The inspection took place on 27 July 2017 and was announced. The provider was given 48 hours’ notice as the home is a small home for adults who are often out during the day. We needed to be sure someone would be in.

MIG House Residential Care Homes is a care home for four adults with learning disabilities. At the time of our inspection four people were living in the home.

The home 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.

The service was last inspected in July 2015 when it was rated ‘good’. The service remained overall ‘good’ at this inspection.

People and relatives told us they felt safe at the home. Staff were knowledgeable about safeguarding adults from avoidable harm and abuse. The home responded to incidents in an appropriate way, ensuring lessons were learnt and appropriate referrals were made if required.

The service identified and mitigated risks faced by people in their daily lives. Measures in place to mitigate risk were clear for staff to follow and people were involved in processes designed to reduce the risk of harm.

There were enough staff on duty in the home. Staff were recruited in a way that ensured they were suitable to work in the home.

People were supported to take medicines by staff. There was clear information on people’s medicines, and people were as involved in the process as they were able to be. Staff carried out daily counts of medicines stocks and the registered manager completed monthly audits. This ensured medicines were managed in a safe way.

When new staff joined the service they completed a comprehensive induction. Staff received training to ensure they had the knowledge and skills required to meet people’s needs. The registered manager completed monthly supervision with staff and each staff member had a development plan in place. Staff were supported in their roles.

People were supported to make as many decisions as they were able. Where people made decisions that were unusual for them, this was recorded in a special book to keep track of people’s different choices. Where people lacked capacity to make specific decisions the service worked within the principles of the Mental Capacity Act 2005.

Staff were knowledgeable about people’s dietary needs and preferences. People were involved in choosing the menu options and records showed people were supported with a varied diet. People were supported to be involved in meal preparation.

People living in the home had a range of long term health conditions. Staff supported people to attend appointments with healthcare professionals and there were clear records of advice from healthcare professionals.

People and staff had developed strong, positive relationships with each other. There was a positive, friendly atmosphere in the home. Throughout the inspection people teased staff in a friendly manner. Staff interacted with people in a positive way that recognised and valued them as individuals.

Staff worked to promote people’s independence and respected their privacy. People told us staff respected their privacy and treated them with dignity and respect.

Care plans were highly personalised and goal focussed. People’s independence was promoted and they were supported to achieve specific goals and rewarded for achieving them. People, relatives and external professionals told us people had made excellent progress and developed their skills and abilities while living in the home.

Information about complaints, and house meetings were available in a format that was accessible to people living in the home. People were able to provide feedback about their experiences and the home acted on this feedback and made changes as a result.

We inspected MIG House Residential Care Home on 9 July 2015. This was an announced inspection. The service was given 48 hours’ notice because we needed to be sure that someone would be in.

The service provides accommodation and support with personal care for up to four adults with learning disabilities. At the time of our inspection three people were using the service.

At our previous inspection of the service on 28 May 2013, we found arrangements were not in place to enable people to consent to the care provided. During this inspection we checked to determine whether the required improvements had been made. We found the service was now meeting the regulation.

There was a registered manager at the service at the time of our inspection. 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 and associated Regulations about how the service is run.

At this inspection we found the provider had systems in place to protect people from the risk of harm. Staff understood how to keep people safe and knew the people they were supporting very well. For example, staff had a good understanding of what constituted abuse and the abuse reporting procedures. People’s finances were managed and audited regularly by staff. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were enough staff to keep people safe. Robust recruitment and selection procedures were in place to make sure suitable staff worked with people who used the service. Staff were skilled and experienced to meet people’s needs because they received appropriate training, supervision and appraisal. The service met the requirements of the Deprivation of Liberty safeguards.

Care was personalised and delivered to a good standard. People received good support to make sure their nutritional and health needs were appropriately met. People’s needs were assessed and care and support was planned and delivered in line with their individual care needs.

The service had good management and leadership. The provider had a system to monitor and assess the quality of service provision. Safety checks were carried out around the service and any safety issues were reported and dealt with promptly.

We spoke with people using the service and their family members and they were generally happy with the care and support provided by the service. One person told us, "I like it here, I can do what I want." We observed that people were given choices and were able to make their own decisions.

People's needs were assessed and care and treatment was planned. Care plans and risk assessments were regularly reviewed. People were aware of what was in their care plan and told us that their care and support was delivered in line with it. However we were concerned that people were being deprived of their liberty without the appropriate authorisation being in place.

There were safeguarding vulnerable adults and whistle-blowing policies in place which the staff were familiar with. Staff had been trained in safeguarding vulnerable people and had a good knowledge about safeguarding issues.

The service had effective recruitment and selection processes in place. We found that appropriate checks were carried out before staff were allowed to work with people using the service. We reviewed several records relating to people using the service, the staff, and management of the service and found the records were accurate, up to date and fit for purpose.

People were involved in planning their care. On the day of our visit one person had gone to college. The other two were engaged in various activities throughout the day. These included watching TV, playing games or going out to doctor’s appointments. People told us that they were happy and referred to MIG house as their “home”. We observed that people appeared relaxed. People showed us their rooms and told us how they had chosen the decoration.

Medicines were handled appropriately. Staff knew people’s allergies and had received up to date training on administration of medication. Staff worked according to the medicine policy and knew what to do if someone refused medication.

Staff received appropriate professional development and regular training, supervision and annual appraisals. Staff felt supported by management and had knowledge about the care needs of people they looked after.

Care plans were up to date and contained individualised risk assessments and support plans. Health action plans and “My hospital passport” documentation were updated regularly.

People’s, relatives and staff views were listened too and taken into account most of the time. One person said, “I go to bed when I want. Staff let me chose what I eat or what I wear.” However one relative said staff listened but did not always rectify concerns in a timely manner. We asked management about this they showed us evidence that they usually responded to concerns in a timely manner.