This comprehensive inspection took place on 12 December 2018 and was unannounced.

St James Mews is a ‘care home’. People in care homes receive accommodation and nursing or 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.

St James Mews is registered to provide accommodation and personal care support for up to nine people with a learning disability, physical disability, people who misuse drugs and alcohol, autistic spectrum disorder, sensory impairment, younger adults and mental health needs. The purpose built accommodation was situated within a gated mews and split into two parts. There was a five bedded male only house and a four bedded female only house. At the time of our inspection there were nine people living at the service.

At our last inspection on 24 April 2018, we rated the service Good. We re-inspected this service earlier than planned due to concerns that had been raised about people’s safety. At this inspection we found the evidence continued to support the rating of Good.

Prior to this inspection there had been disruption to the service from people displaying behaviours that challenged the service, staff and other people. At this inspection we found that people continued to receive safe care. Risks associated with people's care and support were managed safely. People’s care needs were fully assessed and people were involved in the day to day planning of their care and making choices about their lives and routines.

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.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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 told us they felt safe and comfortable with the staff who supported them. There was a relaxed and friendly atmosphere around the home. People told us staff were kind and caring.

There were sufficient staff to provide safe and individual care to people. Staff were suitably trained and received regular supervisions and appraisals.

Medicines continued to be managed safely and people received their medicines as prescribed.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

Staff knew the people they were supporting well. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care.

Risk assessments continued to be in place and they identified current risks to people as well as ways for staff to minimise or appropriately manage those risks.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us they were provided with opportunities to follow their interests and hobbies and they were introduced to varied activities. People told us their privacy, dignity and confidentiality were maintained.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed.

The provider had a compla

This comprehensive inspection took place on 24 April 2018 and was unannounced.

St James Mews is a ‘care home’. People in care homes receive accommodation and nursing or 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.

St James Mews is registered to provide accommodation and personal care support for up to nine people with a learning disability, physical disability, people who misuse drugs and alcohol, autistic spectrum disorder, sensory impairment, younger adults and mental health needs. The purpose built accommodation was situated within a gated mews and split into two parts. There was a five bedded male only house and a four bedded female only house. At the time of our inspection there were nine people living at the service.

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 on going 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.

At this inspection we found the service remained Good.

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.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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 and their relatives told us they felt safe and comfortable with the staff who supported them. There was a relaxed and friendly atmosphere around the home. People told us staff were kind and caring.

There were sufficient staff to provide safe and individual care to people. Staff were suitably trained and received regular supervisions and appraisals.

Medicines continued to be managed safely and people received their medicines as prescribed.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

Staff knew the people they were supporting well. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care.

Risk assessments continued to be in place and they identified current risks to people as well as ways for staff to minimise or appropriately manage those risks.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us they were provided with opportunities to follow their interests and hobbies and they were introduced to varied activities. People told us their privacy, dignity and confidentiality were maintained.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed.

The provider had a complaints procedure in place and people who used the service and their relative were aware of how to make a complaint.

The provider had an effective quality assurance process in place. Where actions were identified as a result of these they w

The inspection was carried out on 11 January 2016 and was unannounced.

The service provides care and support for up to nine people with learning disabilities. People who used the service had moderate care needs; however, some were at higher risk of presenting challenging behaviours which may harm themselves or others. At the time of our inspection there were eight people using the service. The purpose built accommodation was split between one four bedded male only house and one four bedded female only house within a gated mews.

A registered manager was not employed 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. However, a manager had applied to register with the CQC.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. The manager understood when an application should be made. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.

People were kept safe by staff who understood their responsibilities to protect people living with learning disabilities. Each person had a key worker who assisted them to learn about safety issues such as how to evacuate the building in an emergency and to speak to if they felt unsafe. The manager had plans in place to ensure that people who may not understand what to do would be individually supported by a member of staff if there was an emergency. Staff had received training about protecting people from abuse. The management team had access to and understood the safeguarding policies of the local authority and followed the safeguarding processes.

The manager and care staff used their experience and knowledge of caring for people with learning disabilities and complex needs effectively. Staff assessed people as individuals so that they understood how they planned people’s care to maintain their safety, health and wellbeing. Risks were assessed within the service, both to individual people and for the wider risk from the environment. Staff understood the steps to be taken to minimise risk when they were identified. The provider’s policies and management plans were implemented by staff to protect people from harm.

There were policies and procedures in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely. Where people could retain the information, they had been supported to understand what their medicines were for and when they needed to take them. This was reinforced by staff who administered medicines.

People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell. Good quality records were kept to assist people to monitor and maintain their health. Staff had been trained to assist people to manage the daily health challenges they faced from conditions such as epilepsy and diabetes. People had been supported to understand their health conditions and had been given information to help them manage their own health and wellbeing.

We observed and people described a service that was welcoming and friendly. Staff provided friendly compassionate care and support. People were encouraged to get involved in how their care was planned and delivered. Staff were deployed to enable people to participate in community life, both within the service and in the wider community.

Staff upheld people’s right to choose who was involved in