We inspected the service on 1 August 2018. The inspection was unannounced and was the provider’s first inspection since it was registered.

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.

Winslow is a nursing home and accommodates up to six people with a learning disability and or autism and mental health needs. People had their own individual apartments and received high levels of staff support. On the day of our inspection, six people were living at the service.

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.” Registering the Right Support CQC policy.

A registered manager was in place but they were not based at the service and were not available at this inspection. On the day of our inspection a new manager was in place who was due to take over as registered manager. 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.

Staffing levels were sufficient but concerns were identified in the staff skill mix. Agency staff were frequently used to cover staff shortfalls whilst new permanent staff were recruited, but this could have been better planned for. Safe staff recruitment practices were followed.

There were insufficient systems and processes in place to ensure the management of medicines and infection control measures, were effectively and safely monitored and managed.

Adult safeguarding policies and procedure were in place and followed to protect people. Risks associated with people’s needs, including the environment had been assessed and planned for. People had complex mental health needs and positive behavioural support plans were used, to provide staff with guidance of how to manage behaviours safely and effectively.

Accidents and incidents were recorded, monitored and analysed to ensure people received safe support and if lessons could be learnt to reduce further risks.

People had received an assessment of their needs that also considered their protected characteristics under the Equality Act, to ensure they did not experience any form of discrimination. People were involved in agreeing the plan of visits to the service before they moved to the service permanently. This is known as a transition plan.

Staff received an induction and ongoing training relevant to people’s needs and support, to enable them to provide effective care and treatment.

People received sufficient to eat and drink, they were involved in menu planning and staff encouraged health eating and independence was promoted.

People’s physical and mental health needs were assessed, planned for and monitored. Staff worked effectively with external health care professionals to support people with good health outcomes.

People lived in an environment that met their individual needs and preferences. They had opportunities to spend time with others in communal areas if they choose.

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 support this practice. Staff were aware of the principles of the Mental Capacity Act 2005.

People were supported by a core staff team, who were caring, compassionate and who knew their needs, preferences and what was important to them. Staff respected peo