About the service: Newlands Cottages provides personal care and support for up to four male adults with learning disabilities or autism. The accommodation is divided into two cottages. Three people live in one cottage and another person lives in the other. At the time of our inspection four people were using the service.

At the time of the provider’s registration, the care service had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. However, we found care was provided in line with these values which include choice, promotion of independence and inclusion. People living with learning disabilities and autism at Newlands cottages were supported to live as ordinary a life as any citizen.

People’s experience of using this service: Since our last inspection in January 2018, the provider had made the required improvements to address the previous two breaches of regulations. Risks to people’s health and wellbeing had been more fully assessed and staff had the information they needed to support people and keep them safe. Arrangements for staff training had improved to ensure that people received appropriate care and support. In addition, a registered manager had been recruited and people, relatives and staff spoke positively about how management of the service had improved.

People received support from staff who were trained and supported to carry out their role. There were enough qualified and skilled staff at the service and staff worked flexibly to meet people’s needs. This meant people received their care and support when they needed it. The provider followed an appropriate recruitment process to employ suitable staff.

Newlands Cottages was kept clean and health and safety checks were carried out to make sure people lived in a safe environment. Although there had been home improvements, parts of the premises remained in need of redecoration or repair. The provider had a refurbishment plan to improve these areas and people were involved in deciding on the changes, for example, choosing a new kitchen and paint colours for redecoration.

Staff knew how to recognise and report any concerns they had about people’s care and welfare and how to protect them from abuse. Medicines were managed safely and people had their medicines at the times they needed them.

People were supported to be healthy and their healthcare needs were monitored to help keep them safe and well. The staff worked with and referred people to other health care service to support people’s wellbeing. Where people needed support with their emotional needs, relevant health and social care professionals were involved.

People were involved in planning and preparing their meals according to their choices. They took part in activities they were interested in and staff encouraged people to try new ones.

Staff promoted and respected people's diversity and lifestyle choices. Care plans were personalised and provided staff with guidance about how to support people and respect their wishes. Information was made available in accessible formats to help people understand the care and support agreed.

People were encouraged to remain as independent as possible and develop their skills. Support plans recorded what was important to the person and were current. Where people's needs changed, the provider responded and reviewed the care provided.

People were supported to have choice in their daily lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff showed understanding, patience and people were treated with respect and dignity.

People were involved in the running of the service and were consulted on key issues that may affect them. The provider used a range of audits and checks to monitor and assess the quality and safety of the service. Where issues were identified, action was taken to improve the care

8 -10 Newlands Cottages is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. 8 -10 Newlands Cottages provides personal care and support for up to four male adults with Autistic Spectrum Disorders and associated behaviours. The accommodation is divided into two cottages. Three people live in one cottage and another person lives in the other. At the time of the inspection the home was providing care and support to four people.

The home did not have 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. The previous registered manager left employment in June 2016. A number of different managers had run the home during that time. The current manager had managed the home for one month prior to this inspection. At the time of this inspection they were in the process of applying to the CQC to become the registered manager for the home.

This inspection was carried out on 18 January 2018. At our last inspection of this service on 13 of October 2015 the service was rated Good. At this inspection we found two breaches of our regulations because action had not been taken to support a person where risks to them had been identified and not all staff had received training relevant to the needs of the people living at the home.

We found that people had not experienced consistent support because there had been a high turnover of staff at the home and a frequent change of managers. The manager and regional manager told us they were trying to establish a staff team to address this. The manager and two staff had recently started working at the home and recruitment was underway to employ further staff. People using the service were actively involved in the recruitment of staff.

The provider had safeguarding adult’s procedures in place and staff had a clear understanding of these procedures. There was enough staff on duty to meet people’s needs. Appropriate recruitment checks took place before staff started work. People received their medicines as prescribed by health care professionals.

The manager demonstrated a clear understanding of the Mental Capacity Act 2005 and the home acted according to this legislation. Peoples care files included assessments relating to their dietary needs and preferences and people said they enjoyed the food at the home. People had access to a GP and other healthcare professionals when they needed them.

Most people said staff were kind and caring; however one person felt that staff were sometimes disrespectful towards them. The manager took immediate action to address this issue. People had care plans and risk assessments that provided guidance for staff on how to support people with their needs.

People's privacy and dignity was respected. People said they had been consulted about their care and support needs. People received appropriate end of life care and support when required. Peoples care plans included a section that referred to diverse needs such as their religion, culture, sexuality and lifestyles. People were supported by staff to partake in activities that met their needs. The home had a complaints procedure in place and people said they were confident their complaints would be investigated and action taken if necessary.

