This was an unannounced inspection, which meant the staff and the provider did not know we would be visiting. The inspection was carried out by one inspector on the 21 and 29 August 2018.

The last inspection was completed in July 2017 where the service was rated as Requires Improvement. This was because people’s medicines were not always being managed safely.

Staff were not taking part in a fire drill in line with Trust’s policy. Hot water, food temperatures were not being checked at the appropriate intervals in accordance with the provider’s policies and procedures. Whilst these areas were addressed shortly after the inspection with the registered manager taking appropriate action the provider’s quality assurance checks had not identified these shortfalls. At this inspection, we found sufficient improvements had been made and the legal requirements had been met.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager in post. They had worked in the home for five years. 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 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 was the vision of the Trust, the registered manager and staff working at 46 Bath Road. People were very much part of their local community and care was tailored to the person.

46 Bath Road provides accommodation, personal care and support for up to six people. People who live at the home have a learning disability. There were six people living at 46 Bath Road, although one person was in hospital at the time of the inspection. The home is situated in Longwell Green close to shops, links with public transport and other amenities. There was a minibus available to enable people to go further afield.

Improvements had been made since the last inspection which included a review of documentation. This work was ongoing with care plans being updated with support from a representative from the Trust. New daily records had been introduced which captured what was happening for each person on a daily basis. Records were maintained of hot water and fridge temperatures and staff had taken part in regular fire drills. This ensured any risks were minimised and kept people safe. The service has improved to good.

People were safe. There were sufficient numbers of staff to meet people’s needs. However, due to staff vacancies there was a lot of bank and agency staff working in the home. This meant people could not always go out if staff were not familiar to the service and knew the people well. Risk assessments were carried out to enable people to receive care with minimum risk to themselves or others. People received their medicines safely.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management, checks on the equipment, fire systems and safe recruitment processes.

People received effective care because staff had the skills and knowledge required to effectively support them. People's healthcare needs were monitored by the staff. Other health and social care professionals were involved in the care and supp

This was an unannounced inspection, which meant the staff and the provider did not know we would be visiting. The inspection was carried out by one inspector on the 26 and 27 July 2017.

The last inspection was completed 12 May 2015 where the service was rated as Good.

46 Bath Road provides accommodation, personal care and support for up to six people. People who live at the home have a learning disability. There were six people living at 46 Bath Road, although one person had been admitted to hospital four days prior our visit.

The home is situated in Longwell Green close to shops, links with public transport and other amenities. There was a minibus available to enable people to go further afield.

46 Bath Road is a dormer bungalow with bedrooms situated on the ground floor and an office on the first floor. The building and the garden was suitable for people with physical disabilities. Specialist equipment was in place to assist with personal care including bathing and moving and handling equipment. Each person had their own bedroom which they had personalised.

There was a registered manager in post. They had worked in the home for four years. 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 service has been rated as requires improvement. This was because people’s medicines were not always being managed safely.

Staff were not taking part in a fire drill in line with Trust’s policy. Hot water, food temperatures were not being checked at the appropriate intervals in accordance with the provider’s policies and procedures. These areas were addressed shortly after the inspection with the registered manager taking appropriate action. However, the provider’s quality assurance checks had not identified these shortfalls.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse. Staff had been trained to follow these procedures. Systems were in place to ensure people were safe, which included risk management and routine checks on the environment. People received their medicines safely. The registered manager told us about the safe recruitment processes. Recruitment records were held at the main office of the Trust. An inspection will be organised to the Trust’s main office to review recruitment information in the near future.

There were sufficient, skilled and experienced staff working at 46 Bath Road. There was always familiar staff on duty. Regular and familiar bank staff were used to cover any shortfalls in staffing.

Staff were caring and supportive and demonstrated a good understanding of their roles in supporting people. Staff received training and support relevant to their roles. Systems were in place to ensure open communication, which included team meetings and daily handovers. A handover is where important information is shared between the staff during shift changeovers. This ensured important information was shared between staff enabling them to provide care that was effective and consistent.

People were treated with kindness and compassion by staff. The atmosphere was relaxed and we saw that staff knew people well. People appeared relaxed around staff. People’s views were sought during care reviews, resident meetings and annual surveys. Complaints were responded to and, learnt from to improve the service provided.

People were involved in a variety of planned activities in the home and the local community. These were organised taking into consideration people’s interests and hobbies. Good links had been built with the local church where some people attended regular services and coffee mornings.

We found there were two breaches of the Health and Social Ca

This was an unannounced inspection, which meant the staff and the provider did not know we would be visiting. The inspection was carried out by one inspector on the 12 May 2015.

