We carried out a comprehensive inspection of Marlow on 25 July 2018.

Marlow is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Marlow is registered to provide accommodation for people requiring personal care for up to 15 people, older people and younger adults with learning disabilities or autistic spectrum disorder, physical disabilities, sensory impairments and mental health support needs.

People lived in separate parts of the premises of the service; the downstairs of the building was called Marlow and upstairs there were two smaller self-contained flats. At the time of the inspection there were 15 people in total living at Marlow. 11 people lived in Marlow and four people lived in Marlow flats.

Marlow 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 this service can live as ordinary a life as any citizen.

The service 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.

This was the first inspection of the service since it was registered with the Care Quality Commission (CQC) in June 2017.

People told us they felt safe. One person said, “I feel very safe and comfortable”. There were systems and processes in place to keep people safe from abuse. Staff had received safeguarding training and understood how to recognise signs of abuse and their responsibilities to report this internally and externally if concerned.

People had risk assessments in place that identified any potential hazards to their well-being, the risks this presented and the control measures needed to keep them safe. Where ever possible, people were involved in this process and restrictions on their independence were minimised.

Systems for ordering, storing, returning and disposing of medicines were overseen by the registered manager and were operating safely. The service had enough staff to meet people’s needs and there were safe recruitment processes.

The premises and equipment within it were well maintained and clean and hygienic. Staff received infection control training and used plastic gloves and aprons when supporting people with personal care tasks.

People and their relatives told us that the service was effective. People’s physical, psychological and social needs had been comprehensively assessed to ensure they were able to meet their preferred support outcomes.

Processes were in place to ensure there was no discrimination for people when they made their support decisions. Staff received Equality and Diversity training and there was an 'Equal Opportunities, Diversity and Anti-Oppressive Practice' policy.

All new staff received a comprehensive induction that met the Care Certificate standards. The Care Certificate was introduced in April 2015 and is a standardised approach to training for new staff working in health and social care. It sets out learning outcomes, competencies and standards of care that care workers are nationally expected to achieve.

There were comprehensive induction, probation and on-going training and supervision processes to help staff to deliver effective support. Staff worked well with external agencies, such as local authority social and healthcare services and other providers to help co-ordinate people’s support so their needs could be effectively met.

People were invo