This inspection took place on 6 December and 9 December 2017 and was unannounced.

The service is registered to provide residential care for up to six people with learning disability or mental health conditions. At the time of our inspection six people were using the service. 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. This means people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post. 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 felt safe at the home and with the staff who supported them. People were protected from abuse and avoidable harm. This was because staff had been on training and had the knowledge and awareness they required to do their job effectively and help to keep people safe.

People’s medicines were managed safely within the service and where people wanted to they were supported to be responsible for their own medicines.

Risk assessments and care plans helped promote the safety of people when they were out in the community and within the home.

People were very well supported to exercise choice and control of their lives. The staff team supported them in the least restrictive way they could. There were policies and systems in use that helped the staff to do this. People were supported with their health needs and staff monitored their wellbeing.

People were supported to with enough to eat and drink to maintain good health. Menus were planned based on each person’s likes and dislikes.

The requirements of the Mental Capacity Act were met for people at the home. People were supported to have as much choice and control of their lives and staff supported them in the least restrictive way possible. There were policies and systems in the home that supported the staff and people who lived there.

People were encouraged and supported by the staff to maintain their independence. The staff team respected people’s privacy and dignity. People were cared for by a staff team that knew and understood their individual needs extremely well. People felt very relaxed about talking with staff members and raising any concerns or worries with them.

The service was very flexible and responded creatively to people’s individual needs or wishes. Activities were highly individualised to fully reflect people’s interests, wishes and choices. Care plans contained personalised information to help staff provide high quality care and support.

People received care based on their needs and preferences. They were supported to be fully involved in all aspects of their care and were supported to lead their lives in the way they chose. . People’s views and opinions were proactively sought and listened to. Feedback from people receiving support was taken constructively to drive improvements.

The home was very well run and people, staff and professionals all spoke extremely highly of the registered manager. The registered manager was extremely inclusive in the way that they ran the home. The registered manager was very positive in their approach about the care being provided for people and this was evident throughout our visit. The registered manager was a very strong role model for staff. They showed they had a very caring and generous approach with their team and the people who lived at the home. For example, they always made plenty of time for people whenever they wanted to speak with them. The staff we met also told us that the registered manager always gave them a great deal

The inspection took place on 07 August 2015 and was unannounced. The service was last inspected in April 2013 and met with legal requirements at that time.

50 Vassal Road is a service run by Milestones Trust. The home is registered to provide personal care for a maximum of six people. People who live at the home have complex learning disabilities and require specialised support and assistance. At the time of our visit there were six people living there.

There was a registered manager for 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 were kind and caring in their approach and people and staff interacted in a positive way.

The atmosphere in the home was warm, friendly and supportive and staff spent a lot of time

talking and being sociable with people.

People were well supported to eat and drink enough to be healthy. People were encouraged to be independent and to help prepare their meals.

Care and support was planned with people’s involvement. People’s needs were clearly identified in their care records as well as what assistance was required to meet them. Staff knew how to support people in the ways that were explained in their care records. People were encouraged to make choices about how they were supported in their daily lives.

People were supported by a well-established, committed and properly trained team. The registered manager was providing supportive and effective leadership of the home. Professionals who worked with the home had very positive opinions about the service. One healthcare professional told us that they had recommended that student nurses should work there because the home was so well run and provided excellent care.

There was a system in place to ensure that the requirements of the Mental Capacity Act 2005 were implemented if needed. This legislation protects people who lack capacity to make informed decisions about their lives. Deprivation of Liberty Safeguards (DoLS) applications are authorised to make sure that people at the home would be supported in a way that did not inappropriately restrict their freedom.

Staff felt very supported by the registered manager and they were being properly supervised and developed in their work. Staff were encouraged to take part in a range of different training in subjects relevant to the needs of people who lived at the home. People told us the registered manager was always available if they needed to see them.

Complaints were investigated and responded to properly. People were supported to make their views known and they had up to date information to help them to make a complaint.

The registered manager had an innovative approach to running the service. This benefited the people who lived there. For example, they had built up links with a local university and students ran a range of activities and arts and crafts groups that people attended.

The provider had ensured that regular checks on the quality of care and service were carried out. When needed, actions were carried out to improve the service.

People living at the home could not always communicate verbally. We observed staff interaction with people in the home during our inspection and we spoke with two people's relatives. Relatives spoke highly of the home they told us "I'm just full of praise for them, I think they do a fantastic job" and "We're more than happy, our relative loves it there".

Staff always sought people's consent before doing anything and followed legal procedures when making decisions in people's best interests. People were actively supported by staff who explained things carefully when seeking consent. People's right to refuse was respected.

People had individualised care plans in easy read format. People's likes and dislikes were central to these plans and staff provided support in the ways people chose.

The premises and equipment were appropriate and suitably maintained. The provider had now implemented an effective quality assurance process.

Records at the home were now up to date and contained relevant information needed to ensure people's care needs were met.

People who lived at the home received personalised support which met their needs and promoted their independence. There was an established staff team who knew people well and treated them with warmth and respect. Staff told us they loved working at the home and one member of staff told us they were very lucky as they looked forward to coming to work.

We saw that people were relaxed in the home and were supported to be as independent as possible. Everybody living at the home had an individual program me of activities and three people were supported to work part time.

Staff were thoughtful about people’s individual needs and had ensured they catered for these as much as possible. For one person who had frequent falls they had come up with an innovative solution to protect them from injury whilst maintaining their dignity.

Staff received up to date training and were well supported through both formal and informal supervision.

Care records, however, were only partially completed and risk assessments were not accessible to all staff. The home had lost all records in a fire two years ago but had still not developed new care plans. The provider’s regular quality assurance visits by the area manager had identified this issue but no action plan had been developed to address this issue. Due to problems with the home’s computer system monthly audits by the manager had not saved correctly and the home could not evidence these had taken place.