This inspection took place on 25 September 2018 and was unannounced.

Spode Close is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Spode Close is a purpose-built block of self-contained studio style apartments. The service provides accommodation and support for up to seven people with a learning disability, autistic spectrum disorder, physical disabilities or a combination of these kinds of impairment. At the time of the inspection three people were living at the service.

The care service had 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 our last inspection on 13 July 2017 we had rated the service 'Requires Improvement' as we had identified breaches to legal regulations. These related to risks identified in support plans not being always followed by appropriate risk assessments, health and safety checks, auditing, and the provider not following their disciplinary procedure.

Following the last inspection, we asked the provider to complete an action plan. We needed the provider to inform us on how they intended to improve.

There was no 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. The service was run by a manager who was to become registered with the Care Quality Commission (CQC).

During the inspection we found that the risks identified in support plans were not always followed by appropriate guidance to staff on how to minimise the risks. However, despite the lack of written guidance staff were knowledgeable on how to minimise the identified risks. They were able to consistently explain to us how would they act in order to mitigate the risks. We brought this to the attention of the manager who produced a detailed risk assessment on the day of the inspection.

People's capacity was assessed in accordance with the Mental Capacity Act 2005 (MCA). However, information regarding people's consent was not always recorded. We reported this to the manager. As a result, they provided us with evidence they had recorded people's consent where needed.

There were gaps in the records. Quality assurance systems were in place but had failed to identify the issues which we found at the inspection.

People told us they feel safe. Staff had completed safeguarding training and had access to relevant guidance. They were able to recognise whether people were at risk and knew what action they should take in such instance.

Accidents and incidents were monitored and relevant action was taken to keep people safe.

Medicines were managed safely. Staff were recruited safely and in sufficient numbers, but the deployment of staff within the service did not ensure people could always participate in meaningful activities.

Staff were supported to undertake training to support them in their role, including nationally recognised qualifications. They received on-going supervision and appraisal to support them to develop their understanding of good practice and to fulfil their roles effectively.

People were supported to make choices about their food and drink. Staff ensured people received meals which suited their nutritional needs to help them maintain a healthy weight.

People told us staff were kind and caring and respected their privacy and dignity. Staff supported people

The unannounced inspection took place on 13 July 2017.

Spode Close is a purpose-built block of self-contained studio style apartments. The service provides accommodation and support for up to seven people with a learning disability, autistic spectrum disorder, physical disabilities or a combination of these kinds of impairment. At the time of the inspection three people were living at the service.

At the time of inspection there was no registered manager at the service. 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. In the absence of the registered manager the service was run by a peripatetic manager. The peripatetic manager is a type of manager who travels to different care homes and stays for a short time at each location to ensure that they are appropriately managed.

During the inspection we found that the risks identified in support plans were not always followed by appropriate guidance to staff on how to minimise the risks. As a result, the service was unable to ensure people received care and support which met all their needs with potential risks appropriately managed.

Medicines were administered safely. However, the system to ensure that fridge temperatures were recorded and action taken if outside of the safe limits was not effective.

People were not always protected from environmental risks. Health and safety checks were not completed in accordance with the provider’s policy.

Staff did not always receive appropriate on-going training to enable them to deliver safe care. As a result, the service failed to ensure that people were protected by staff who knew how to meet their specific needs.

The service did not always act in accordance to the Mental Capacity Act 2005 (MCA). In some care plans there was no evidence of any best interest meetings or any mental capacity assessments, or the information regarding the lasting power of attorney (LPoA) was out of date.

There was a complaints policy available in an easy-to-read format, however, it was not displayed in the communal areas. The complaint policy available at the reception contained some out of date information which might be confusing to some people.

The provider followed their disciplinary procedure, however, results of internal investigations had not always been reported to the DBS.

Staff had a clear understanding of how to recognise and report safeguarding concerns and knew who to contact and how. Staff understood how to whistleblow and had access to essential phone numbers to call to report any issues.

Staffing levels were adequate and recruitment practices were safe as relevant checks had been completed before staff worked unsupervised.

People were supported to eat enough food and drink sufficient amounts of liquids, and their care plans included information about their dietary needs and risks identified in relation to nutrition and hydration.

People's dignity and privacy were respected and promoted by staff. Staff knew each individual's specific communication methods and were aware of changes in people needs.

Staff had a thorough knowledge of each person they supported and helped people to identify their individual needs and the goals they wanted to achieve in the future.

Auditing was insufficient or non-existent in some areas, for example, the health and safety checks, risk assessments and care plans were not thoroughly audited. The service had made improvements in other areas such as reviewing daily notes, creating hospital passports and health action plans. The service had their own quality assurance systems in place to make further enhancement.

The peripatetic manager was respected and valued by people, their relatives and staff.

We found two breaches of