This inspection took place on 20 and 24 October 2016 and was announced.

The Wheelhouse provides accommodation and personal care for a maximum of four adults with learning disabilities and autistic spectrum disorders. At this inspection four people were living there.

A registered manager was in post and was present throughout this inspection. 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 were safe as staff had been trained and understood how to support people in a way that protected them from danger, harm and abuse. People had individual assessments of risk associated with their care and support. Staff members had access to people’s risk assessments and were aware of how to protect people from harm.

The provider followed safe recruitment practices with staff before they started work to ensure they were safe to work with people. People received help with their medicines from staff who were trained to safely administer these. People had their medicine when they needed it.

People received care and support from staff that had the skills and knowledge to meet their needs. Staff members attended training that was relevant to the people they supported. Staff received support and guidance from a management team who they found approachable.

People had their rights upheld by staff members who knew the appropriate legislation which directed their roles.

People were involved in decisions about their care and had information they needed in a way they understood. When people could not make decisions for themselves staff understood the steps they needed to follow to ensure people’s rights were upheld.

People had access to healthcare when needed and staff responded to any changes in their need promptly and consistently. People were supported to maintain a healthy diet and regular exercise which promoted well-being.

People’s likes and dislikes were known by staff who supported them in a way which was personal to them. People had positive relationships with the staff members who supported them. People had their privacy and dignity respected and information personal to them was treated with confidence.

People and staff members felt able to express their views and felt their opinions mattered. The provider and registered manager undertook regular quality checks in order to drive improvements. The provider engaged people and their families and encouraged feedback.

We undertook this inspection to review infection control practices. This was following non-compliance, which had been identified at the last inspection on 04 June 2014. The provider subsequently submitted an action plan outlining the steps they intended to take to rectify the issues identified. The action plan identified how the service would make improvements.

Our inspection team was made up of one adult social care inspector. We answered our question; Is the service safe? Below is a summary of what we have found. The summary is based on our observations during the inspection. Four people were resident in the service at the time of our inspection. We undertook a tour of the home, looked at staff records and records relating to the management of the service. We spoke individually with the manager.

We found that the home had made the improvements they told us they would. This included a total refurbishment of the laundry facilities and replacement of all floors throughout the home. The upgrading of the environment in this way meant that the home could now be appropriately cleaned and thus reduce the risk of the spread of infection. We also saw evidence that through the process of on-going auditing and training, the home had ensured that staff had a better understanding of infection control.

Our inspection team was made up of one inspector. We answered our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary describes what people who used the service and the staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found the home to be clean and tidy at the time of our visit. Some outstanding maintenance work however meant that some areas of the home could not be appropriately cleaned so as to reduce the risk of infection. In particular the laundry room required re-tiling and a number of floor coverings throughout the home were damaged and needed to be replaced. Staff had received training in infection control and used personal protective equipment, such as gloves and aprons to ensure that they protected themselves and others.

Staffing levels were sufficient to meet the needs of the people who lived at The Wheelhouse. We were told that two people required 1-1 staffing throughout the day and saw that this was always provided. Staff demonstrated a good understanding of the needs of the people who lived at the home. We saw that people were appropriately supported throughout the inspection.

We found evidence that the home had taken steps to ensure that it was compliant with the Mental Capacity Act and Deprivation of Liberty Safeguards. Through staff training and ongoing care plan reviews we found that the home had taken appropriate action which ensured that people received support that protected their legal rights and balanced safety with choice.

Is the service effective?

We saw that people had good relationships with the staff who supported them and we observed positive relationships between them. We found that the home had good systems in place to ensure that people were appropriately consulted and informed about their care. Where people were required to make more complex decisions about issues such as treatment, the home had appropriate systems in place to gain valid consent.

Is the service caring?

We observed that people received sensitive and discreet care. We saw that people's choices were respected and that staff involved them in their care. We found that people had comprehensive care plans which provided detailed guidance about how they should be supported. This meant that the provider had taken steps to ensure people received the care they needed in a way that made them feel comfortable.

Is the service responsive?

People's needs were continually assessed. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and support had been provided in accordance with people's wishes. Staff had a good understanding of people's needs and demonstrated that they recognised and responded when these changed.

Is the service well-led?

The provider had good systems in place to monitor and improve the services provided. The registered manager had a good knowledge and oversight of the running of the home. The provider had various systems in place to ensure it regularly monitored and audited the quality of service provided at The Wheelhouse.

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

We observed positive two-way interaction between staff and people living at the home. We saw from care plans and the use of various aids to communication such as pictures and objects of reference that every effort was made to involve people in developing and implementing their own care plans.

We examined all the care plans for the four people living at the home and found that they were inclusive, person-centred, relevant and regularly reviewed to ensure the welfare and safety of people.

Staff we spoke with understood what constituted abuse and were familiar with the proper procedures to follow in relation to safeguarding people. All had received recent training and relevant contact numbers were readily available.

We examined four staff files which showed that people were only allowed to work with people at the home once proper checks and induction training had been completed.

There were appropriate storage, recording and administration procedures in place at the home in relation to medication to ensure that people were kept safe.

The home had clearly displayed information about their complaints procedure. This was also displayed in pictorial format to support people living at the home.

It was only possible to meet with one of the four people living at the home at the time of our visit. Due to the complex communication needs of the people living at the home, it was not possible to gather direct quotes for the purpose of this report.

During our inspection we met two of the four people living in the home. Due to their complex communication needs it was not possible to gather direct comments from them on the outcomes assessed. However, we met with a relative who spoke positively about the delivery of care to the person they visited. They told us they felt well informed and worked as "part of a team" to support their relative.

We spoke with two care staff in addition to the manager. They told us they felt well supported and were provided with the necessary training and knowledge to fulfil their roles. Staff expressed satisfaction with the positive work the home was undertaking with the people living there. We observed interactions between staff and the people they cared for, and saw that these were conducted in a sensitive and professional manner.

We reviewed relevant supporting documentation for staff and the people living in the home. We found that people in the home had opportunities to express their views about aspects of their care and the day to day operation of the home. All records viewed were well ordered, accessible, updated and securely stored