This comprehensive inspection was carried out on 08 January 2019 and was announced.

Smock Acre is a ‘care home’. People in care homes receive accommodation and 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. Smock Acre is registered to provide accommodation and personal care for a maximum of three people. The home specialises in providing care to people with learning disabilities and 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. At the time of our inspection there were three people living in the service. The service was arranged over one floor.

The service had 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 we rated the service 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.

Processes were in place to keep people safe from different types of abuse. When risks to people or the environment were identified, action was taken to minimise them. There were enough staff to meet people's needs and staff were recruited safely. People were supported with their medicines in a safe way. People were protected by the prevention and control of infection. Lessons were learned when things went wrong.

People’s needs were assessed and care and support was delivered in line with current legislation and best practice guidelines. Staff had the skills, knowledge and experience to meet people’s needs. People were supported to lead healthier lives and had timely access to healthcare services. People were supported to eat and drink enough to maintain a balanced diet. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People were treated with kindness and compassion. People were supported to express their views and be actively involved in making decisions about their care and support. People’s relatives were also involved in decision making. People were encouraged to be as independent as possible. People’s dignity and privacy was respected. People’s personal information was kept private.

People received person-centred care that was responsive to their needs. People knew how to complain and complaints were responded to in line with the service’s policies and procedures. Staff knew how to identify people who might be coming to the end of their life.

Staff said the service was open, transparent and that they felt supported by their managers. There were audits in place which checked the quality of the service being provided. Staff were involved in developing the service. The registered manager had developed links with the local community.

Further information is in the detailed findings below.

This inspection was carried out on 21 April 2016 and was unannounced.

Smock Acre provides accommodation and personal care for up to three people with a learning disability. The service is a converted bungalow. There were three people living at the service at the time of our inspection.

A registered manager was leading the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were kind and caring to people and treated them with dignity and respect at all times.

The registered manager was leading the staff team and had oversight of the service. Staff felt supported by the registered manager and were motivated. The registered manager and staff shared the provider’s vision of a good quality service.

There were enough staff, who knew people well, to meet their needs. The registered manager had considered people’s needs when deciding how many staff were required to support people in different activities. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs.

Checks had been completed to make sure staff were honest, trustworthy and reliable. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.

Staff had completed the training they needed to provide safe and effective care to people and held recognised qualifications in care. The registered manager met regularly with staff to discuss their role and practice. They supported staff to provide good quality care.

People’s care and support was planned and reviewed with them and others who knew them well, to keep them safe and help them be as independent as possible.

Plans were in place to keep people safe in an emergency. Staff knew the signs of abuse and were confident to raise any concerns they had with the registered manager. Systems were in place to manage complaints received.

People received the medicines they needed to keep them safe and well. Action was taken to identify changes in people’s health, including regular health checks. People were offered a balanced diet that met their individual needs.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). Arrangements were in place to apply to the supervisory body for a DoLS authorisation when necessary. People were not restricted and went out when they wanted to.

The requirements of the Mental Capacity Act 2005 (MCA) had been met. The registered manager had assessed people’s capacity to make decisions when this was needed. Staff supported people to make decisions and respected the decisions they made. If people lacked capacity, decisions were made in people’s best interests with people who knew them well.

People enjoyed a variety of activities, with support when needed. Possible risks to people had been identified and were managed to keep them as safe as possible, while supporting them to be independent.

The registered manager worked alongside staff and checked that the quality of the service was to the required standard. The registered provider also completed regular checks. Any shortfalls found were addressed quickly to prevent them from happening again. People, their relatives, visiting professionals and staff were asked about their experiences of the care.

Accurate records were kept about the support people received and the day to day running of the service care. These provided staff with the information they needed to provide safe and consistent care t

We spoke with people and also observed the interactions between people and staff. There were three people using the service at the time of our inspection. We observed how people reacted and responded to see if people indicated they were happy, bored, discontented, angry or sad because they were not able to communicate with us verbally.

We saw that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We saw records that showed how people's health needs were supported and that the service worked closely with health and social care professionals to maintain and improve people's health and well-being.

The provider had provided an environment that was suitably designed and adequately maintained with the exception of some flooring. The home was clean and free from offensive odours.

People were cared for by qualified and experienced staff and there were enough staff to meet people’s needs.

Systems were in place to monitor the service that people received to ensure that the service was satisfactory and safe.

We made an unannounced visit to the service and spoke with the deputy manager and staff members. There were three people using the service at the time of our visit.

We used a number of different methods to help us understand the experiences of people using the service. This was because the people had complex needs which meant they were not all able to tell us their experiences.

We observed the interactions between people and staff. We observed how people reacted and responded to see if people indicated they were happy, bored, discontented, angry or sad.

People who use the service indicated that they were happy at the home. They were relaxed and responsive in the company of staff. Records showed that people had the care and support they needed to remain well and healthy.

We saw that the provider had measures in place to help safeguard people from abuse. We saw that there were measures to check that people were reliably provided with the facilities and services they needed.

Staff engaged with people in a warm and positive way and supported people where needed. Staff told us that they felt supported in their work and worked closely as a team. There were enough qualified, skilled and experienced staff to meet people’s needs.

We saw evidence that staff had their work quality checked by the manager on a regular basis.