This inspection was unannounced and took place on the 06 and 14 November 2018. Hazlegrove and Martingrove provides accommodation and support with personal care to a maximum of 15 people with a learning disability.

Hazlegrove and Martingrove 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.

Hazlegrove and Martingrove can accommodate up to 15 peoples and the service comprises an 11 bedroomed house, which contains a self-contained two bedroomed flat and, on the same site a detached four bedroomed house. At the time of our inspection 13 people were living at Hazelgrove and Martingrove. 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.

There was a registered manager in place. 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 and associated Regulations about how the service is run.

People felt safe at Hazlegrove and Martingrove and they were very much at the heart of the service. We received positive feedback from people’s relatives and health professionals. People received care that was based around their individual needs and that ensured care was personalised.

Staff enjoyed working at the home and understood the needs of people using the service and supported people in a personalised way. Staff knew people well and we saw that care was provided respectfully and sensitively, taking into account people’s different needs.

Relevant recruitment checks were conducted before staff started working at the service to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.

The risks to people were minimized through risk assessments. There were plans in place for foreseeable emergencies and fire safety checks were carried out.

People were supported to take their medicines safely by suitably trained staff. Medication administration records (MAR) confirmed people had received their medicines as prescribed.

People received varied meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes and went out of their way to provide people with what they wanted.

Staff sought consent from people before providing care or support. The ability of people to make decisions was assessed in line with legal requirements to ensure their liberty was not restricted unlawfully. Decisions were taken in the best interests of people. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible.

New staff completed an induction designed to ensure they understood their new role before being permitted to work unsupervised. Staff received regular support and one to one sessions or supervision to discuss areas of development. They completed a wide range of training and felt it supported them in their job role.

People were cared for with kindness, compassion and sensitivity. Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.

People were involved in their care plans and reviews. Residents meetings’ and surveys allowed people to provide feedback, which was us

This service was inspected on 29 July 2016. The inspection was unannounced. We returned on 8 August 2016 to complete the inspection.

Hazelgrove and Martingrove is registered to provide accommodation and support for up to 15 people and specialises in providing support to people who have a learning disability. The service comprises an 11 bedroomed house, which contains a self contained two bedroomed flat and, on the same site a detached four bedroomed house. At the time of our inspection 13 people were living at Hazelgrove and Martingrove. Most people had lived at the service for a number of years.

The service was well led with an experienced 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.

A particular strength of the service was that it had an open and friendly culture. People knew each other well and there were friendly and respectful relationships between people who lived at Hazelgrove and Martingrove and the staff team. People were encouraged to be as independent as possible but where people needed some support this was provided in an unobtrusive and sensitive way. Staff had a good understanding of people's needs and wishes and assisted people in line with these.

People said they were safely cared for. Staff were trained to keep residents safe and they knew how to raise a concern if they saw poor practice. Risk to people's health and welfare, as well as environmental risks were regularly discussed and recorded and reviewed regularly.

There were sufficient staff deployed to meet people's needs. New staff received an effective induction which gave them time to get to know people and the support they required. There was a good range of on-going training provided and staff were well supported through supervisions and appraisals.

People were encouraged to be responsible for the own medicines but where medicines were managed by staff on people's behalf this was done safely. Staff had a good understanding of people's health care and nutritional needs. They sought and followed advice where necessary from health care professionals so people

could maintain optimum health and wellbeing.

People were protected because staff were aware of and followed the principles of the Mental Capacity Act ((MCA) 2005. Consent was sought from people before care and support was given. If people required support with decision making then staff made referrals to the right professionals to ensure that decisions were made in people's best interests.This included support from advocates.

People were supported to choose and engage in activities they enjoyed both inside and outside the home. They were encouraged to be involved in developing the service and were asked their views and opinions regularly.

There were good quality assurance processes in place to help to ensure the care and support provided remained of a good standard and that it met regulations.

During our visit we spoke with members of staff, reviewed records and made observations.

We saw that people had an individual plan of care that included their needs and personal preferences and detailed people's physical and emotional healthcare requirements. In order to meet people's needs we saw that staff worked with a variety of healthcare professionals including physiotherapists and occupational therapists. We saw that people had access to advocacy services if needed.

People were protected from the risk of abuse or harm by there being safeguarding policies and procedures in place and by staff knowing how and when to use them. People were protected from the risk of infection by staff being appropriately trained and infection control measures being in place.

Policies and procedures were in place to ensure care and support was delivered to people in line with their needs and wishes. .

Care plans were kept under regular review and risks to people's safety were assessed by a suitably qualified member of the staff team. Plans to reduce and monitor risk to both people using the service and others were recorded.

We saw there was a caring and experienced staff team and that staff were well supported and trained to carry out their duties.

Processes were in place to monitor accidents, incidents and complaints and the quality of service being provided. Quality audits were undertaken to ensure the home was kept under regular review.

We saw that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. A carer told us "I am happy my relative is living here, they have all their needs attended to".

We spoke to staff and saw records that showed us that people were protected from abuse and that their care was planned and delivered in a safe, respectful and dignified way.

Staff we spoke to and records we saw demonstrated that staff were suitably experienced to support people living in the home. A staff member told us "there is a friendly atmosphere here and people are happy and well cared for".

We spoke to six people who lived in the home. They all told us that they were asked about their care and involved in decisions about their care and treatment. They told us they were involved in the community and had opportunities available daily to access activities in the home and the community. One person told us they were involved in art projects in the community; they said "I go out when I want to" and "I enjoy my art".

One person told us that they felt very independent in the home and were supported as required. They said their individual preferences were respected, such as what time they wished to go to bed and get up in the morning and meal preferences.

One person told us that they enjoyed living in the home, saying “I am able to do all the activities I enjoy".

People told us they liked where they live and were treated well by staff, who provided good support.

People said they felt safe in the home and said they would speak to staff or the manager if they had any concerns. People were confident that any concerns would be addressed.