This inspection took place on 16 February 2017 and was unannounced. At our previous inspection in November 2014 we had no concerns about the quality of care and the service was rated as Good.

Little Ingestre House provides accommodation and personal care for up to 15 people with a physical disability. There were 13 people living at the home when we visited.

There were two registered managers'. 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 were being safeguarded from abuse as staff and the management team followed the local safeguarding procedures if they suspected someone had suffered potential abuse.

Risks of harm to people were assessed and action was taken to minimise the risks through the effective use of risk assessment. Staff knew people's risks and followed their risk assessments.

There were sufficient numbers of suitably trained staff to keep people safe and meet their needs in a timely manner.

Staff had been recruited using safe recruitment procedures to ensure they were of good character and fit to work with people who used the service.

People's medicines were stored and administered safely by trained staff.

The principles of The Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) were being followed as the provider was ensuring that people were consenting to their care.

Staff told us and we saw they had received training and were supported to be effective in their roles.

People were supported to maintain a healthy diet dependent on their individual preferences. People received regular health care support and were referred to other health care agencies for support and advice if they became unwell or their needs changed.

People were treated with dignity and respect and their right to privacy was upheld.

Care was personalised and met people's individual needs and preferences. People were involved in the planning of their care.

People were supported to participate in hobbies and activities of their choice within the home and community.

The provider had a complaints procedure and people's complaints were taken seriously and acted upon.

The provider had systems in place to monitor and improve the quality of service.

This inspection took place on 25 and 27 November 2014 and was unannounced.

Little Ingestre provides accommodation and personal care to 13 people with a physical disability. There were 12 people living at the home when we visited.

Little Ingestre 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.

People’s wishes were always taken into account on the way their care was planned and delivered. People were involved in developing the service through a ‘resident group’ that identified areas where the service could be improved. We saw that the provider listened to their views and took positive action to respond to requests for changes and improvements in the service provided.

People told us they felt safe. Risks to people were managed effectively. Risks were identified, assessed and plans were in place to minimise the risks to people and to ensure that people’s wishes were respected. Risks were regularly reviewed with the person concerned.

Staff knew about different types of abuse and knew how to respond to any concerns. Appropriate action was taken when concerns were identified.

There were sufficient staff on duty to provide people with the care they needed in the way they wanted. The staffing levels were adapted when people’s needs changed. There was a robust recruitment procedure in place to make sure that suitable staff were recruited to provide people’s care.

Effective systems were in place to make sure people received their medicines in the manner and at the time the doctor prescribed. People confirmed that they always received their medicines.

People were supported by staff that were trained and supported to provide care to a satisfactory standard. Where people had specialist needs staff had the knowledge and skills to provide care that met their needs.

People’s health and nutritional needs were met. People had a choice of meals and mealtimes were a positive experience. Where people had specialist dietary requirements they received the correct care and support to make sure these needs were met. People accessed health care services. They saw their GP when they were ill and received specialist health care support from professionals including a dietician and speech and language therapists. People received dental and eye check-ups.

The care staff followed the guidance of the Mental Capacity Act 2005. When people needed support to make decisions this was recorded and we saw this was acted upon. Where people were unable to make more complex decisions this was done in their best interest and included significant people who knew them well. The managers were aware of the provisions of the Deprivation of Liberty Safeguards(DoLS). No one at the service was subject to any restrictions that required a DoLS authorisation.

People told us and we observed that people were supported in a caring and compassionate way. Their rights to privacy and dignity were promoted. Care staff knew how people expressed their wishes and made sure that their views were acted upon in the way their care was provided.

People received individualised care that was responsive to people’s preferences. People made choices about their lifestyle and how their care was provided. People had the opportunity to take part in hobbies and interests of their choice as well as trying out new experiences. People went out into the community. This was an area that the provider had identified could be further developed.

People told us the service was well led. We observed that the managers were very visible and knew people well. Care staff felt valued and encouraged to develop their knowledge and skills. Staff felt confident that any concerns over care practices would be acted upon.

There were effective systems in place to review and monitor the care people received. Where any shortfalls were identified action was taken to improve the service. The managers and providers were continually trying to improve the service provided to people that lived at the home.