About the service: Meylan House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. It was registered for the support of up to seven people with learning disabilities and/or autism. Seven people were using the service at the time of the inspection.

Why we inspected: We undertook an unannounced focused inspection of Meylan House on 30 April 2019. We had received concerns from an anonymous whistle-blower about the practice of a member of staff. Alongside this we had received a high level of notifications of incidents between people who lived in the service. As a result, we undertook the focused inspection to investigate these concerns to ensure that risks were being managed safely. No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity, so we did not inspect the Key Questions of Effective, Caring or Responsive. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

People’s experience of using this service:

People were protected from abuse and avoidable harm. The provider had reported any concerns or allegations to safeguarding when it was identified. Where required, investigations were thorough.

The service shared information about risks consistently and reliably with staff and relevant others, including in handover meetings when staff changed over and other meetings.

Staff had received training and support was provided from a positive behaviour support team. This helped staff to identify and manage any risks that could result from behaviours that challenge.

Staff performance relating to unsafe care was recognised and responded to appropriately and quickly. Where concerns were brought to the provider’s attention, there was an appropriate thorough investigation involving all relevant staff and others.

Medicines systems were organised, and people were receiving their medicines when they should. The provider was following safe protocols for the receipt, storage, administration and disposal of medicines.

The provider and registered manager had an understanding of prioritising safe and high-quality care. There was evidence to demonstrate what action had taken place in response to concerns and incidents and in planning to prevent similar incidents in the future.

The service had effective governance, management and accountability arrangements. Where necessary, management had accounted for the actions, behaviours and performance of staff. Concerns are investigated in a sensitive and confidential way, and lessons are shared and acted on.

Rating at last inspection: At the last inspection the service was rated Good (published on 14 November 2017).

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated as Good.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk. The report from our last comprehensive inspection, can be found by selecting the 'all reports' link for Meylan House on our website at www.cqc.org.uk.

The inspection took place on 5 October 2017 and was unannounced. Meylan House supports up to seven adults with a learning disability and complex behavioural needs, as well as autism.

Meylan House is required to have a registered manager. A registered manager is a person who has registered with the CQC 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. The new manager was present and assisted us during this inspection. The registered manager for the service left in May 2017. Another manager had applied for the registered manager post; however, left their post in August 2017 before registration was completed. At the time of the inspection a new manager was in place who had applied to be registered with the Care Quality Commission (CQC). Their CQC application is currently being processed. The manager is being supported by the assistant area director.

People were kept safe by staff that had received training on safeguarding adults and understood their responsibilities to report concerns. Risks had been appropriately assessed and control measures were in place to minimise the risks.

People received their medicines as prescribed. Staff had training and were checked to ensure they continued to be competent when administering medicines.

Recruitment processes were designed to ensure only suitable staff were selected to work with people. There were sufficient numbers of staff to meet the needs of people who currently used the service. New staff were supported with an induction when they commenced work in the service, including shadowing opportunities. Relevant training had been received such as managing medicines, food hygiene, health and safety and first aid.

Staff were supported through annual appraisals and a number of supervisions throughout the year. Staff told us that they felt supported by the manager and that communication was effective.

Staff were aware of their duties under the Mental Capacity Act 2005. They obtained people's consent before carrying out care tasks and followed legal requirements where people did not have the capacity to consent.

We saw people were cared for and their dignity upheld. Relatives confirmed staff encouraged people to retain their independence on a day-to-day basis.

Care plans were personalised and centred on people's preferences, views and experiences as well as their care and support needs.

Measures were in place to assist people to raise concerns with staff. Complaints were investigated and responses given.

Auditing and quality assurance systems were in place to identify any actions required to ensure the safety and quality of the service.