This was an unannounced inspection which took place on 16 and 17 January 2017. We had previously inspected this service on 17 and 19 November 2015 when we found that the service had not met all the standards inspected and was rated as Requires Improvement.

1-2 Broadstone Close is two semi-detached houses which are joined together with an internal adjoining corridor. Although 1-2 Broadstone Close is registered as one service with the Care Quality Commission, people living there consider them as two separate houses and treat them as such. Four people live at 1 Broadstone Close, and five people live at 2 Broadstone Close. The service is registered to accommodate nine people for nursing or personal care. The service does not provide nursing care. Nine people were living there at the time of our inspection. The service provides support to people who have learning disabilities.

The service had a registered manager in post at the time of our inspection. 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.

There was not always enough staff to support people at times when they needed. People, relatives and health and social care professionals felt there were occasions where additional support should be available to ensure people’s needs were met.

People had mixed views about the amount of support they had to take part in activities in the home and the local community. Staff were not consistently recording what support was offered, and what actually happened. The provider could not assure themselves people were being encouraged and supported to take part in a range of activities and hobbies that were meaningful to them.

People were protected from the risk of abuse, and staff were knowledgeable about how to recognise and report concerns of abuse. There were systems in place to protect people from the risk of harm and abuse, and people, relatives and staff felt confident to raise concerns about unsafe care. People were supported to be as independent as possible whilst remaining safe. Key information about people’s care needs was available to staff in the event of an emergency.

Staff were recruited in a safe way. The provider took steps to ensure checks were undertaken to ensure that potential staff were suitable to work with people needing care. Staff received regular supervision and had checks on their knowledge and skills. They also received an induction and training in a range of skills the provider felt necessary to meet the needs of people at the service. Staff received training and ongoing supervision to ensure that their skills, attitudes and values met the provider’s requirements.

Medicines were managed, stored, administered and disposed of safely. Staff received training and ongoing skills assessments that enabled them to be confident in supporting people with medicines.

People consented to care and support in many aspects of their daily lives, and were encouraged to make their own choices. Appropriate arrangements were in place to assess whether people were able to consent to their care, where this was needed. The provider met the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DOLS). This ensured people’s care was provided lawfully, and they had their rights respected.

People were supported to have a varied and balanced diet. People were encouraged to participate in the planning and cooking of meals. They had access to a range of health and social care professionals for advice, treatment and support. Staff monitored people’s health and well-being effectively, and responded quickly to any concerns.

People felt cared for by staff who treated them with kindness, dignity and respect.

We spent time with people in the lounge areas of both sides of the home spoke with six of the eight people resident on the day of our visit. We took the opportunity and observed people’s daily routines and interactions with others from a distance.

People using the service appeared relaxed and interacted with staff members in a positive way, some were occupied with cooking activities and others watching the television. Of the people that commented one person told us “I like to watch the football, England won the other night” and “They (the staff) asked me to go shopping today, I like to go but not in that rain”.

We observed staff talking with and assisting people throughout the time of our visit, this was done with the peoples’ privacy and dignity in mind and showed the staffs’ awareness of peoples individual support needs.

We looked at areas of care planning, nutrition, medicine administration staff support and at the general safety around the home, and found the home was compliant in all those areas.

We spoke to the six people who live at 1-2 Broadstone Close to ask for their views on the care that they received. We also spoke to four staff members. We found people were able to make informed decisions about their care and treatment. One person told us they “like it here. The staff help to support me and I feel safe.”

We found people experienced care, treatment and support that met their needs and protected their rights. One person told us that the “staff are nice and look after me well.” Another person told us that “staff were very nice. I have no problems." A member of staff told us that they were “proud to work here. I enjoy working with the service users and it is a nice home to work in.”

We found people who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We found people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We also found people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

We inspected this service because we were concerned that we had not visited for some time. We wanted to check that the staff were providing good care and that the service was compliant.

We spoke with two people who live at the service and they both told us they liked living at the home. They said they could make choices about their day to day life such as when they got up, went to bed and what they did with their day. They told us they did chores such as washing, cleaning and shopping and could prepare their own drinks and snacks. This helped them remain independent.

We asked people what they did with their free time and they told us they went out to clubs, to college and went out into the community. One person was going to see a rock concert the day after our visit. People told us they saw their family, friends and partners when they could and when they wanted to. We observed that people could choose to come and go as they pleased.

This was an unannounced inspection which took place on 17 and 19 November 2015. We had previously inspected this service on 16 October 2013 when we found that the service met all the standards inspected.

1-2 Broadstone Close is two semi-detached houses which are joined together with an internal adjoining corridor. The service is registered to accommodate nine people for nursing or personal care. The service does not provide nursing care. Nine people were living at the service at the time of our inspection.

The service had a registered manager in post at the time of our inspection. 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 protected from the risk of abuse, and staff were knowledgeable about how to recognise and report concerns of abuse. The provider informed the local authority about any concerns of potential abuse, but did not always inform CQC as they are required to.

There were systems in place to identify risks and protect people from the risk of harm. People were supported to be as independent as possible whilst remaining safe. Key information about people’s care needs was available to staff in the event of an emergency.

People felt there was enough staff to support them, but staff had mixed views on this. They identified occasions where additional support should be available to ensure people’s needs were met.

The provider had recruitment processes in place which ensured they only employed staff who were suitable to work at the service.

Medicines were managed, stored, administered and disposed of safely. Staff received training and ongoing skills assessments that enabled them to be confident in supporting people with medicines.

Staff received training and ongoing supervision to ensure that their skills, attitudes and values met the provider’s requirements.

The understanding and application of the Mental Capacity Act was not always followed consistently. Although there was clear evidence of best interest decision making that complied with the MCA, people’s capacity was not assessed.

People were supported to have a varied and balanced diet. We saw people were encouraged to participate in the planning and cooking of meals.

People were supported to maintain good healthcare with regular visits to their GP and, where appropriate, specialist healthcare. Staff knew how people liked and needed to be supported at appointments.

Staff were caring and kind, and demonstrated they understood how to support people with dignity and respect. Staff knew people’s likes, dislikes, preferences and histories, and were able to use this knowledge to provide support that demonstrated that people living at the service mattered to them.

People were involved as much as possible in planning and reviewing their own care, and people had access to independent advocacy to support them to do this. Care and support was centred around people’s preferences and assessed needs.

People were supported to access a range of activities in their local community. Staff demonstrated that they understood that maintaining family and friend relationships was important and meaningful to people.

People felt able to express concerns or complaints about the service and knew how to do this. We saw concerns and complaints were managed well.

The service was not always well led. The provider did not always make notifications to CQC as required by law. The provider and registered manager supported the staff team to deliver a service that met people’s needs. The provider had systems and checks in place to ensure the service was of good quality, and could demonstrate where improvements had been identified and made.