The manager and area manager had identified a number of areas where improvement was required and were taking steps to address these areas. Staff said they enjoyed working at the home and they received good support from the manager and area manager.

On the day of our visit we spoke with three of the four people living at the home who told us what living there was like and about how they spent their time. One person said ‘it’s lovely; warm and friendly; homely. I can choose what I do here.’ Another, who liked organising things and told us about the activities planned for Christmas. All three said that they lived liked living there and that they could choose how they spent their time.

People told us about their goals and what staff were doing to support them in achieving these. There was a family like atmosphere in the house.

From the information in the files we looked at and from what people told us we judged that people were treated with respect and were involved with decisions about their care. People were supported to be as independent as possible and care was provided in a way which met people’s individual needs.

We saw that people were involved in choosing and preparing meals and were provided with good quality nutritious food. Staff encouraged people to eat healthily.

We saw that people were cared for by suitably qualified staff of good character.

The home operated a concerns and complaints policy which ensured that issues people were concerned about were taken seriously and formal complaints dealt with appropriately.

We spoke with all three people who lived at the care home. People told us they were happy with the care they received and that staff supported them to do as much for themselves as they could. People also told us they felt safe living at Newlands Cottage, and got on reasonably well with their fellow house-mates and the staff that worked there. During our inspection we saw staff treated the people who use the service with respect and kindness. One person said “I am very happy living here, the staff are nice”, and another person we told us “I am pleased I came here, it’s been a brilliant move for me”.

We also found that people received effective and safe care and support from suitably trained and experienced staff that were familiar with people’s individual needs and preferences. Furthermore, the provider had effective systems in place to routinely assess and monitor the quality of service that people received.

This service provides support to people with learning disabilities, mental health needs and behaviours which may challenge the services they require. The accommodation is divided into two cottages. There is a self-contained one bedroom flat with a lounge, kitchen, a WC and showering facilities, and own enclosed garden. The second cottage has three single occupancy bedrooms, kitchen/dining area, two lounges, WC's, a bathroom, office, staff sleep-in room and garden. The laundry facilities are shared. There were four men using the service at the time of our inspection.

This inspection took place on 13 and 15 October 2015 and was unannounced. At our previous inspection in December 2013, we found the provider was meeting the regulations we inspected.

A registered manager was in post at the time of the 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.

People lived in a safe and comfortable environment although some parts of the premises were in need of redecoration or repair. Renovation work was in process at the time of this inspection and there was an ongoing programme of refurbishment to improve areas of the home.

Staff understood how to protect people from harm and provide safe care. Risks to people’s health and safety were well managed and the service encouraged people to take positive risks. Medicines were managed safely and people had their medicines at the times they needed them.

There was enough skilled and experienced staff to meet people’s needs. Additional staff were provided for one to one support and to enable people to regularly access activities outside of the home. The provider followed an appropriate recruitment process which helped ensure that people were protected from unsuitable staff. Staff received a structured induction and essential training at the beginning of their employment. This was followed by ongoing refresher training to update and develop their knowledge and skills. Staff also undertook training specific to the needs of people they supported. This included managing behaviour that might challenge others.

Care and support was individual and based on the assessed needs of each person. People were involved in reviewing and providing feedback on the care and support they received. The care plan records included important information on how each person liked to live their life. Staff knew people well and were able to explain what mattered most to individuals.

People’s rights were protected because the provider acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). This legislation is used to protect people who might not be able to make informed decisions on their own. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them. Staff understood people’s rights to make choices about their care and support and their responsibilities where people lacked capacity to consent or make decisions.

People took part in activities that interested them and were supported to maintain relationships with family and friends who were important to them. Individuals were encouraged to build and develop their independent living skills both in and outside the service.

People’s health needs were monitored and they had access to health care services when they needed them. Any advice from external professionals was included in their care and acted on accordingly. People were supported to keep healthy and their nutritional needs and preferences were met.

There was an open and transparent culture in the service. Staff experienced effective leadership and direction from the registered manager. They felt fully supported to undertake their roles and were given regular training, supervision and development opportunities. Staff were aware of the values of the service and understood their roles and responsibilities. Meetings were held regularly and were used to discuss any areas of concern, any changes to policies and to get feedback from staff.

Systems were in place that encouraged feedback from people who used the service, relatives, and staff and this was used to improve their experience at the service. The provider carried out consistent audits to monitor the quality and health and safety of the service. Where improvements were needed or lessons learnt, action was taken.