This inspection took place on 1 and 4 May 2018 and was unannounced. One inspector carried out the inspection on the first day and two inspectors on the second day.

Plean Dene 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. Plean Dene is a local authority residential care home which provides accommodation for up to thirteen people with learning disabilities including Autism who need support with their personal care. At the time of our inspection there were nine people living in the home.

The home was arranged over two floors with most of the bedroom accommodation on the first floor. There were bathrooms available to people on each floor. There were three communal areas in the home, which were a dining room, a quiet sitting area and a lounge. There was a large garden that people could easily access. People could use the kitchen with staff members supporting them.

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 last comprehensive inspection of this service was in February 2016 when the service was rated Good. At this comprehensive inspection we found the service remained good.

Quality assurance systems had not highlighted some shortfalls in the provision of mandatory training. We have made a recommendation about this.

The principles of the Mental Capacity Act 2005 were not being followed as required; best interest decisions were not in place for all people that required them. Consent was not being sought in line with legislation.

There were not effective systems in place to ensure that staff received training necessary to their roles. We have made a recommendation regarding this.

The risks relating to people's health and welfare had been assessed. However, they were not consistently recorded and therefore the information was not always clear.

The environment was clean and well maintained. Environmental risks were assessed robustly and processes were in place to audit and maintain the safety of people in the home.

Where accidents, incidents, and near misses had occurred there was an effective system in place to ensure that appropriate action was taken to mitigate any risks or prevent reoccurrence.

There were robust arrangements in place for the safe recording, storage and administration of medications.

People’s families told us they thought the home was safe. The provider had appropriate policies in place to protect people from abuse and had robust recruitment procedures. Staff had received safeguarding training and demonstrated an understanding of the action they would take if they identified any concerns.

People were supported to have enough to eat and drink and were encouraged to make choices. Staff supported people to eat and drink, when necessary and encouraged people to be as independent as possible.

There was enough staff to meet people's needs and to enable them to support people to engage in activities and access the community. Staff provided person centred care and knew people’s needs well. They spoke to people with kindness using good communication methods and showing dignity and respect.

The registered manager understood their responsibilities for end of life care and knew how to access relevant support if needed.

Plean Dene is a care home run by the local authority, which provides accommodation for up to 13 people who have a learning disability. At the time of our inspection there were nine people living in the home.

The inspection was unannounced and was carried out on 09 and 11 February 2016.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

The families of people living at the home told us they felt their relatives were safe. Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided enough information to allow staff to protect people whilst promoting their independence.

People were supported by staff who had received the appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training. Healthcare professionals such as GPs, chiropodists, opticians and dentists were involved in people’s care when necessary.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect. People were encouraged to maintain their family relationships.

People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people in a patient and friendly manner.

People who were not able to communicate verbally showed that they understood and they made their wishes known to staff. Staff were responsive to people’s communication styles and gave people information and choices in ways that they could understand. They were patient when speaking with people, who used a variety of signs, noises and body language to express themselves. Staff were able to understand people and respond to what was being said.

People’s families were involved in discussions about their care planning, which reflected their assessed needs. Each person had an allocated keyworker, who provided a focal point for that person and maintained contact with the important people in their lives.

There was an opportunity for families to become involved in developing the service and were encouraged to provide feedback on the service provided. They were also supported to raise complaints should they wish to.

People’s families told us they felt the home was well-led and were positive about the registered manager who understood the responsibilities of their role. Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the home.

There were systems in place to monitor quality and safety of the home provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

We looked at five care plans and associated risk assessments and found they included the necessary information to inform staff as to the specific care people required. We saw that although most of the people were not able to verbally communicate with staff, they were able to demonstrate their understanding of what they were being asked and make their wishes known. We saw staff seeking consent from people before providing care and support.

We spoke with one person who used the service and with the families of three other people. They told us they were happy with the level of care provided. The person we spoke with said “I am very happy here. They help me with my bathing”. A family member told us “the home is superb. [Their relative] has reached the utopia of his life”. Another family member said “I would give it five stars out of five”. We spoke with two care managers and a visiting health professional. They told us they did not have any concerns regarding the care provided by the home. A care manager said “My overall impression is the home is empowering, positive and caring”.

We saw the home had effective systems in place to protect people from abuse. The person we spoke with told us “I feel safe. It is the safest place I’ve been”. We saw there were enough qualified, skilled and experienced staff available to meet people’s needs. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We found the provider had an effective quality assurance system and they sought the views of people who used the service and their families through regular surveys.