This was an unannounced inspection that took place on 9 November 2018. The service was last inspected in 2016 where there were no breaches in regulation seen and the home was rated as Good. We found at this inspection that 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.

3 & 4 Glebe Lane is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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 care home can accommodate up to eight people in a bungalow and a small house that are next to each other but have separate adapted facilities. there were seven people living in the home when we visited. People in the service were living with a learning disability and, in some instances, with a physical disability and complex health needs. The home does not provide nursing care.

The home had a suitably qualified and experienced registered manager who had a background in social care and in management. 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 staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and spoke to us about how they would identify any issues and report them appropriately. Risk assessments and risk management plans supported people well. Good arrangements were in place to ensure that new members of staff had been appropriately vetted and that they were the right kind of people to work with vulnerable adults. Accident and incident management was of a good standard.

The registered manager kept staffing rosters under review as people's needs changed. We judged that the service employed enough support staff by day to meet people's needs. Staffing levels at night were being changed to meet people's needs.

We made a recommendation about continuing to review staffing at night.

Staff were appropriately inducted, trained and developed to give the best support possible. We met team members who understood people's needs and who had suitable training and experience in their roles.

People had reviews of their medicines on a regular basis. Medicines were stored safely. We noted that some, but not all, staff did not always sign the records in a timely manner but this was being addressed by the provider under their quality monitoring, supervision and disciplinary processes.

People in the home saw their GP and health specialists whenever necessary. The staff team had good working relationships with local GP surgeries, community nursing services and specialist health care professionals.

Good assessments of need were in place, and the staff team reviewed the delivery of care for effectiveness. They worked with health and social care professionals to ensure that assessment and review of support needed was suitable and up to date.

People told us they were satisfied with the food provided and we saw suitably prepared meals being served. Good nutritional planning was in place. Special diets and support needed to take enough nutrition and hydration were in

This was an unannounced inspection carried out by an adult social care inspector. It took place over two days 2 and 3 September 2016.

3 Glebe Lane is a four bedroomed bungalow which provides care for four people in single rooms. 4 Glebe Lane is a four bedroom house where four people live. The service cares for people with a learning disability who may also have a physical disability. Both houses have suitable shared spaces and small gardens. The staff care for people in both properties and the people who live in both houses visit each others buildings as they are next door to each other. The houses are in a quiet residential area of Distington within easy access of the village amenities and public transport.

The home has an experienced and suitably qualified registered manager who has been in post for a number of years. 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 in the home were protected from potential harm and abuse because staff understood their responsibilities and had received suitable training in safeguarding matters. Both houses were safe and secure and the registered manager had ensured that maintenance was on-going and that there was a suitable emergency plan in place.

Every person in the home had a risk assessment that covered their care needs and risks around activities. There were suitable risk assessments in place regarding the building and the grounds. Accidents and incidents were minimal and suitable risk management in place to lessen or prevent any accidents.

Staffing levels met the assessed needs of people in the service. The registered manager changed the rosters when people's care and support needs changed so that staffing met these needs.

Staff were suitably recruited and West House had human resources policies and procedures in place. The organisation had grievance procedures and less formal ways of staff being able to 'whistle blow' if necessary.

Medicines were suitably managed with staff receiving training and checks on competence.

Both buildings were clean and tidy and staff had training in prevention of infection. They understood how to use personal protective equipment.

Staff received good levels of support through supervision, appraisal and checks on competence. We saw that new staff had a thorough induction and then received both formal and informal supervision. More experienced staff had support that helped with their overall personal development. Records showed that the staff team discussed best practice issues in supervision and in team meetings as well as informally during their shifts.

The registered manager had a good understanding of the Mental Capacity Act 2005 and staff had received training on making decisions in people's best interests, Deprivation of Liberty authorities and on consent. There had been no incidents where restraint had been used but staff had receive suitable training on behaviours that challenge and how to manage them.

Staff supported people to prepare their own snacks and to help with meal making wherever possible. People received good quality food that was home cooked in the service. People also went out for meals. Staff were trained to support people who had difficulties managing a normal diet.

Both buildings were of a domestic nature but the provider had made suitable adaptions where people had problems with their mobility. Some parts of the buildings looked a little tired but the registered manager told us of plans to continually upgrade the environment. Staff supported people to keep their homes neat and tidy. Both buildings were warm, comfortable and homely.

Staff explained things to people with care and patience, They helped and supported people b

People we spoke with said they liked living in the home and that the staff treated them well. They told us they could choose what they liked to do. One person told us, “The staff are great they help me work out what I like to do and then we put it into a person-centred plan so we can see when I’ve done it.”

We were able to see that people were supported to lead active and meaningful lives and had frequent access the local community. We observed people being supported by staff to undertake meaningful tasks and activities. Some people told us they liked to do their own chores and help with the housework. There was a relaxed and homely atmosphere with a friendly rapport between staff and people living in the home.

We saw that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. The home had developed good links with healthcare professionals to ensure that people’s health needs were being well met.

People were supported to play a central part in decision-making. One person told us, “Staff have been brilliant at helping me with my illness and I’m starting to keep hold of my own medication.”

The home was well designed and equipped to effectively and safely care for people with limited mobility and more complex healthcare needs.

The home is registered for 7 people with learning disabilities. When we visited we spoke with all three people who lived in the semi-detached house. We also spoke with three people living in the bungalow. The fourth person was out attending a day services centre. We also spent time sitting with people and observing the interactions and support they received from staff.

Those people who had verbal communication all had good things to say about the home and the care they received. All said they got on very well with the staff who were kind and caring, and helped them to lead active lives. Everyone we spoke with said they were helped to follow their interests and have different hobbies.

Those with more limited communication were observed to be at ease and responded positively to staff by for example smiling, laughing and using other forms of communication.

On the day we visited people were busy coming and going with staff to doctors appointments, shopping trips, out to day services and to cafes.

People told us:

“I like it here much more than my last place. I get on better with the other people and the staff are great”

“Staff help me to do the things I wanted to do. They don’t force me to do anything I don’t want to do”

“I like to go shopping and to cafes and when I ask, staff take me to my mothers grave”.