We inspected this service on 12 November 2018. The inspection was unannounced and carried out by one adult social care inspector. The adult social care lead inspector was joined by a dental inspector who looked in detail at how well the service supported people with their oral health.

The service is a ‘care home’ operated by Individual Care Services. The service, 2 Laurel Drive, provides accommodation with personal care for up to five adults. People cared for at the home are living with learning disabilities, and complex health and physical disabilities. People in care homes receive accommodation and 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. At the time of our inspection visit, there were four people living at the home.

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 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 last inspection in February 2016 all five key areas were rated as Good. At this inspection we found, overall, the quality of care had been maintained and people continued to receive a service that was caring, effective and responsive to their needs. Some improvements were required in the safety of the service. The overall rating continues to be Good.

There were enough staff on shift with the appropriate level of skills, experience and support to meet people’s needs and provide effective care. Staff knew what action to take in the event of an emergency and had been trained in first aid.

Staff understood their responsibilities to protect people from the risks of abuse. Staff had been trained in what constituted abuse and would raise concerns under the provider’s safeguarding policies. The provider checked staff’s suitability to deliver care and support during the recruitment process. Staff received training and used their skills, knowledge and experience to provide safe care to people.

Risks of harm or injury to people had, overall, been assessed and management plans were in place. However, plastic door wedges were used by staff to prop open fire doors, some fire doors did not always fully close due to maintenance work having added a plastic strip to a door frame. This posed potential risks to people and improvement was required in relation to the fire safety of the home.

The home was clean and tidy and staff understood how to prevent the risks of cross infection.

The deputy manager had identified some improvements were required to ensure fire safety was maintained at the service. Improvements were due to be completed before the end of November 2018 and included replacement closure devices on some fire doors.

People were encouraged and supported to maintain good health. Staff frequently liaised with other healthcare professionals. People received their prescribed medicines in a safe way.

Staff worked within the principles of the Mental Capacity Act 2005. The registered manager understood their responsibilities under the Act. Four people had authorised deprivation of liberty safeguards (DoLS) in place when their care and support included restrictions in the person's best interests.

Staff supported people in a caring and compassionate way. Relatives described staff as kind in their approach to their family members. People had very limited verbal communication and use

This inspection took place on 11 February 2016. 2 Laurel Drive provides care and accommodation for up to five people with a diagnosis of a learning disability or autistic spectrum disorder. Four women lived at the home at the time of our visit.

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.

People received care from a consistent kind, caring staff team who treated them with respect and promoted their rights. Staff had strong, caring and supportive relationships with people and their relatives. Staff worked in an inclusive manner and relatives felt involved and that their views were listened to.

Staffing levels ensured people were supported safely within the home and outside in the community. Relatives were confident people received safe care in a safe environment from staff who knew what they were doing. Staff understood their responsibility to keep people safe and report any concerns about people's wellbeing. Identified risks were used to inform people’s care, which was planned in a way that promoted their safety. Medicines were stored safely and securely and people received their medicines as prescribed.

Staff received induction, training and support to enable them to meet people's needs effectively. Staff understood and followed the Mental Capacity Act 2005 (MCA) to seek people’s consent or appropriate authorisation before they received care. This included authorisation by the relevant authority for any restrictions to people’s freedom that were deemed as necessary to keep them safe; known as Deprivation of Liberty Safeguards (DoLS).

Each person had a care plan that included information on maintaining the person’s health, their daily routines and preferences. Staff understood, communicated with and supported people in a way that met their individual needs.

There was a stable management team who staff said were approachable and supportive. Staff felt listened to and regular meetings gave them the chance to meet together as a staff team and discuss people's needs and any new developments for the service. There was a system of checks to ensure the quality of service provision was maintained.

When we visited 2 Laurel Drive we did so unannounced which meant that no one who lived at or worked at the service knew we were coming. During our visit we met all of the people that lived in the home. We also met and spoke with a senior support worker and three members of support staff.

People living in the home had complex needs which meant that they were not always able to tell us their experiences. We spent time during our visit observing care to help us understand their experiences.

We saw that people appeared comfortable and relaxed in their surroundings. People appeared happy in the company of the staff and responded to them with smiles and vocalisations when staff approached them. We saw that staff treated people with kindness and compassion, and clearly understood their non verbal methods of communication.

People had care plans in place that identified their care and support needs and were kept up to date. Staff told us that they found the information in people's plans helpful when learning about each person's needs. "I read them a lot, I find them really useful" was a comment made.

We saw that there were processes in place to ensure that medication was managed safely on people's behalf.

We saw that the environment provided for people to live in was suitably designed, well maintained and very homely. People's individual space had been personalised to reflect their individual taste.

When we visited 2 Laurel Drive we spoke with the manager, four staff and one person who lived in the home.

People living in the home had complex needs which meant that they were not always able to tell us their experiences. We spent time during our visit observing care to help us understand their experiences.

We observed that people appeared comfortable and at ease in their surroundings and with the staff. One person we spoke with told us that they were happy living in the home by nodding their head and smiling when we asked.

People had care plans in place that contained information to assist staff with meeting their care needs. Staff we spoke with were knowledgeable about people's care needs and were able to tell us about them.

We found that the quality of the service provided was measured through appropriate checks and measures.

The people who use this service all have communication difficulties. Those we were able to speak to indicated they were happy living in the home by either nodding or smiling when we asked them. A couple of people responded with the word “happy” when we asked. They also told us they enjoyed the food they were given, whilst others demonstrated their enjoyment of their evening meals by indicating that they would like extra helpings. We asked people if the staff were nice and treated them well. Those that were able gave us a positive response by again smiling and nodding.