63 Lambrook Road is registered to provide accommodation and personal care for up to four people. At the time of our inspection four people with a learning disability were using the service.

The inspection was announced. The provider was given 48 hours' notice because we visited at the weekend and, we wanted to make sure people using the service, the registered manager and staff would be available to speak with us. The inspection was carried out by one adult social care inspector.

At our last inspection in December 2015 we found a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider had not always fully assessed the needs of people using the service and put plans in place to meet their needs. At this inspection we saw the provider had taken the action they had identified in their action plan. As a result improvements had been made and the service was no longer in breach of this regulation.

At the last inspection, the service was rated Requires Improvement.

As a result of this inspection we have rated the service Good.

Why the service is rated good:

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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 was designed and delivered around the individual needs of people, provided by caring staff who were well supported by the registered manager and, was continually seeking to improve. It was also very clear that people and staff viewed 63 Lambrook Road as people’s home. We did not find any breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection.

People were safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work with people to assess their suitability. Medicines were well managed and people received their medicines as prescribed.

The service was effective in meeting people’s needs. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. The physical environment was personalised and met people’s needs. The service complied with the requirements of the Mental Capacity Act 2005 (MCA).

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People’s views were actively sought and they were involved in making decisions about their care and support. Information was provided in ways that were easy to understand.

The service was responsive to people’s needs. People received person centred care and support. They were offered a range of activities both at the service and in the local community. People were encouraged to make their views known and the service responded by making changes.

The service was well led. The registered manager provided good leadership and management and was well supported by the provider. The vision and culture of the service was clearly communicated to and understood by staff. A comprehensive and sophisticated quality assurance system was in place. This meant the quality of service people received was monitored on a regular basis and where shortfalls were identified they were acted upon.

The inspection took place on 23 December 2015 and was unannounced. The service was last inspected in April 2013 and met with legal requirements at that time.

63 Lambrook Road is a service run by Milestones Trust. The service is registered to provide personal care for up to four people. People who live at the home have complex learning disabilities. At the time of our visit there were four 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.

People said they felt safe but we found potential risks to certain individual’s safety. One person had made accusations that another person at the home had been abusive to them. Although there had been no evidence to substantiate this, and both people had been assessed as having mental capacity the person who the allegations were made towards had not been told about them. This potentially compromised their rights and meant that the allegations had not been fully investigated.

One person had moved into the home seven days before our visit. The registered manager said that a senior manager had assessed the needs of the person before they moved to the home. However, there was no written assessment in the home that explained how to meet the person’s needs. This meant there was a risk that the person’s needs would not be met.

Peoples care plans had not been regularly reviewed and updated. This meant they did not show whether they were up to date and an accurate reflection of what people’s current needs were. This put people at risk of receiving unsafe care

There were quality assurance systems in place, but these had not identified shortfalls in the service. This meant that the overall quality of care was not being effectively monitored.

The provider carried out appropriate checks before staff commenced work to help ensure that only suitable staff worked at the home.

People told us the food was good and there was plenty of choice. Staff told us that an individual’s dietary needs were assessed and people were regularly consulted about their food preferences. People were able to see their GP, optician and other health care professionals for regular health checks and if they were not well.

At the time of our inspection everyone at the home was able to make decisions for themselves. However, the provider had systems in place so that the requirements of the Mental Capacity Act 2005 were implemented. This legislation protects people who lack capacity to make informed decisions in their lives. Deprivation of Liberty Safeguards (DoLS). DoLS are authorised to make sure that people in care homes, hospitals are looked after in a way that does not inappropriately restrict their freedom.

People were supported by staff who were kind and friendly in their manner. People were supported to make decisions about the care and support they received.

The service sought feedback on how the home was run. Yearly quality assurance questionnaires were sent to people, their relatives and staff to seek their views on how the service is run.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report

We inspected the service in response to concerns that we were made aware of prior to our visit. This information helped us decide what areas we chose to inspect. On the day of our inspection of 63 Lambrook Road there were four people living at the home.

This location was inspected by one Adult Social Care Inspector. We spoke with two people who use the service and the registered manager .The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found which describes what we observed, what the staff told us, and the records we looked at.

Is the service safe?

Risks to people who used the service were being managed safely. People's care records showed how possible risks to safety and wellbeing had been identified. The actions that were needed to reduce risks and to keep people safe had been clearly explained.

There were systems in place to ensure that the home was clean and infection control risks were minimised. People who lived at the home felt that it was always kept clean.

Is the service effective?

The two people who we spoke with told us they were happy and satisfied with how they were supported with their needs by the staff at the home. One person said “you must give the staff 100 marks out of 10”. Another comment we were told was “the staff are doing their jobs properly”.

Staff were being supervised in their work so that they provided effective care that met people’s needs. The staff undertook training and learning opportunities about mental health issues and a range of health and safety topics. They had also been on training to understand how to protect people from the risks of abuse.

Is the service caring?

The manager assisted people in a way that was caring and respectful in approach. One person told us "the staff are tremendous and the home has a happy atmosphere”. Another comment we were told was “the staff do their jobs properly and it’s nice here”.

Is the service responsive?

People told us they spoke with the staff regularly and were able to tell them about any concerns they had. One person told us “I’d go straight to the manager or the other manager who comes and see us”. Both people told us that the registered manager spent time with them regularly to find out how they were. They told us the manager was “very nice” and listened and responded to matters they raised with them.

Is the service well-led?

The registered manager demonstrated that they understood the needs of people who used the service. People told us that the manager was approachable. One person said, “I can speak to them anytime I like”.

People told us they were happy at the home and it was evident staff supported people's individuality. People told us they had opportunities to go out and to take part in activities they enjoyed. During our inspection two people were out all day and another person had chosen to go shopping. Staff understood and supported people's right to make their own decisions about how they lived their lives.

People received an individual service; staff knew people well and understood their care needs. Each person had a care plan and any risks to them had been assessed; however care plans had not always been updated when people's needs changed.

The home was clean throughout, homely, and people's rooms were personalised. The accommodation was suitable for people's needs and well maintained. There was suitable and sufficient equipment for people's needs.

Staff received regular training and supervision. The provider carried out regular checks on the quality of the service and operated an effective complaints system.

We spoke to two people who lived at the home. One person said, “I’m getting on really well, the staff are lovely”. Another person told us that, “If I want anything they do it for me”.

63 Lambrook Road is a bungalow in a residential street. There was a homely environment, the lounge felt comfortable and people had their belongings around them. There were framed photographs of people who lived there on the wall. People had access to the garden. One person had a pet cat and staff supported them to look after it.