The Paddocks is registered to accommodate up to six people. It specialises in providing support to people with a learning disability who may also have autism and display challenging behaviour. At the time of the inspection there were six younger adults living at the service. There is level access to a secure garden to the side and rear of the property and the first floor was accessed by a flight of stairs.

There was 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.

People’s individual care plans included information about who was important to them, such as their family and friends and we saw that people took part in lots of activities in the home and in the community. Activities included trampolining, shopping, bowling, cooking, watching planes, horse riding and attending social clubs and community events.

People’s care needs were kept under review. One person’s relative commented they were informed “Straight away” of any changes and commented the staff were “Good as gold". People were well looked after and supported and they were encouraged to be as independent as possible.

People were encouraged to stay in touch with their families and receive visitors who were made to feel welcome. We observed friendly and genuine relationships had developed between people and staff. One person told us, “They [staff] are very kind”.

People were encouraged to express their views and had completed surveys. Feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People also said they felt listened to and any concerns or issues they raised were addressed.

People were happy and relaxed with staff. People felt safe and there were sufficient staff to support them. The registered manager commented “First and foremost is people’s safety and happiness”.

People were encouraged and supported to eat and drink well. There was a varied daily choice of homemade meals. Special dietary requirements were met, and people’s weight was monitored, with their permission. Health care was accessible for people and appointments were made for regular check-ups as needed. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately and people receive their medicines on time.

People were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place.

Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed. A relative told us “One thing I was really impressed by was, (Person’s name) once tripped over broke their glasses within about a week the steps were removed and replaced with a ramp and support rails”. Emergency procedures were in place in the event of a fire and people knew what to do, as did the staff.

Staff had received the training they needed to support people effectively and there were opportunities for additional training specific to the needs of people such as autism. Staff received one-to-one meetings with their manager and formal personal development plans were in place.

Staff were asked for their opinions on the service and whethe

People were unable to tell us about their experience of the care and treatment they received. This is because people who use the service had learning difficulties and were unable to tell us about their experience. In order to understand people's experience we reviewed three people's care plans, we spoke to staff, observed people with staff and we spoke with two people's relatives.

We found that people were supported to make day to day decisions about their care. Where people lacked capacity to give their consent to some decisions these were made appropriately in their best interests. A person's relative told us "everything is discussed with me and X choices are respected - it's a super home".

We found that care was planned and delivered to meet people's needs safely and to promote their wellbeing. A person's relative told us "the home suits X need's very well", another relative told us "I am very lucky and X is very lucky, the activities are tailor made to meet their needs".

We found that the home was clean and the provider had the appropriate procedures and practices in place to prevent and control the risk of infection. People were supported by staff that were appropriately trained and supported in their role. A staff member said "I do the best I can to help people feel happy and secure".

The provider had a complaints policy and procedure in place and this was available to people in an accessible format to meet people's communication needs.

When we visited, four people were at home, two people were out in the community accompanied by the staff.

We observed information about health and safety and safeguarding people was appropriately displayed.

We found that people's diversity, values and human rights were respected by the way people were cared for. We saw people were given choices and supported to participate in activities in the local community.

One person told us, ’'I like to live here’' and another said ‘'I like the staff.'’ We witnessed good interactions between staff and people. People were observed to be happy, relaxed and well cared for. We found people's needs were assessed and care and treatment planned and delivered in line with their individual care plan.

Staff told us they felt supported and received appropriate training for their role.

The manager told us lessons learnt from incidents were used to improve the service delivered. We found good systems were in place to ensure the safety of medicines.