2, 3 and 4 Nightingale close provides accommodation and personal care for up 18 people who have a learning disability and may also have mental health needs. On the day of our inspection there were 17 people living in the service. One person was in hospital and they had one vacancy.

When we last visited the service it was rated good.

At this inspection we found the service remained good.

People were safe because staff supported them to understand how to keep safe and staff knew how to manage risk effectively. There were sufficient numbers of care staff on shift with the correct skills and knowledge to keep people safe. There were appropriate arrangements in place for medicines to be stored and administered safely.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. Management and staff understood their responsibility in this area. Staff were committed to ensuring all decisions were made in people’s best interest.

Staff had good relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected at all times. People and their relatives were involved in making decisions about their care and support.

Care plans were individual and contained information about how people preferred to communicate and their ability to make decisions.

People were encouraged to take part in activities that they enjoyed, and were supported to keep in contact with family members. When needed, they were supported to see health professionals and referrals were put through to ensure they had the appropriate care and treatment.

Relatives and staff were complimentary about the management of the service. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service.

The management team had systems in place to monitor the quality and safety of the service provided.

The inspection took place on 8 January 2015 and was unannounced.

2, 3 and 4 Nightingale Close provides care and accommodation for up to 18 people who have a learning disability. Accommodation is provided in three separate bungalows.. The service does not provide nursing care. At the time of our inspection there were 18 people using the service.

A registered manager was in post at the service. 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 the last inspection on 14 November 2013 the provider was in breach of Regulation 20 HSCA 2008 (Regulated Activities) regulations 2010. We asked the provider to take action to make improvements to incident recording and updating people’s care records. The provider sent us an action plan on 27 November 2013 stating they would meet the legal requirements by 10 December 2013 and this action has been completed.

People were safe because staff supported them to understand how to keep safe and staff were aware of their responsibilities in managing risk and identifying abuse. People received safe care that met their assessed needs.

There were enough staff who had been recruited safely and who had the skills and knowledge to provide care and support to people in ways that they preferred.

People’s health and emotional needs were well managed by staff who consulted with relevant health care professionals. Staff supported people to have sufficient food and drink that met their individual needs.

People were treated with kindness and respect by staff who knew them well and who values their views.

People were encouraged to follow their interests and hobbies and were supported to maintain relationships with friends and family so that they could enjoy social activities in the wider community.

There was an open culture and the management team demonstrated good leadership skills. Staff felt values and they were keen to provide good quality care and support.

The management team had systems in place to check and audit the quality of the service. The views of people and their relatives were taken into account to make improvements and develop the service.

2, 3 and 4 Nightingale close are individual bungalows where people live and care is provided for them. Each bungalow is run by a coordinator and the running of the service is overseen by the registered manager.

We found that the service had appropriate arrangements in place for obtaining consent to care. Where appropriate the service had mental capacity assessments in place in accordance with the Mental Capacity Act 2005.

We found that the provider had systems in place to maintain the safety and welfare of service users. The service provided staff with specialised training to ensure the safety of people with specific medical needs.

We saw that the registered manager showed effective leadership skills and that all staff were expected to provide a high quality of care to people. The provider had good arrangements to promote effective performance of the service. We found that there were systems in place to work collaboratively with other stakeholders and care providers in respect of people’s care needs.

The provider had not always ensured that people’s care was regularly reviewed and the updates documented in the care records. Some care plans and medical plans were not reviewed, current or did not directly reflect people’s care needs.

We spoke with four people who used the service during our inspection. People told us that they were involved in their care and their care planning by working with the staff to write their care plans to fit their needs. People told us they were always involved in discussions about their care. They said that they were well treated and that staff were respectful to them when assisting them with their needs, addressing them by their preferred name and knowing how to help them when they experienced challenging situations. People told us that they regularly go out to the shops, to the cinema and on day trips to places such as the zoo and go on holidays. People said that the staff team met their needs and that they made sure that they had everything that they wanted.

People told us that they felt safe living at Nightingale Close. One person said that they “Loved it” and that the staff supported them in all that they did. They said that the staff helped them to keep safe both indoors and when they went out. They said staff supported them in arranging their holidays each year and made specific arrangements for day trips out if it was what they wanted.

People told us they were very happy with the service. They said that they enjoyed living in Nightingale Close. They told us that the staff team were really good and that they supported them in making decisions for themselves.

People told us that they were involved in their care. They said that they were well treated and that staff were respectful to them. People told us that they regularly go out to a local college, to the shops and on day trips and holidays. People said that the staff team met their needs and that they made sure that they had everything that they wanted.

People told us that they felt safe living at Nightingale Close. One person said that they liked living there and that the staff supported them in all that they did. They said that the staff helped them to keep safe both indoors and when they went out.

People told us that they liked living at Nightingale Close. They said that they had everything that they needed and that the home was always kept nice. People told us that they liked the staff. They said that the staff always treated them well and spoke to them respectfully. People told us that they felt that the staff knew what they had to do and how they had to do it.

People told us they were very happy with the service. They said that they enjoyed living in Nightingale Close. They told us that the staff team were really good and that they supported them in making decisions for themselves.