The inspection took place on 21 August 2017 and was announced. The registered manager was given short notice of the inspection, because we needed to make sure they and the people who lived at the home were available to assist with the inspection.

30 Keepers Crescent provide care and accommodation for up to five people with a learning disability. There were five people living in the home on the day of the inspection and there was a registered manager in post. 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. At the time of our last inspection the service was providing a good quality of service. At this inspection they continue to do so.

Although safe staffing numbers were maintained the skills mix, due to staffing shortages, impacted upon people’s current opportunities to receive a responsive service.

People were supported safely. Staff had a good understanding of potential abuse and knew how to protect people from the risk of harm. Risks were identified and well managed in order to keep people safe. Staff were confident they could safely manage behaviours of concern. Consistency and good routines helped people feel safe and secure. Staff were recruited through safe recruitment practices meaning that only people suitable to work in the role were appointed.

People were protected by safe systems in place to enable them to receive their medicines safely.

People were supported by staff who had the knowledge and skills to provide effective support. Staff received good training opportunities and training had been developed around the individual needs of the people who used the service. Staff felt very well supported by the registered manager and their colleagues.

Staff knew people well and communicated effectively with people. Staff worked well as a team to meet people’s complex and changing needs.

People enjoyed a balanced and healthy diet. Staff were creative to offer variety and choices.

People’s constantly changing health care needs were met and staff worked closely with healthcare professionals to ensure people’s conditions were identified and managed.

People were supported by staff who were kind and caring. People were encouraged to express their individuality and be as independent as they were able. People were supported to develop and maintain friendships and personal relationships. People’s privacy and dignity was respected and promoted and people knew how they should be treated.

People were at the heart of the service delivery and support was centred on people’s individual needs and wishes. People had experienced a number of health challenges and staff had responded to these positively and proactively.

Support was very person centred and records detailed people’s life histories, hopes and dreams as well as their support needs.

People were confident that their complaints would be listened to, taken seriously and acted on.

The service was well led. The provider, as an organisation, was looking at innovative ideas to improve the service. Staff felt consulted, involved and valued. People’s relatives were regularly asked for their views about the quality of the service and reviews of care and support identified that people were receiving a good service. There were systems in place to monitor practices and processes. The environment required improvement in some areas and the registered manager was actively addressing this.

The inspection was unannounced and took place on 21 April 2015. At the last inspection in August 2013, we found the provider was meeting the regulations we inspected.

30 Keepers Crescent provides care and accommodation for up to five people with a learning disability. There were five people living in the home on the day of the inspection. There was a registered manager in post who was on planned long term leave. An acting manager was covering the post. 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 were cared for safely. Staff knew how to protect people against the risk of abuse or harm and how to report concerns. There were enough staff to support people at the time of the inspection. However, due to an increase in one person’s needs staff felt an additional member of staff was required to ensure they were able to respond to people’s needs in a timely manner. Managers had identified this and were in the process of getting the person’s needs reviewed. People’s medicines were given when they needed them by staff who were trained and had their competency assessed.

People were supported by staff who had the skills to meet their needs. Staff had received training and felt supported in their roles. Staff were supported to carry out their roles effectively through a planned programme of training and support. People were supported to make their own decisions and choices. Staff understood and promoted people’s rights and people were supported to maintain their health. People’s healthcare needs were assessed and planned to meet their needs.

Staff were kind and caring and had developed positive working relationships with the people they supported. People were treated as individuals, were listened to and respected by staff who knew them well. Staff were aware of people's need for privacy and dignity however, on one occasion we saw one person’s privacy and dignity was not considered. Managers informed us they would take action to look into this.

People were supported to maintain their identities and received care and support that was individual to them. People were at the centre of their care and staff were responsive to their needs. People's care plans and risk assessments were personalised. Staff were able to tell us how people preferred their care and support to be delivered. People were encouraged to participate in a range of activities and staff knew how to raise concerns on behalf of the people they supported.

There was a positive and open culture in the home. The acting manager was approachable and supportive and ensured people were well cared for. People’s views were sought about the quality of the service. Audits were carried out on a regular basis to monitor and improve the service people received.

There were four people living in the home at the time of our visit. Although we met three people, they were not able to express their views about the service in any detail. However, everyone we saw appeared to be happy and relaxed in the home.

We saw good evidence that people were supported to make as many decisions for themselves as possible. When people lacked the capacity to make important decisions, meetings were held to make decisions for them that were in their best interests.

We found that care plans were person centred and contained lots of information about people’s choice and preferences. Staff told us that the care plans contained all the information they needed to provide consistent care.

We found that medicines were safely stored, handled and administered. Medicine records were accurate and doctors’ instructions were properly acted upon.

We found that appropriate checks were properly carried out on staff before they were allowed to start work.

The provider had a suitable complaints procedure in place. It had been made available to people’s relatives and representatives and was available in an easy to read format for those who needed it.

Staff we spoke with told us that they enjoyed their work. They told us that there was a good team spirit and that they were well supported by the manager.

The service supports a maximum of four people with learning disabilities and complex support needs.

We met with people who lived at 30 Keepers Crescent during our visit. One person was able to share their views and experiences with us about the service that they received. Three people were not able to do so and therefore we also spent time observing routines and interactions. We spoke with the three staff who were working at the home on the day of our inspection. We reviewed the very detailed care and support plans belonging to one person and looked at additional information as detailed within this report.

People were supported to live full and active lives. People took part in a range of leisure and social activities, both at home and in the local community. The level of support people required varied and this was accommodated by the home.

Likes, dislikes, preferences and goals were considered in relation to the care and support that people received. Everyone was seen to be treated with dignity and respect.

People were involved in developing independent living skills with staff support and encouragement. We saw one person preparing their breakfast with support and one person going to the kitchen at lunch time and choosing what they wanted to eat.

Staff met people’s care and support needs in ways that they preferred and we saw that detailed records gave staff the information that they required to do this. Plans were in place to support people to enjoy their lives and staff were aware of risks, people's rights and their responsibilities in order to enable them to do this.

People were supported by a well established, knowledgeable and well trained staff team who knew their care and support needs well. Staff told us that they were offered a range of training opportunities that were specifically designed to meet the needs of the people that they supported.

People were protected because staff were confident to recognise and report abuse.

The home effectively ensured that people's views were considered and listened to in relation to the running of the service. Staff responded to verbal and non verbal communication methods to identify and respond to people's requests.

The organisation had comprehensive quality monitoring tools in place to ensure that they maintained good quality care.