This was an unannounced inspection that took place on 8 June 2016.

13 Manor Crescent provides accommodation for up to four people with learning disabilities and who may also have a physical disability. The accommodation is on one level and consists of four bedrooms with ensuite bathrooms. The home is owned and operated by New Generation Care Limited. There is also a care home for people with learning disabilities next door that is run by the same organisation and shares the same staff team and manager.

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 and associated Regulations about how the service is run.

In June 2013, our inspection found that the service met the regulations we inspected against. At this inspection the home met the regulations.

People were happy living at the home and most relatives with the service provided. Some relatives and a healthcare professional expressed concerns about staff turnover and the level of support received by the manager, from the organisation. During our visit there was a welcoming, friendly atmosphere with people out doing activities and interacting positively with staff. People chose their activities with staff support and, attended them within a risk assessed environment. The house also provided a safe environment to live in. The activities were varied and took place at home and within the community.

The records were kept up to date, covered all aspects of the care and support people received, their choices, activities and safety. People’s care plans were fully completed and the information contained was regularly reviewed. This supported staff to perform their duties efficiently and professionally. People were encouraged to discuss their health needs with staff and had access to GP’s and other community based health professionals, as required. People were supported to choose healthy and balanced diets that also met their likes, dislikes and preferences. This enabled them to be protected from nutrition and hydration associated risks. They said they were happy with the choice and quality of meals they ate.

The person who was at home, knew who the staff that supported them was and the staff knew them, their likes and dislikes. They were well supported and they liked the way their care was delivered. Relatives also said staff worked well as a team and provided them with updated information. They had appropriate skills and provided care and support in a professional, friendly and supportive way that was focussed on people as individuals. The staff were trained and accessible to people using the service and their relatives. Staff said they enjoyed working at the home. They received good training and support from the manager.

Relatives said the manager was approachable, responsive, encouraged feedback from people and consistently monitored and assessed the quality of the service provided.

During our inspection we had a limited conversation with one person who used the service and undertook a SOFI (Short Observational Framework for Inspection) tool for two other people. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We spent one hour observing people in the morning. We found that people who used the service had positive experiences. Staff were interacting in a positive manner with people who used the service and were offering them choices and engaging them in activities. For example, one person required one to one support and this was provided. Another person required one to one support with an identified personal care need. We observed how this was discussed with the person and how the person then chose the member of staff they wanted to support them.

We looked at two care files, records of health care appointments and daily notes maintained at the service. We spoke to three relatives, two members of staff and the registered manager.

People who used the service had complex and severe learning difficulties, therefore they were not able to tell us about their experiences. To help us understand the experiences people had we used our Short Observational Framework for Inspection (SOFI) tool. The SOFI tool allowed us to spend time watching what was going on at the service for a period of time and helps us to record how people spend their time. It also allowed us to observe the type of support they received and whether they had positive experiences. We spent one hour observing people in the morning. We found that people who used the service had positive experiences. Staff were interacting in a positive manner with people who used the service and were offering them choices and engaging them in activities. Staff were able to communicate by reading the person’s body language, facial expressions and gestures. We saw that people were being supported as stated in their care plans, for example, one person required one to one support that was provided. Another person had a keen interest in music and staff had engaged them in a musical activity.

The people who used this service were non- verbal, however we were able to have a very limited discussion with one person.

When asked, one person who used the service told us that they had a care plan. They conveyed to us that they make choices every day, and that staff were always available to help them to do things they wanted to.