We inspected this service on 17 December 2018. The inspection was unannounced and carried out by one inspector and an expert by experience.

The service is a ‘care home’ operated by Polesworth Group Homes; a non-profit and independent provider of support for people with learning disabilities. The service, 32 Station Road, is one of eight services provided by Polesworth Group Homes Limited. The service provides accommodation with personal care for up to seven adults living with a learning disability and complex health care conditions. People in residential care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection visit, there were seven people living at the home.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post. 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 our last inspection in May 2016 we rated the service as Good. At this inspection, we found improvements were needed to the overall quality of the care people received. The service remained caring, effective and responsive to people's needs. Some improvements were required in risk management and the quality checks undertaken. The overall rating is now 'Requires Improvement'.

Overall, risks were assessed and staff knew how to keep people safe, but information available to staff about identified risks had not always been updated in a timely way by the registered manager. Improvement was needed in managing the potential risks of entrapment injuries posed by using bed rails.

The provider checked staff’s suitability to deliver care and support during the recruitment process. Staff understood their responsibilities to protect people from the risks of abuse because they had received ‘safeguarding’ training, and knew how to raise concerns under the provider’s safeguarding policies. The registered manager and provider understood and followed their legal responsibilities when safeguarding concerns were identified to them. Overall, the service was clean and tidy, however, there were some risks of cross infection because staff had not consistently taken actions to minimise risks.

There were sufficient, trained staff to meet people’s needs, which had been assessed. People were encouraged and supported to maintain good health through healthy eating. Staff supported people to access healthcare services, and received their prescribed medicines from trained staff. Staff had received training in the Mental Capacity Act 2005 and worked within the principles of the Act. Managers understood their responsibilities under the Act and when ‘best interests’ meetings should take place.

Staff were compassionate, kind and caring toward the people they supported. People’s privacy and dignity was respected and staff took opportunities to promote people’s independence. People and relatives were complimentary about the service and had no complaints. Staff felt happy in their job role.

The registered manager and provider checked the quality of the service to make sure people’s needs were met. However, audits had not consistently been effective in identifying where improvements were required. Feedback was encouraged from people and relatives.

This inspection took place on 26 May 2016 and was announced.

32 Station Road provides care, support and accommodation for up to seven people with a learning disability. At the time of our inspection visit there were seven people living in the home.

The service was last inspected on 5 August 2013, when we found the provider was compliant with the essential standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

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.

People were comfortable with the care staff who supported them. Relatives were confident people were safe living in the home. Staff received training in how to safeguard people from abuse and were supported by the provider’s safeguarding policies and procedures. Staff understood what action they should take in order to protect people from abuse. Risks to people’s safety were identified, minimised and responsive towards individual needs so people could be supported in the least restrictive way possible and build their independence.

People were supported with their 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 potential issues were identified and action could be taken as a result.

There were enough staff to meet people’s needs. Staffing was tailored to support people to maintain hobbies, interests and activities they enjoyed. The provider conducted pre-employment checks 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 start work until these checks had been completed.

The provider assessed people’s capacity to make their own decisions if it was identified people might lack the capacity to do this. Staff and the registered manager had a good understanding of the Mental Capacity Act and the need to seek consent from people before delivering care and support wherever possible. Where restrictions on people’s liberty were in place, legal processes had been followed to ensure the restrictions were in people’s ‘best interests’. Applications for legal authorisation to restrict people’s liberty had been sent to the relevant authorities in a timely way.

People told us staff were respectful and treated them with dignity. We observed interactions between people which confirmed this. Records also showed people’s privacy and dignity was maintained. People were supported to make choices about their day to day lives. People were supported to maintain any activities, interests and relationships that were important to them.

People had access to health professionals whenever necessary, and we saw the care and support people received was in line with what had been recommended by health professionals. People’s care records were written in a way which helped staff to deliver care that was based on each person’s needs. People were involved in how their care and support was delivered, as were their relatives if people needed support from a representative to plan their care.

Relatives told us they were 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 registered manager was approachable and responsive to their ideas and suggestions. There were systems to monitor the quality of the support provided in the home. The provider ensured that recommended actions from quality assurance checks were clearly documented and acted upon by the registered manager as they undertook regular unannounced

When we visited 32 Station Road we met and spoke with three people who lived in the home, the home manager, three support workers, the cook and two members of domestic staff.

People we spoke with told us that they liked the home and felt safe there. Observations we made indicated that people were well cared for, comfortable and at ease with the staff. "I am alright here. I think they do look after me" was one comment made. Another person smiled and nodded when we asked if they were well looked after.

Staff appeared to know people well and demonstrated confidence in meeting their needs. People had care plans in place that contained information to assist staff with meeting their care and support needs. Staff we spoke with knew about people's needs and were able to tell us about them.

Measures and processes were in place to ensure that people were protected from the risk of infection.

Equipment was in place to support the staff with providing care for people.

Recruitment processes were in place to ensure that staff employed by the provider were suitable to work with vulnerable people.

When we visited 32 Station Road we spoke with four people who lived there, four staff members and the manager.

We looked at the care planning documentation for two of the people who used the service to see how their care was provided and managed.

We talked with staff who demonstrated they were aware of people’s care and support needs. Staff said they were trained to help them understand how to meet people’s needs and give the support people needed.

We found that staff were knowledgeable about people’s interests and preferences. We saw that people led active lifestyles with the support they needed and took part in a range of social and educational opportunities.

Staff spoken with were very motivated, caring and positive about working in the home and praised the teamwork and supportive atmosphere.

The people we spoke with were complimentary about the staff and appeared comfortable and relaxed in the environment of the home. People told us; “It’s really nice here, there’s everything you need,” and “I like all the staff.”