooking food, which allowed an informed choice to be made by each individual. Staff and manager ensured access to healthcare services were readily available to people and worked with a range of health professionals, such as social workers, community mental health nurses and GPs; to implement care and support plans.

Staff were respectful and compassionate towards people ensuring privacy and dignity was valued. People were supported in a person centred way by staff who understood their roles in relation to encouraging independence whilst mitigating potential risks. People were supported to identify their own interests and pursue them with the assistance of staff. These person centred activities took place within the service as well as in the community.

Systems were in place to make sure that people’s views were gathered. These included regular meetings, direct interactions with people and questionnaires being distributed to people, relatives and healthcare professionals. The service was assisted to run effectively by the use of quality monitoring audits the manager carried out, which identified any improvements needed. A complaints procedure was in place and has been implemented appropriately by management.

People we spoke with told us that they were content and well cared for at Dexter Close.

We saw that care and treatment for each person was planned and reviewed with their involvement and consent as far as possible. Risks to the health, welfare and safety of people using the service were identified and managed.

People enjoyed the food provided at the service and were able to exercise choice about what they ate and drank.

People's medicines were managed safely by competent staff. However, further improvements would ensure better storage arrangements and management.

Staff were recruited safely. Staff were also trained and supported to care for people properly and to keep them safe.

People we spoke with told us that they were satisfied with the staff and what they did each day. They told us that they knew what was in their support plan and were involved in deciding daily routines and the way their rooms were furnished and decorated. People told us that staff supported them in accessing the local and wider community, so that they could take part in their chosen interests and activities. People also told us that they were satisfied with staff attitudes towards them.