The inspection took place on 19 April 2018. The inspection was announced.

Downers Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Downers Court accommodates three people in two single storey bungalows. All the people that lived at the service were men. People were not able to communicate their feedback and experiences verbally of living at 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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

The service had 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.

Risks were appropriately assessed and mitigated to ensure people were safe. Medicines had not always been managed safely. Records evidenced that people had received their medicines as prescribed. Stock balances did not always tally with medicines records. Staff had not always followed the provider’s policy when booking in new medicines. The registered manager took immediate action to review the medicines practice, this included a thorough audit of stock, changes to medicines disposal and increased auditing.

Effective systems were in place to enable the provider to assess, monitor and improve the quality and safety of the service. Having identified shortfalls during the inspection the registered manager immediately reviewed the quality checking processes and put in place new and revised systems to ensure that people were safe.

People were happy with their care and support. They indicated this through smiling, high fives and through their interaction with the staff supporting them. Staff had built up good relationships with people. Relatives confirmed that people were happy living at the service.

The service provided outstanding care and support to people enabling them to live as fulfilled and meaningful lives as possible.

Staff were cheerful, kind and patient in their approach and had a good rapport with people. The atmosphere in the service was calm and relaxed. Staff treated people with dignity and respect. People’s privacy was respected. The service was small and homely.

People were supported to maintain their relationships with people who mattered to them. Relatives told us they were able to visit at any time. Relatives shared examples of how the service had positively impacted on their lives.

There were enough staff deployed to meet people’s needs. The provider had not always operated safe and robust recruitment and selection procedures to make sure staff were suitable and safe to work with people. The registered manager took immediate action to address this during the inspection which ensured the service had a full employment history for each staff member.

Staff knew what they should do to identify and raise safeguarding concerns. The registered manager knew their responsibilities in relation to keeping people s

We carried out this inspection on the 1 March 2016 and it was unannounced.

Downers Court provides care and accommodation to up to three adults. The service offers 24 hour support to individuals with a learning disability, complex needs and / or a mental health diagnosis through a person centred approach. There were three people using the service at the time of our inspection.

People had a limited ability to verbally communicate with us or engage directly in the inspection process. People demonstrated that they were happy in their home by showing warmth to the staff that were supporting them. Staff were attentive and communicated with people in a warm and friendly manner. Staff were available throughout the day either on a one staff member to one person or two staff members to one person when out in the community. One person was supported by three staff members. Staff responded quickly to people’s requests for care and support. We observed staff supporting people with their daily activities.

A registered manager was employed at the service. 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.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

There were enough staff with the skills required to meet people’s needs. Staff were recruited using procedures designed to protect people from the employment of unsuitable staff. Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.

Staff respected people in the way they addressed them and helped them to move around the service. Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or the lunch was served and at other times during the day.

Staff had been trained to recognise and respond to the signs of abuse. Discussions with them confirmed that they knew the action to take in the event of any suspicion of abuse. Staff understood the whistle blowing policy and how to use it. They were confident they could raise any concerns with the registered provider or outside agencies if this was needed.

Staff were knowledgeable about the needs and requirements of people using the service. Staff involved people in planning their own care in formats that they were able to understand, for example pictorial formats. Staff supported them in making arrangements to meet their health needs.

Medicines were managed, stored, disposed of and administered safely. People received their medicines when they needed them and as prescribed.

People were provided with food and fluids that met their needs and preferences. Menus offered variety and choice.

There were risk assessments in place for the environment, and for each individual person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. People were involved in making decisions about their care and treatment.

There were systems in place to review accidents and incidents and make any relevant improvements as a result.

Management investigated and responded to people’s complaints and relatives/advocates said they felt able to raise any concerns with staff.

People were given individual support to take part in their preferred hobbies and interests.

There were systems in place to obtain people’s views about the quality of the service and the care they received. People were listened to and their views were taken into account in the way the service was run.