The service is registered to provide care for up to three people living with mental health needs or learning disabilities. At the time of our inspection two people were living at the service.

At our last inspection in April 2015, the service was rated ‘Good’. At this inspection we found that the service remained ‘Good’ for being safe, caring, responsive and well-led, however ‘Requires Improvement’ was identified for effective.

We found inconsistencies in how the Mental Capacity Act 2005 (MCA) was being applied. Where people lacked mental capacity to consent to specific decisions about their care and support, appropriate action in accordance with MCA had not always been taken. The registered manager was already aware of this shortfall. MCA training had already been planned for staff including the registered manager.

The storage and management of medicines were found to be correct but the administration of one particular medicine had not always been administered as required. The registered manager took immediate action to address this issue.

People’s needs had been assessed and care plans were in place to support staff of how to meet people’s needs. Information about one person’s particular health condition did not have a care plan or risk assessment completed. However, staff were able to tell us about this condition and how they supported the person. Some people had periods of high anxiety that affected their mood and behaviour. The strategies in place to guide staff of how to support people were found to lack specific detail and instruction. The registered manager took immediate action and addressed this concern.

Staff had access to the support, supervision and training that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

People continued to receive safe care. They were supported by staff who knew how to recognise and report any signs that people were abused or at risk of abuse. The provider had procedures in place for staff to report concerns and for those concerns to be investigated and acted upon.

Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs. People were supported by staff that were caring and treated them with dignity and their privacy was respected. People’s independence was promoted within the service.

People were supported to live the life that they chose and care plans supported staff to provide a person centred approach.

People and their relatives felt they could raise a concern and the provider had systems to manage any complaints that they may receive.

The provider had arrangements in place for monitoring and assessing the quality of care people experienced. These included seeking and acting upon the views for people who used the service and others.

We carried out our inspection on 4 February 2015. The inspection was announced. We gave 48 hours’ notice of the inspection because the service is small and the manager was often out of the office supporting staff or providing care. We needed to be sure they would be in.

The service provides accommodation for up to three people who require nursing or personal care. The service specialises in care for younger people with learning difficulties and autistic spectrum disorder. It is located in a residential area in East Leake, a village near Loughborough in Leicestershire. At the time of our inspection one person was using the service.

The service had a 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 and associated Regulations about how the service is run.

Staff understood and put into practice the provider’s procedures for safeguarding people from abuse and avoidable harm. They advised people using the service about how to keep safe in the home and when they were out enjoying activities. People knew how to raise concerns. The provider had enough suitably skilled staff to be able to meet the needs of people using the service. Staff prompted people to take their own medicines and had effective procedures for reminding people to take their medicines when they were not at 26 Brookside Avenue.

People using the service were supported by staff who had received relevant and appropriate training. This meant staff understood the needs of people they supported. Staff were supported through effective supervision and training. Staff understood the relevance to their work of the Mental Capacity Act 2005. They knew how to seek people’s consent before they provided care and support.

Staff supported people with their nutritional needs by providing information about balanced diets and healthy eating. They supported people to prepare their own meals. People were supported to access the relevant health services when they needed to.

People using the service told us that staff were considerate and caring. The provider had matched people’s needs with the skills and knowledge of care workers. That was particularly the case in terms of activities that people enjoyed. People were able to enjoy a variety of sports and recreation because care workers played an active participatory role in them. People were supported by care workers who understood their needs. People were involved in the assessments of their needs and in reviews of their plan of care. People were provided with information about their care and support options and were involved in decisions about their care and support. Care workers respected people’s privacy and dignity.

People’s plans of care were centred on their specific needs. Those plans had agreed aims and objectives which care workers helped people to achieve. People knew how to raise concerns if they needed to. The person we spoke with were very pleased with the care and support they had experienced.

The provider had aims and objectives that were understood by staff and the person using the service. They had effective procedures for monitoring and assessing the quality of service that promoted continuous improvement.

On the day of our inspection, two people using the service were unavailable to speak to us, and the third person was not comfortable speaking with us. We spoke with the registered manager at 26 Brookside Avenue and three members of staff who worked with the people using the service. We also spoke with the relative of a person using the service and a social care professional.

We found people were able to make informed decisions about their care and support. One relative told us that staff “are always very careful to get [their family member’s] consent” and “always talk to [their family member] in a way that is appropriate.”

We found people experienced care and support that met their needs and protected their rights. We found people’s care needs had been assessed. Care and support was delivered in a way that met people’s needs and ensured their safety and welfare.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We found the provider had robust systems in place relating to the management of medicines.

Staff were supported in their work and were confident that they were able to provide the care required.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained. We found the provider had clear and effective systems in place relating to record keeping.

As part of our inspection on this service we spoke with one out of the two people living at the home as one person was not comfortable speaking with us. We spoke with the registered manager at the home and two of the support staff who worked with the people using the service. We also spoke with the relative of someone using the service.

The person using the service told us they were happy living at the home. They told us that they had been in other homes prior to coming to this one and that they were happier now they lived here. They commented that: "It's alright living here. The staff are alright to me. They sort things out for me."

The staff we spoke with told us that they enjoyed working at the service and that they felt supported. One staff member said: "I feel very supported. It's the best place I've worked." Another commented that: "I really enjoy it here, it's everything that care should be. We encourage them to make better choices and live the life they choose."

A relative of someone living at the home said: "We are very happy with the service. He calls it home which shows he's happy there and that he wants to be there." They said they were in regular contact with the home.

We reviewed the care plans in place at the home which were detailed and informative. We reviewed incidents which had been recorded by the service and found some errors in relation to the administration of people's medication. We looked at medication as a result of our visit.