This was our first inspection of Laurel Grove, following a change of provider registration, in February 2017. The inspection was unannounced and carried out by one inspector on 26 July 2018. Laurel Grove is a care home service and has been developed and designed in line with the values that underpin the Registering the Right Support CQC policy and other relevant nationally recognised 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.

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. Personal care is provided in one adapted building for up to three adults with learning disabilities. Accommodation is provided over three floors with access to communal kitchen, laundry, dining and lounge facilities, including a quiet lounge and private outdoor space. En-suite and a large adapted bathroom and toilet facilities are also provided, along with dedicated staff facilities. At our inspection, there were three people living at the service who received personal care.

Laurel Grove has a registered manager who supports two small care home locations for the provider. 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 deputy manager was appointed at this location, to support the registered manager.

People received safe care in a clean, well maintained environment, which they were comfortable and happy with. People and staff were informed and confident to raise any safety concerns relating to people’s care, if they needed to. People felt safe at the service and staff knew how to keep them safe from any risk of harm or abuse.

Staffing measures, emergency contingency planning and related safety procedures, helped to ensure people’s safety at the service.

Risks to people’s safety associated with their health conditions and environment, were assessed before people received care and regularly reviewed in consultation with them. People’s medicines were safely managed.

Any safety or health related incidents were monitored and analysed, to help inform any care improvements needed. Related care or service improvements were shared with staff and monitored to help prevent any re-occurrence.

People received effective care. Staff were trained and informed to provide people’s care. 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 promoted this practice.

People’s needs were assessed before they received care and regularly reviewed. Staff supported people to maintain and improve their health and nutrition in consultation with relevant external health professionals. Staff followed any related instructions for people’s care when required.

Staff consulted with people to optimise their inclusion, understanding and ownership of their agreed care; and to ensure effective information sharing with external care providers when required. People were provided with care and service information in a format they could understand.

People continued to receive individualised care from staff, who were kind, caring and fostered good relationships with them and their families. Staff understood and followed people’s preferred daily living routines and lifestyles. This was done in an individualised way that helped to ensure people’s choice and independence.

Staff knew how to communicate with people in the way they preferred and understood. Peo