This focused inspection took place on 27 February 2017 and was unannounced.

We carried out an unannounced comprehensive inspection of this service on 12 and 17 August 2016 at which a breach of legal requirements was found. Specifically the provider had breached Regulation 15 about premises and equipment. We found that temperature control systems for the safe storage of medicines and refrigerated food were not effective at identifying and addressing risks. This was because records showed that temperatures were consistently too high and that there had not been sufficient action to address risks arising from this.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the 'all reports' link for this service on our website at www.cqc.org.uk.

'Norwood – 159a Station Road' is a care home for up to eight adults. The service is spacious and provides accommodation on the ground and first floor. It specialises in providing services to people who have a learning disability or who are on the autistic spectrum. Autism is a lifelong condition that affects how a person communicates with and relates to other people, and how they experience the world around them.

There was a registered manager in post at the service. 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.

At this inspection, we found that the provider had followed their plan and legal requirements had been met. Food in fridges and freezers was being stored at safe temperatures. Medicines throughout the service were securely stored at appropriate temperatures. Records showed regular monitoring of temperatures for food and medicines, and that safe temperatures were being maintained.

This inspection took place on 12 and 17 August 2016 and was unannounced. The service met all of the regulations we inspected against at our last inspection in October 2013.

‘Norwood – 159a Station Road’ is a care home for up to eight adults. The service is spacious and provides accommodation on the ground and first floor. It specialises in providing services to people who have a learning disability or who are on the autistic spectrum. Autism is a lifelong condition that affects how a person communicates with and relates to other people, and how they experience the world around them.

There was a registered manager in post at the service. A registered manager is a person who has registered with the 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 outstanding feature of the service was that staff were exceptional at communicating effectively with people on an individual basis, and used this as a basis for valuing people and developing their autonomy and independence. Staff had received a lot of support to develop skills in these areas, and there was on-going investment at embedding these processes. This had a positive impact on people’s behaviours and the involvement in their care. This helped to demonstrate a very caring service, which matched the highly positive feedback we received from people’s relatives.

We found there to be a positive, inclusive and empowering culture at the service. The registered manager led by example, providing good support to staff and ensuring that appropriate values were upheld towards people using the service.

Attention was paid to people’s safety but in a way that minimised restrictions on their freedoms. For example, whilst many people had positive behaviour support plans in place to help minimise use of any behaviours that challenged the service, there was little reliance on as-needed medicines as part of those plans. Instead, there was an emphasis on recognising and understanding people’s communications, and providing a service that responded to their experiences. There were also effective safeguarding procedures in place.

People were treated with respect and their privacy and dignity was promoted at all times. Attention was paid to keeping the service clean. The service had a number of long-standing staff who knew people well, which helped to enable positive and trusting relationships to be developed with people using the service. There were enough staff working at all times, although there was some reliance on agency staff to address staffing vacancies.

People had opportunities to take part in a variety of activities both in the premises and the community. Good effort was made to match and develop activities that matched people’s abilities and preferences.

People received good support in respect of their individual healthcare and nutritional needs. The service liaised promptly if there were any concerns about anyone’s health, and followed community healthcare professional advice well.

Whilst the provider’s mandatory training was not consistently completed by some staff, staff received a range of additional training that helped to ensure that people using the service received effective and individualised care.

The service took appropriate action if they believed a person needed to be deprived of their liberty for their own safety. However, further work was needed with ensuring that the principles of the Mental Capacity Act 2005 were consistently applied for everyone using the service.

The service listened to feedback and acted on it. There was a formal complaints process in place but it had not been needed recently.

The service audited quality to help ensure good care was provided. Changes were made to the service as a result of any concerns being identified.

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People who used the service had learning difficulties and with one exception, did not express their views to us during this inspection. One person who used the service and two relatives who spoke with us by phone indicated that people were well cared for and staff had treated people with respect and dignity.We observed that staff were gentle and pleasant when caring for people. They spoke in a respectful manner towards people and people responded well to staff.

Staff were aware that all people who used the service should be treated with respect and dignity. The home had arrangements for ensuring that the personal needs and preferences of people were respected regardless of their background. Relatives we spoke with provided confirmation that the religious and cultural needs of people had been responded to.

The care needs of people had been carefully assessed. Risk assessments together with guidance to staff on minimising risks to people had been prepared. There was evidence that people and their representatives had been consulted regarding the care plans prepared. However, not all the care plans had been reviewed regularly. People were engaged in a range of activities which they liked.

Staff had been provided with essential training and were knowledgeable regarding their roles and responsibilities. Relatives and some staff informed us that overall, there were sufficient staff to care for people. However, some staff stated that more staff were needed as they were sometimes very busy.

The home had a complaints procedure. Relatives said they knew who to talk to if they were unhappy with the services provided.

People's communication difficulties prevented them from telling us much about their views of the service, but they appeared very content and most were enjoying themselves when we visited. Relatives told us they were very happy with the care the service provided and how they felt included and supported. They praised the enthusiasm of the manager.

The service was homely and comfortable. Staff and people using the service interacted spontaneously and were relaxed with each other. We observed lots of positive interaction and engagement. People were treated with respect and dignity. Care plans contained support plans and risk assessments that were actively reviewed when needed.

People were safe from the risks of abuse as the provider had been alert to potential hazards and had taken steps to ensure staff understood the issues involved and had acted to reduce the risks of neglect or abuse.

Staff were supported and trained. They felt the service was well managed and enjoyed working there.

The provider had a wide range of monitoring and feedback mechanisms in place and used their results to improve the service.

Some people who use the service have severe learning difficulties and communication was limited. However, we were able to speak to some of them and obtain their views. We also observed interaction between them and staff who were attending to them. We noted that people who use the service were able to wake up late if they chose to. They appeared relaxed and were able to move freely in the home. Some went out to join in community activities accompanied by staff.

The feedback we received from some of them and their representatives was positive and indicated that people who use the service were well cared for. They informed us that staff had treated them with respect and the needs of peole who use the service had been attended to. They stated that there were meetings in the home where people who use the service or their representatives could express their views.

Staff were noted to be interacting regularly with people who use the service and encouraging them to participate in activities, have their lunch or go out to the day centre. Staff were knowledgeable regarding the individual needs of people who use the service. The records indicated that staff had been given the necessary essential training. Supervision sessions with the manager had also been arranged and documented.

The home had consulted and asked people who use the service and their representatives about their views. We were also informed that staff had regular one to one sessions with people who use the service and they would ask them how they were getting on. These sessions were documented and provided information regarding how they felt about the service and what their choices were. The area manager had also carried out quality checks on the care provided.

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