This inspection took place on 19 February 2018 and was announced. We gave the provider 48 hours’ notice to ensure someone would be available to speak with us and show us records. We contacted family members by telephone on 23 February 2018.

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

Dunelm accommodates up to four people in one adapted building. 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. On the day of our inspection there were three people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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.

We last inspected the service in December 2015 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the safe administration and storage of medicines.

The home was clean, spacious and suitable for the people who used the service, and appropriate health and safety checks had been carried out.

The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff.

There were sufficient numbers of staff on duty to keep people safe and support them in the local community. Staff were suitably trained and received regular supervisions and appraisals.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

Family members were complimentary about the standard of care at Dunelm. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care records showed that people’s needs were assessed before they started using the service and support plans were written in a person-centred way. Person-centred means ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.

People were set targets, which were goals for them to work towards in areas such as improving independence and their quality of life.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

The provider had a complaints procedure in place. There had not been any complaints made however people who used the service and family members were aware of how to make a complaint.

The provider had an effective quality assurance process in place. Staff said they felt supported by the registered manager. People who used the service, family members and staff were regularly consulted about the quality of the service via m

The inspection was carried out on 21 December 2015 and 4 January 2016 and was unannounced. We last inspected the service on 26 November 2013. The registered provider met the regulations we inspected against at that time.

Dunelm provides care for up to four people with a learning disability or autism spectrum disorder. At the time of our inspection three people were living at the home.

The home 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.

Family members told us they were happy with their relative’s care. One family member said, “Excellent care. They are amazing.” Another family member commented, “Okay really, they care. They take care of [my relative] well.” Kind and considerate staff treated people with dignity and respect. One family member commented, “[My relative] has his dignity.” Staff supported people to develop daily living skills and promote their independence as much as possible.

Family members felt their relatives were safe living at Dunelm. One family member said, “[My relative] is very safe where he is. I would be the first to shout. I wouldn’t wish [my relative] to be anywhere else.”

Staff had a good understanding of safeguarding and whistleblowing, including how to report concerns. All staff had completed safeguarding adults training. One staff member said, “We are here to look after the service users. If I didn’t raise concerns I wouldn’t be doing my job.” Staff told us concerns would be taken seriously and investigated.

People received their medicines safely and on time from trained and competent staff. Medicines administration records (MARs) were accurate and regular checks were carried out to help ensure medicines were managed appropriately.

Potential risks had been identified and assessments were in place to guide staff about how to keep the person safe. For example, when people accessed the local community.

There were enough appropriately recruited staff to meet people’s needs and keep them safe. Staff told us staffing levels were under review due to a change in people’s needs within the service. One staff member said, “[Staffing levels were] fine as far as I am concerned. We have enough staff.” There were on-call arrangements in place should staff require assistance overnight.

A range of health and safety checks were carried out, such as checks of fire safety, firefighting equipment and emergency lighting. People had up to date personal emergency evacuation plans (PEEPs) to guide staff on how to keep people safe in an emergency. The registered provider had a business continuity plan to deal with emergency situations. Incidents were logged and a record of action taken to prevent the situation from happening again.

People were cared for by a skilled and well-supported staff team. One staff member told us, “I always feel I can go and talk to someone.” One staff member said, “All my training is up to date.” Records confirmed all training was up to date at the time of our inspection. Staff members told us they were able to discuss anything they wanted with their line manager.

The registered provider followed the requirements of the Mental Capacity Act 2005 (MCA). Deprivation of Liberty Safeguards (DoLS) had been authorised for all three people using the service following a MCA assessment and best interest decision.

Staff had a good understanding of people’s communication needs. They described how they supported people with making day to day decisions about their care. Staff adapted their communication style to meet the needs of individual people.

Staff had the skills to support people when they displayed behaviours that challenged. Staff used diversion, distraction

We viewed all of the private living spaces and the communal areas in the home and found a safe, inviting and friendly atmosphere throughout. There was a large, bright and airy communal lounge, a conservatory and a well-kept garden. We were told by the parent of person who lived there that the home was always spotlessly clean and that they were happy with the level of comfort and maintenance provided. We were also told that parents were always given "full uninhibited access" to the home and that they had found staff to be "very caring."

We spoke to two members of staff who spoke positively and without prompt regarding local management, training and working conditions.

We reviewed the comments and complaints file kept in the office. There had been no formal complaints since any of the people who lived there had joined the home.

We were unable to speak to all of the people using the service at Dunelm because of their complex needs, which meant they were not able to tell us their experiences. Although one person did provide us with some comments we gathered some evidence of people's experiences of the service by reviewing the care records, surveys from relatives and observing how staff interacted and communicated with people.

Four people were living at Dunelm at the time of our visit.

Most people were unable to converse with us due to their speech impairments, but one person who could said, “It’s okay”.

We spoke with a visiting relative who told us they had, “No concerns whatsoever” and, “Staff are excellent, he (a relative) is really well cared for”.