About the service: 31 King Edwards Grove provides accommodation and personal care for up to eight people with a learning disability and autism. At the time of the inspection eight people were living at the service.

The service had been developed and designed in line with the values that underpin the CQC Registering the Right Support policy 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.

People's experience of the service:

• Staff understood the risks to people and the measures in place to keep them safe. Systems were in place to ensure people’s medicines were managed safely and to reduce the risks associated with the spread of infection.

• Sufficient numbers of staff were employed to meet people’s needs and ensure they had maximum choice and control in their lives. This included supporting people to access a wide range of activities in the community that reflected their specific needs and interests.

• The recruitment, induction and training processes in place ensured staff had the right skills and experience, and were suitable to work with people who used the service.

• Staff supported each other and were observed treating people with dignity and respect.

• People received personalised care responsive to their needs, including health care services. The registered manager and staff worked well with other agencies to ensure people received the support and services they needed. People were involved in choosing their meals and drinks. Staff monitored nutrition and meals were based on people’s individual choice and preferences.

• People’s communication needs had been assessed and were meeting the requirements of the Accessible Information Standards. This set of standards sets out the specific, approach for providers of health and social care to identify, record, share and meet the communication needs of people with a disability, impairment or sensory loss.

• Staff felt supported in their roles and had confidence in the manager. There was an open culture of learning from mistakes, concerns, incidents and accidents and other relevant events. Staff understood how to raise concerns and felt comfortable doing so.

Rating at last inspection: Good (Report published 17 August 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 in line with our re-inspection programme. If any concerning information is received we may inspect the service sooner.

31 King Edwards Grove provides accommodation and personal care for up to eight adults with a learning disability and/ or autistic spectrum disorder. At the time of our inspection eight people were living in the home. The inspection took place on 27 July 2016 and was unannounced. At the previous inspection, held in June 2014 we found that the service was meeting the required standards.

The home was presented as an ordinary detached house over two floors with access to the first floor via stairs. People had single rooms. Communal space consisted of a lounge area and dining room. There was a private garden at the rear of the property.

There was a manager in post who was in the process of becoming registered by the Care Quality Commission (CQC), and they were at the home at the time of our inspection. 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.

The home was well decorated and adapted to meet people’s needs. The home had a homely feel and reflected the interests and lives of the people who lived there, with photos of people and staff.

People who were able to communicate with us gave us positive feedback about the home and the caring nature of staff. Other people were able to demonstrate in other ways that they felt safe and cared for at the home, for example through their interaction with staff.

There were sufficient numbers of staff to meet the needs and preferences of the people that lived there. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police. Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff ensured that people were involved in these decisions by speaking with people and making sure care plans were personalised and easy to read.

People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff. Staff supported people in a way which was kind, caring, and respectful.

Staff helped people to keep healthy and well, they supported people to attend appointments with GP’s and other healthcare professionals when they needed to. Medicines were stored safely, and people received their medicines as prescribed. People were involved in their food and drink choices and meals were prepared taking account of people’s health, cultural and religious needs.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Where people’s liberty may have been restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

The provider regularly sought people’s and staff’s views about how the care and support they received could be improved. There were systems in place to monitor the safety and quality of the service that people experienced.

Our inspection team was made up of an inspector who answered our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff treated people with dignity and respect throughout our visit. People said they liked living at the home. We saw there were robust safeguarding procedures in place that staff were trained in and knew how to operate. Details of areas or circumstances of concern specific to individual people were also recorded in the sample of care plans we looked at.

The organisation had systems that made sure the manager and staff learnt from events that took place at the home. These may have included accidents and incidents, listening to people's concerns and any complaints. This reduced the risks to people and helped the service to improve.

The home had effective policies and procedures in line with the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Relevant staff were trained and understood when an application for a mental capacity assessment should be made and how to submit one. This meant that people and their rights were safeguarded. We toured the building, garden and saw that the home was generally safe, clean and hygienic with well-maintained equipment that was regularly serviced. This meant people were generally not put at unnecessary risk.

People’s care needs were taken into account by the manager and this was reflected in the rota when making decisions regarding the required staff numbers, qualifications, skills and experience. This ensured that people’s needs were met.

We saw that policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

There was an advocacy service available which meant that people could access additional support if they needed it.

People's health and care needs were assessed with them by the home and those that wished were involved in contributing to their care plans. Any specialist care and support such as dietary, mobility or equipment needs had been identified in people's support plans. These were written from the perspective of the individual.

We saw that there were regular audits of the service as well as meetings between staff and between staff and the people living at the home. These ensured that any decisions or actions could be monitored and followed up.

Is the service caring?

We saw that people were supported by kind, competent and attentive staff. The staff were patient and gave encouragement when supporting people. People we spoke with told us they liked the staff and we saw that people behaved in a comfortable and relaxed manner when engaging with staff.

People and their relatives completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed. We saw two support plans in which people’s preferences, interests, aspirations and diverse needs were recorded and that the care and support provided was in accordance with this information.

Is the service responsive?

People regularly completed a range of activities at home and within the community. During our visit people were engaged in a number of activities with staff, including attending activities outside of the home. We saw charts that showed people attended and carried out a number of activities individually and as a group.

Is the service well-led?

We saw that the manager and staff listened to people's needs, opinions and acted upon them. The service worked well with other agencies and services to make sure that people received support in a seamless way. This was demonstrated by the relationship the home had with community based health and other services.

Regular audits of the service were made by an external operations manager and feedback was provided to the manager through regular meetings.

Appropriate notifications to the Care Quality Commission were made.

We spoke to five people using the service, four staff members and the manager during this unannounced inspection visit.

People living at 31 King Edwards Grove told us "I'm happy here", "It's a good home", "I like it here" and "It's alright". The individuals spoken to said that they were treated with dignity and respect by care staff and were supported to take part in activities of their choosing.

We observed people using the service being supported to attend medical appointments, the cinema and to go for meals or drinks out locally on the day we visited.

Staff spoken to said that they were well supported by senior staff and received the training they needed to do their job. Each person spoken to felt able to raise any concerns about the service provided should they have any.

We spoke to four people who use the service, four staff members and the manager during this unannounced visit.

Comments from people who use the service included 'I like living here', 'I like it here', 'I find it ok' and 'it's alright'. One person told us 'the staff help to support me with my needs' and told us about the things they did each day including swimming, shopping, attending work placements and having aromatherapy massages. Another person told us that they were 'always busy during the week'.

The people we spoke to said the staff treated them with dignity and respect. Comments included 'they are nice', 'they help me' and 'they're alright' when we asked about the staff who worked with them.

People using the service said they generally enjoyed the food provided to them. Comments included 'I like the food', 'we are having spaghetti bolognese today - I like it' and 'ok, a bit samey'.