About the service:

2 Central Avenue is a residential care home that provides personal and nursing care for up to four adults who have a learning disability and who may also have an autistic spectrum disorder. At the time of the inspection there were three people living at the service.

People’s experience of using this service:

• Risks to people were identified to prevent people from receiving unsafe care and support. However, not all risks for people were lessened at the earliest opportunity for their safety and wellbeing.

• Although staffing levels were not always maintained, this did not impact on people using the service.

• People received their medication as prescribed but minor improvements were required to PRN ‘as required’ protocols.

• Recruitment procedures were followed to ensure the right staff were employed but improvements were required to ensure profiles from staff employed through an external agency were sought and readily available.

• People were protected by the providers arrangements for the prevention and control of infection.

• Staff had an induction to carry out their role and responsibilities effectively. Staff had the right competencies and skills to meet people’s needs and received regular training opportunities. Suitable arrangements were in place for staff to receive regular formal supervision.

• People’s nutritional and hydration needs were met. People received appropriate healthcare support as and when needed from a variety of professional services. The service worked together with other organisations to ensure people received coordinated care and support.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

• People were treated with care, kindness, dignity and respect. People received appropriate care and support that met their needs and preferences. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported.

• Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual circumstances.

• Social activities were available for people to enjoy and experience both ‘in house’ and within the local community.

• Arrangements were in place to assess and monitor the quality of the service provided. However, areas which required improvement were not picked up by the registered provider’s or manager’s quality assurance arrangements.

• The service sought people’s and others views about the quality of the service provided.

Rating at last inspection:

Following the last inspection the rating of the service was ‘Good’ (Last report published September 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as outlined in our inspection programme and schedule. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 5 July 2016 and was unannounced.

2 Central Avenue is a care home providing care and accommodation for up to 4 people living with a learning disability. The home does not provide nursing care. At the time of our inspection there were four 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.

Staff had a good understanding in how to keep people safe. Staff knew who to contact if they had concerns about a persons’ safety. There were sufficient numbers of skilled staff to keep people safe and meet their needs. There were systems in place to manage medicines and people were supported to take their prescribed medicines safely. The provider had a robust recruitment process in place to protect people from the risk of avoidable harm.

Staff were experienced in meeting people’s needs and were enabled to continue developing their skills. Decisions were made in people’s best interests. Where there were restrictions on people’s freedom, staff had taken the necessary measures to protect people and ensure their human rights were protected. Staff were skilled in supporting people were supported to make choices about the care and support their received.

Staff supported people to have a well-balanced diet and spent time enabling them to have a say in what food and drink they ate. People’s health needs were monitored and managed by staff with input from relevant health care professionals. As people’s health deteriorated staff developed new skills and knowledge to enable them to continue to meet individual needs.

People had developed long-standing relationships with staff and felt comfortable in their presence. Staff had the skills to support people to communicate their preferences. Staff respected people’s right to dignity and respect.

Support was flexible and outlined in detailed person centred care plans. People were enabled to take part in activities inside and outside of the service. People were involved in residents meetings and could provide feedback about how the service was run. Complaints were usually resolved informally.

The service was well run and staff worked well together and were aware of their roles. Routines and relationships at the service were comfortable and well established and any changes were introduced gradually over time. The provider had systems in place to check the quality of the service and to make improvements where necessary.

As part of this inspection we observed how people were cared for, spoke with the manager, one support assistant, three people who used the service and reviewed two people's care records. On the day of our inspection there were four people living at 2 Central Avenue. The manager told us that the needs of people living at the service were varied and complex. The majority of people had complex communication difficulties and were unable to tell us about their experiences of using the service. Our observations suggested that people living at the service were happy, that they felt safe and were well cared for. It was evident that people who used the service had a good relationship and rapport with support assistants.

People's health and personal care needs were assessed and there were detailed care plans in place for support assistants to follow so as to ensure that people were supported safely and in accordance with people's individual preferences and wishes. Support assistants spoken with demonstrated a good understanding of people's health and personal care needs and how each person wished to be supported.

The provider was able to demonstrate that a robust staff recruitment policy and procedure was in place and followed to ensure that people living at the service were kept safe. We found that medication practices and procedures maintained people's health and wellbeing.

People living at 2 Central Avenue told us that they felt safe living at the home and that they had choice and independence in their day to day lives. They also said that they were happy with the staff team.

Some of the people using the service have limited communication skills, so were not able to provide us with information on many of the outcome areas.

One person communicated really well and they told us that they were happy with the staff, the food and their activities. They told us that they were able to choose their new furniture and that they helped to make up their support plan.

Other people showed through their facial expressions and their body language that they were happy living at 2 Central Avenue.