This inspection took place on 22 and 30 November 2016. Our first visit was unannounced. At our last inspection in September 2013 the provider met the regulations we inspected.

Mallow Crescent provides accommodation and support for up to 33 people who have a learning disability. There are six houses located at the end of a quiet residential crescent with five houses providing long term accommodation and one house providing short term respite support. Mallow Crescent also operates an outreach service providing support to people in their own homes.

The home had 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 using the service felt safe and spoke positively about the support provided to them. They said staff treated them with kindness and respect.

People were supported to lead active lives and maintain relationships with those who matter to them. Their relatives gave positive feedback about the service provided and praised the caring supportive nature of the staff working there. They felt the service was outstanding.

There was strong leadership at Mallow Crescent. An experienced registered manager communicated a strong person centred ethos focusing on valuing each person as an individual and ensuring they had a good quality of life.

Staff completed MCA and DoLS training that helped them to understand issues around capacity and support people effectively. The staff provided information to people in different ways to help them understand and, where possible, make decisions for themselves.

Medicines were stored, administered, recorded and disposed of safely. Staff were trained in the safe administration of medicines and kept records that were accurate.

The staff were well trained and supported. A tailored induction programme focused on ensuring that new staff had the right skills and values, ensuring they were person centred not task orientated in their approach. There was an open positive culture within the service where staff felt valued and appreciated for the work they did by the management team.

Risk assessments were in place that reflected current risks for people at the service and ways to try and reduce these. Support plans were regularly reviewed and updated to ensure the care provided met people’s changing needs. Each person had an ‘All about me’ document produced using photographs that reflected their preferences and what was important to them as individuals.

People and their relatives told us that they felt able to raise any issues or concerns and these were dealt with promptly and satisfactorily. There were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow these.

The way the service was structured and the processes in place ensured staff were clear about their responsibilities and that important information was shared across the six houses in Mallow Crescent. There were effective systems to ensure the quality of the service and obtain feedback from people, their relatives and other stakeholders.

Our inspection was facilitated by the registered manager and we inspected four of the six houses which make up the service. After the inspection we spoke by telephone with people’s relatives. Although we did not speak directly with people who used the service about their care and support, we observed their interactions with staff and each other.

We found that there were processes in place to gain the consent of people or their representatives to the care provided and that people’s rights were upheld.

We spoke with a relative who told us, “I have no worries at all. I’m very happy with the manager and consider myself lucky that my relative lives in such a ‘family’ environment”.

The service had daily cleaning schedules in place to reduce the risk of infection and the houses appeared hygienic and well maintained. The service was deep cleaned annually by a specialist cleaning contractor.

We found that staff were supported in their roles in terms of training, supervision and opportunities for professional development. One member told us, “One of the great things about working here is that the training is superb and the manager supports you and makes sure that your training needs are met

We found that there were effective systems in place to monitor the quality of the care and support provided and that the registered manager kept procedures under review.

This service provided accommodation and support to up to 27 people with learning disabilities on long-term placements and offered respite care for up to six people.

We noted that people who used the service were treated with dignity and respect and were involved in making decisions about their support.

One person who used the service told us, “I’ve been here a long time and it’s very good. The staff are nice”.

A relative of a person who used the service wrote, ‘The house is run very efficiently. All the staff, including the new ones, know my relative well. Pastoral care is excellent’.

We found that support planning and risk assessments were detailed and that care was delivered in line with each individual’s needs.

A relative wrote to the registered manager saying, “I am very satisfied. The staff are wonderful and my relative is always happy to come there”.

We also found that the service had effectively identified areas where people might be vulnerable and had introduced plans to manage the risk of abuse.

During the inspection we saw that the service had a comprehensive staff selection procedure in which people who used the service were involved.

We found that people were made aware of the complaints system and material was provided in a format that met their needs. Complaints were fully investigated and resolved, where possible, to the satisfaction of the complainant.