46 Bath Road provides accommodation, personal care and support for up to 6 people. People who live at the home have a learning disability.

The home is situated in Longwell Green close to shops, links with public transport and other amenities. There was a minibus available to enable people to go further afield.

46 Bath Road is a dormer bungalow with bedrooms situated on the ground floor and an office on the first floor. The building and the garden was suitable for people with physical disabilities. Specialist equipment was in place to assist with personal care including bathing and moving and handling equipment. Each person had their own bedroom which they had personalised.

There was a registered manager in post. They had worked in the home for two years. 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 protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse. Staff had been trained to follow these procedures. Systems were in place to ensure people were safe, which included risk management and routine checks on the environment. People received their medicines safely. The registered manager told us about the safe recruitment processes. Recruitment records were held at the main office of the Trust. An inspection will be organised to the Trust’s main office to review recruitment information in the near future.

There were some staff vacancies which were covered by the Trust’s bank and agency staff. There was always familiar staff on duty with the use of regular bank staff. Staff told us this had impacted on staff morale as some agency staff did not complete household tasks to the same standards as the regular staff. The registered manager has put in additional guidance for these staff to remind them of their responsibilities.

Staff were caring and supportive and demonstrated a good understanding of their roles in supporting people. Staff received training and support relevant to their roles. Systems were in place to ensure open communication which included team meetings and daily handovers. A handover is where important information is shared between the staff during shift changeovers. This ensured important information was shared between staff enabling them to provide care that was effective and consistent.

People were involved in a variety of planned activities in the home and the local community. These were organised taking into consideration people’s interests and hobbies. Good links had been built with the local church where some people attended regular services and coffee mornings.

People’s views were sought through care reviews, house meetings and surveys and acted upon. Systems were in place to ensure complaints were responded to.

People were provided with a safe, effective, caring and responsive service that was well led. The organisation’s values and philosophy were clearly explained to staff and there was a positive culture where people felt included and their views were sought. Systems were in place for monitoring the quality of the service to drive improvements.

When we inspected the home on 18 October 2013 we found that people’s views and experiences were not taken into account in the way the service was provided and delivered in relation to their care. There was inadequate access to the community for people living at the home as there were insufficient staff to support people to go out in the afternoon and evening.

When we returned to the home on 23 January 2014 we found that improvements had been made. There were additional staff available in the afternoons and people confirmed they were able to go out if they wanted to and had been supported to take part in activities outside the home.

People living at the home had good relationships with the staff and it was evident that they knew each other well. We saw that staff spoke to people with kindness and warmth. Visitors to the home told us that the staff attitude to people was ‘excellent’ and the care provided was of a high standard.

Staff knew people’s preferences but we were concerned about people’s lack of access to the community which was attributed to low staffing numbers.

People’s care was assessed and planned and had been regularly reviewed and updated as appropriate. Where needed, health professionals had been involved in people’s care and their guidance followed.

Medicines were stored and administered safely and the home operated a rigorous system of checks in this area.

Staff received training and supervision regularly and were supported to undergo further training in areas they were interested in.

The home operated a quality assurance system which identified risks and actions to be taken.

At the time of our inspection there were six people living at 46 Bath Road and comments we received were positive. Some people were able to tell us of their experience and told us they were happy living in the home and had lived there for some time.

For others who were unable to tell us verbally of their experience, we observed staff interactions to gain a view on the service they received. People appeared relaxed in their own environment and around the staff members.

Comments included; “I am happy here, I cannot go out alone as the road is very busy. I can go in the garden though”, “we go to the pantomime, and we are seeing Oliver”.

One person told us “not all of us can speak here so me and X speak for everyone else”. Another person told us about their recent experience of going at for lunch at a local hostelry. They told us they enjoyed it very much.

People told us if they were unhappy they knew how to make a complaint. This person told us pictorial information was available to help them. Three people also told us how they were involved in their care planning.

We spoke with three members of staff, who told us they felt they delivered a high standard of care to people and were well supported and trained by the organisation.

People who spoke with us were able to discuss their life at the home and what they enjoyed about living there.

People said that they appreciate having their own rooms, and being able to choose how they are decorated. One person told us "I like spending time in my room”.

People said that the home provided some activities for them to participate in each week. One person said "I like reading my magazines".

The manager told us " we have just started a pilot scheme of taking people out the mornings and the afternoons. Some staff members feel that they need longer than an hour to be out as it restricts where they can take people. We are reviewing the length of time people are out on an activity".

People told us that they liked living at the home. One person said "It's my home. I have lived here for years and I will live here for many years yet".

Two people who use the service told us that they felt safe at the home and that staff are "lovely".