This inspection took place on 6 and 7 February 2018. The visit on 6 February 2018 was unannounced.

132 Manor Court Road 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. The home is split over two floors comprising communal areas and a kitchen. The service is registered to provide care and accommodation for to up to eight people with a learning disability. At the time of our inspection there were eight people living in the home.

At our last inspection we rated the service as Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People felt safe with the staff who supported them, and we saw people were comfortable with staff. Staff received training in how to safeguard people from abuse and understood what action they should take in order to protect people from abuse. Risks to people’s safety were identified and minimised to keep people safe.

People were supported with their medicines by staff who were trained and assessed as competent to give medicines safely. Staff recorded medicines administration according to the provider’s policy and procedure, and checks were in place to ensure medicines were managed safely.

There were enough staff to meet people’s needs effectively. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people. Staff told us they had not been able to work until these checks had been completed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and relatives told us staff were respectful and treated people with dignity. We observed this during interactions between people, and records confirmed how people’s privacy and dignity was maintained. People were supported to make choices about their day to day lives. For example, they were supported to maintain any activities, interests and relationships that were important to them.

People had access to health care professionals when needed and care records showed support provided was in line with what had been recommended. People’s care records were written in a way which helped staff to deliver personalised care and gave staff information about people’s communication, their likes, dislikes and preferences. People and relatives were involved in how their care and support was delivered.

People and relatives felt able to raise any concerns with the registered manager. They felt these would be listened to and responded to effectively and in a timely way. Staff told us the management team were approachable and responsive to their ideas and suggestions. There were systems in place to monitor the quality of the support provided, through checks made both by the registered manager and also the provider.

Further information is in the detailed findings below.

This inspection took place on 19th November 2015 and was announced.

The service is registered to provide care and accommodation for to up to eight people with a learning disability. At the time of our inspection there were eight people living in the home.

The service 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 registered manager also manages another service. As the other service is next door, the registered manager is at the home on a daily basis.

People were comfortable with staff, and relatives were confident people who lived in the home were safe. Staff received training in how to safeguard people, and had access to the provider’s safeguarding policies and procedures if they had any concerns. Staff understood what action they should take in order to protect people from abuse. Systems were used effectively to identify and minimise risks to people’s safety. These systems were flexible so people could take risks if they were able to do so and build their independence.

People were administered medicines by staff that were trained and assessed as competent to give medicines safely. Medicines were given in a timely way and as prescribed. Regular checks of medicines helped ensure any errors were identified and action taken as a result. There was enough staff to meet people’s needs, with numbers of staff increased recently in order to support people effectively.

Checks were carried out prior to staff starting work to ensure their suitability to support people who lived in the home. Staff told us they had not been able to work until checks had been completed.

Some people were considered to lack capacity to make day to day decisions such as what to eat, what to drink, what to wear. This had been assessed so staff knew how much support people needed with decision making. However, where applications had been made to deprive people of their liberty under the Deprivation of Liberty Safeguards (DoLS) because they did not have capacity to decide where they wanted to live, this was not clearly linked to an assessment of capacity. Staff had a good understanding of the Mental Capacity Act, and the need to seek informed consent from people wherever possible. Staff followed the principles of the Act throughout our visit.

Staff were respectful and treated people with dignity. We saw this in interactions between people at our inspection visit, and this was also reflected in records kept. People were supported to make choices about their day to day lives. For example, they could choose what to eat and drink, and were supported to prepare their own meals if they wanted to.

People had access to health professionals whenever necessary, and we saw that the care and support provided in the home was in line with what had been recommended. People’s care records were written in a way which helped staff to provide personalised care, which focussed on the achievement of goals. Staff tried to ensure people were fully involved in how their care and support was delivered, and people were able to decide how they wanted their needs to be met.

Relatives told us they were able to raise any concerns with the registered manager, and they would be listened to and responded to effectively, and in a timely way. Staff told us the management team were approachable and responsive to their ideas and suggestions. There were systems to monitor the quality of the support provided in the home, and recommended actions were clearly documented and acted upon. This was achieved through unannounced provider’s visits to check different aspects at each visit.

When we visited 132 Manor Court Road we met all of the people living in the home, the home manager and four support workers.

People living in the home had complex needs which meant that they were not always able to tell us their experiences. We spent time during our visit observing care to help us understand their experiences.

People appeared comfortable and relaxed in their surroundings and were observed to approach staff with ease. Two people indicated that they were happy living at the home, by answering, "Yes I am" or nodding and smiling at us when we asked.

Support plans were in place for people. Staff told us that they provided information which helped them to support people with their needs. Staff members we spoke with knew about people's needs and were able to tell us about them.

People were supported to attend and participate in a variety of activities throughout the week as well as spending time at home.

Measures were in place to ensure that people lived in a well kept, clean and hygienic environment.

Systems were in place to ensure that medicines were managed appropriately for people.

A process was in place for dealing with complaints. Staff were able to explain how they would recognise if someone was unhappy with something. "You can tell when people are not happy with something by their body language, emotions, sign language or physical contact" was a comment made.

During our visit we met all of the people who lived in the home and spoke with three of those people. We were told, "This is a good place to live." People told us they were happy with the care and support they received and liked the staff who supported them. We were told, "The staff are nice."

We saw that people had care plans which described how their needs should be met and identified means of reducing risks to their health and well being. We saw evidence that care plans and risk assessments had been updated on a regular basis so that they remained relevant to people's assessed needs.

We were told that people led active lifestyles and had regular opportunities to go out and do things they enjoyed, with support from staff.

We observed staff interacting with people and saw that they had formed positive relationships with them. We saw that staff were respectful and friendly to people who lived in the home.

We saw that there were systems in place to review the quality of care and service provided to people which invited their views and opinions.