We last inspected this service on 16 March 2016, and found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, relating to medicines management, consent and quality assurance. At this inspection 07 and 08 June 2017, we found that improvements had been made.

Stanley Grange is a small community for adults with learning disabilities and complex needs, nestled between Preston and Blackburn. There are 8 dwellings; houses, flats, bungalows and cottages (some shared, some single occupancy) with a community hall and gardens, set around a village green. The service is registered to provide accommodation and nursing care to no more than six service users. The service is also registered to provide personal care to people in a Supported Living setting. The Registered Provider must only accommodate a maximum of 36 people. On the day of inspection there were 32 people who used the service. Since 1 October 2015, the estate & buildings at Stanley Grange have been owned by Stanley Grange Community Association, a charity set up in 2014 by the families of people living there with the express intention of saving this thriving community from closure.

Future Directions CIC were appointed as the care provider for Stanley Grange 1 October 2015. Since the last inspection on 16 March 2017, Future Directions CIC, has developed a 6 bedded nurse led unit for people whose behaviour can be challenging, and who have moved out of long term institutions.

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. Each individual house on the Stanley Grange site had a team manager, who had oversight and responsibility for the running of the service in that home.

At our previous inspection on 16 March 2016 we asked the provider to take action to make improvements relating to the assessment of people’s mental capacity. At the inspection, we found that improvements had been made. Care files were now found to contain decision specific mental capacity assessments.

At our previous inspection on 16 March 2016 we asked the provider to take action to make improvements relating to the management of medicines. At this inspection we found improvements had been made. We looked at how the service managed medicines. We found that the systems in place for the safe administration of medicines were now sufficient to ensure safe medicines management. Records we checked were completed, up to date and accurate. Staff completed medicine administration records (MARs) sheets. When handwritten, the MARs were found to be a copy of the information displayed on the medicines bottle or box, and this information was checked by two staff members to ensure the information was accurate. The recording of topical treatments, such as creams or ointments, was now consistent.

We found that the registered provider had developed personal emergency evacuation plans (PEEPs) for people using the service. The registered provider took action to keep the premises and equipment safe for people to use. We found that the service's fire risk assessments were up to date, and reviewed periodically. We saw fire alarm tests took place weekly in line with the fire authority’s national guidance. Staff had a good awareness of safeguarding principles and where to report any concerns. Following any safeguarding incidents, we found the registered manager met with staff to debrief and explore system improvement and lessons learnt.

We found that Stanley Grange had sufficient staffing levels to meet people’s currently assessed needs. The service had systems in place to monitor and manage accidents and incidents, and maintain people’s safety and wel

We inspected the service on 16 March 2016, this inspection was unannounced. The service is a new service and so this was the first CQC inspection.

Stanley Grange is a small intentional community for adults with learning disabilities and complex needs, nestled between Preston and Blackburn. It was established in the 1970s by a charity called Cottage and Rural Enterprises (CARE) to provide a home for life for adults. Since 1 October 2015, the estate & buildings at Stanley Grange have been owned by Stanley Grange Community Association, a charity set up in 2014 by the families of people living there with the express intention of saving this thriving community from closure.

Future Directions were appointed as the care provider for Stanley Grange 1 October 2015.

There are 7 dwellings; houses, flats, bungalows and cottages (some shared, some single occupancy) with a community hall and gardens, set around a ‘village green’. On the day of inspection there were 31 people who used the service.

The service has 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.

We looked at how the service managed medicines. We found that the systems in place for the safe administration of medicines were not sufficient to ensure safe medicines management and in breach of the service’s own medicines policy. Records we checked were not always completed and accurate.

Accidents and incidents forms were available to view. However we found that staff were not always completing these in full.

The registered provider had developed personal emergency evacuation plans (PEEPs) for people using the service. The registered provider took action to keep the premises and equipment safe for people to use. However, we found the service’s fire risk assessments were missing some information. We made a recommendation about this.

We looked at how the service gained people’s consent to care and treatment in line with the Mental Capacity Act 2005. We found that the service did not have sufficient systems in place to enable assessment of a person’s mental capacity prior to making any best interest decisions..

We saw evidence that staff were receiving regular formal supervisions. Supervisions and appraisals are important to ensure staff have structured opportunities to discuss their training and development needs with their manager.

We observed staff support people who lived at the service. We saw that staff had good skills to communicate with people on an individual basis and used effective communication. We saw that the staff were confident within their role and understood the needs of the people they supported.

We saw that staff interacted with people in a kind and caring way, and it was obvious that trusting relationships had been created.

People told us that their independence was encouraged in a positive way and their privacy and dignity was consistently promoted.

People had personalised care plans in place to guide staff as to how they wanted their care to be provided. Care plans included details about people's specific preferences and wishes. There was a range of activities for people to take part in through links with the local community.

We found a positive culture at the service was reported by all the staff members that we spoke to. However staff told us that this was work in progress. This was due to the recent change in provider and management.

We found that a quality assurance policy was in place but saw that audits were not always undertaken as part of the quality assurance process. Audits completed were not effective and did not always pick up areas for improvement or evidence of poor practice.

We found a number of breaches of the