16 Cleeve Hill 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.

This inspection took place on 23 January 2019 and was unannounced. There were no concerns at the last inspection of July 2016. Five people can live at 16 Cleeve Hill. At the time of our visit there were 4 people with a learning disability and/or a mental health condition who were living at the service.

There was a manager in post and they were in the process of registering with CQC as the 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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing 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.

Why the service is rated good.

People continued to receive a service that was safe. The manager and staff understood their role and responsibilities to keep people safe from harm. People were supported to take risks, promote their independence and follow their interests. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work to assess their suitability to support vulnerable people. Medicines were well managed and people received their medicines as prescribed. The home was clean and staff followed the providers infection control policy and procedures.

The service remained effective in meeting people’s needs. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. The manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people's rights were respected. People were supported to enjoy a healthy, nutritious, balanced diet whilst promoting and respecting choice.

Staff provided a caring service to people and respected and promoted their dignity. People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care amended to meet their changing needs. The service was flexible and responded very positively to people’s requests. People who used the service felt able to make requests and express their opinions and views.

People benefitted from a service that was well led. The values and culture of the service were clearly communicated to and understood by staff. The manager demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service.

Further information is in the detailed findings below.

16 Cleeve Hill is registered to provide accommodation for five people who require personal care. At the time of our inspection five people with learning disabilities were using the service.

This inspection was unannounced and took place on 22 July 2016.

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 were safe. Staff understood their role and responsibilities in keeping people safe from harm and knew how to raise any concerns. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Medicines were well managed and people received their medicines as prescribed. Infection control measures were in place.

The service was effective. Staff received regular training and the support needed to meet people’s needs. People were supported to make choices and decisions. People had enough to eat and drink. Arrangements were made for people to see their GP and other healthcare professionals when required. People’s healthcare needs were met and staff worked with health and social care professionals to access relevant services. The provider had plans in place to develop and improve the accommodation.

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. Information was provided in ways that were easy to understand. People were supported to maintain relationships with family and friends.

The service was responsive to people’s needs. People received person centred care and support. They were offered a range of activities both at the service and in the local community. People were encouraged to make their views known and the service responded to this by making changes.

People benefitted from a service that was well led. Manager’s had an open, honest and transparent management style. The quality of service people received was monitored on a regular basis and where shortfalls were identified they were acted upon.

We looked at a selection of care records. These were well maintained and contained information regarding the needs and wishes of individuals and recorded the care and support that was provided by staff at 16 Cleeve Hill.

We observed interactions between staff and all of the people living at the home and saw that staff were respectful, patient and kind in their approach. Many of the staff employed had worked at the home for many years and they knew the needs of the people in their care well.

People's special dietary needs had been recorded within care plans and risk assessments. Staff at the home monitored the food and drink of people to ensure their nutritional needs were being met.

Equipment used by people was well maintained, safe and staff knew how to use it in line with the assessed needs of the people in their care.

We spoke with the two members of staff on duty who told us that they enjoyed working at the home and that they worked well together as a team and knew the people living in the home well. One member of staff told us that they received appropriate training and support to enable them to deliver safe and effective care

People living at 16 Cleeve Hill were unable to fully tell us how they had been involved in decisions relating to their care due to the complexity of their learning disability. However, we were able to observe interactions between members of staff and the people they support and we also spoke with staff and looked at care records.

One person took us to their room and told us that they liked living at the home. During our tour of the house we saw that rooms were individually personalised. We also saw that people looked relaxed and comfortable in their home. During our visit we saw that staff interacted with people in a positive, sensitive, and respectful manner whilst attending to their needs. Staff we spoke with told us that they had worked at the home for a number of years and they knew the people they supported well. They told us about the importance of body language and understanding of people’s behaviours in order that they treated as individuals.

People remained safe and well as the service worked closely with health and social care professionals. How people communicated was recorded. Clear information for staff on how to support people who were not able to verbalise how they wanted their care to be provided was in place.

The provider had taken steps to provide care in an environment that was suitably designed and generally well maintained.

People told us they were able to choose how to spend their day.

People told us that they could move freely around the home and the garden and were supported by the staff when out of the home.

They also said the staff were caring and had an understanding of their needs. One person said “the staff here are good and kind”.

Staff that we spoke to said they believed that people were treated well by the team and

they had no concerns about the safety of people living in the home.

During our observations of staff’s interaction with people at the home we saw that they knew individuals’ likes and dislikes and had a caring and friendly approach.