This inspection took place on 20 July 2017 and was unannounced. Our last inspection of the service was in December 2015 when we found people using the service may have been at risk of illness due to poor food hygiene practices and at risk of injury due to ineffective monitoring of health and safety issues. At this inspection we found the provider had made improvements and people were cared for safely.

82 Bear Road is a care home providing accommodation and personal care for up to five people with a learning disability. At the time of this inspection two people were using the service.

The service had a registered manager who also managed another service for the provider. 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 provider had policies and procedures to keep people safe. Staff had received training and ensured they supported people safely.

There were enough staff to support people in the ways they preferred and the provider carried out checks on new staff to make sure they were suitable to work with people using the service.

People’s health care needs were met in the service and they had access to the healthcare services they needed. People received the medicines they needed safely.

The provider carried out checks to make sure people using the service, staff and others were safe.

Staff told us they felt well supported by the provider and registered manager and that they had the training and information they needed to provide people with care and support.

The registered manager and support staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Although people were subject to some restrictions, there were no examples of people being deprived of their liberty unlawfully.

During our inspection there was a relaxed and calm atmosphere in the service and we saw many examples of positive interactions between people and staff. Staff were able to tell us about how each person communicated their choices and preferences, both verbally and non-verbally. The staff and the management team spoke respectfully about the people they cared for.

People were involved in planning and directing the care and support they received. The provider assessed and recorded people’s individual needs and preferences and gave support staff guidance on how to meet these. People’s support plans were focused on their individual needs, wishes and aspirations and were written in a person centred way.

The provider had appointed a qualified and experienced manager who was registered with the Care Quality Commission. The registered manager also managed another of the provider’s services.

The provider carried out audits and checks to monitor quality in the service and make improvements. They consulted people using the service, their relatives or representatives, staff and other professionals to get their views on the support people received.

This inspection took place on 17 December 2015 and was unannounced. At our last inspection on 30 April 2014 the service was meeting all legal requirements.

82 Bear Road is a care home that provides accommodation and personal care for up to 5 people with a learning disability. When we inspected, four men were using the service. At the time of the inspection, the service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 provider appointed a manager in October 2015 and they told us they were completing their registration with CQC.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People may have been at risk of illness due to poor food hygiene practices and at risk of injury due to ineffective monitoring of health and safety issues.

The provider had systems in place for safeguarding people using the service. This included a whistle blowing policy and procedures.

The provider carried out appropriate checks to make sure new staff were suitable to work with people using the service.

Staff told us they were well supported and had the training and information they needed to care for and support people.

The provider rook action to identify and manage possible risks to people using the service.

People had access to the health care services they needed and they received the medicines they needed in a safe way.

Staff treated people with kindness and patience. They gave people the support they needed promptly and efficiently.

People were able to choose where they spent their time.

Staff offered people choices about aspects of their daily lives.

People told us they received care and support that met their individual needs.

The provider and support staff had assessed and recorded people’s individual care and support needs.

There was an appropriate complaints procedure and the provider produced this in an accessible format.

People using the service told us they knew who the manager was and said they could talk with them at any time.

Staff described the provider’s training and information as “very good.” Staff also told us they enjoyed working for the organisation.

The manager and provider carried out a range of checks and audits to monitor the quality of the service.

We spoke with one person using the service, one staff member and the registered manager. At the time of the inspection there were 4 people using the service.

The inspection was carried out by an inspector during one day. This helped answer our five questions;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Support plans had details of people's needs and how these were to be met. These plans were regularly reviewed with the person using the service. Any risks related to care and support being provided were assessed and reviewed regularly to ensure people's individual needs were being met safely.

The medicines prescribed to people using the service were stored in a secure and appropriate manner. We saw that the Medicines Administration Records (MAR) charts were completed appropriately and information was clearly recorded.

The service had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Where DoLS decisions needed to be made the appropriate procedure was followed. The provider also maintained relevant records and arranged for regular reviews of DoLS decisions to take place. We saw copies of records relating to DoLS which were details and up to date.We found the service was meeting the requirements of the Deprivation of Liberty Safeguards. People’s human rights were therefore properly recognised, respected and promoted.

Is the service effective?

People received effective support from staff that were trained and supported by the manager. Staff told us that they received specific training to meet the support needs of an individual in addition to a range of mandatory courses.

We saw people were involved in the writing of their support plan to ensure that it represented their needs and wishes. Information was provided in a suitable format to meet the individual needs of the people using the service to ensure people could access and read their care plan to understand the care that had been planned for them.

Is the service caring?

People were supported by kind, attentive staff who treated them with respect and dignity. We saw they were supportive and encouraged people to be actively involved in their daily care and support. The person we spoke with said they felt safe and were treated with respect. A person we spoke with said The person we spoke with said "The staff are really great and help me when I need help" and "I really like my room, I have my things in it. My keyworker is helping me tidy it up and sort things out". We observed the keyworker encouraging and supporting the person to tidy their room.

Is the service responsive?

A range of activities were available for people based upon their interests and needs. People had choices about the activities they wanted to participate in and were able to undertake other activities that were not part of the scheduled programme.

The service had a complaints policy and procedure. We saw a copy of the complaints procedure was displayed in the dining room in an easy read format. There was also an easy read version of the complaints policy and procedure included in the service information pack provided to people who moved into the home. A person we spoke with confirmed they knew how to make a complaint. We saw that where complaints had been received these had subsequently been responded to appropriately.

Is the service well led?

The service had a quality assurance system in place. Records seen by us showed that any identified issues relating to how the care and support was provided were addressed promptly. As a result the quality of the service was continuingly improving.

An annual satisfaction survey was completed by the provider to gain the views of people using the service, their relatives and staff. The results were analysed and where areas for improvement were identified appropriate action was taken to make the necessary improvements. This ensured that the service took account of the people's, their relatives' and staff's views in improving the service. .

Regular audits of the care plans and risk assessments were carried out. Each identified action target date for completion and the actual date the action was completed. This helped to ensure that people received a good quality service at all times.

We spoke with two people who use the service, three members of staff and looked at the care records of two people. People told us “I like living here the staff are good, we get help to maintain our independence." Other comments included "I have a job, a girlfriend and I see my social worker and doctors."

We looked at how people were involved in their care and found that people had detailed assessments of their needs including information about their likes and dislikes. The service had also carried out assessments of people's abilities so they were able to understand where people required support to be more independent.

People were supported to attend medical appointments and to receive annual health checks such as dentists and opticians. Care records we looked at were reviewed monthly and where there were changes in people's needs care plans had been updated to reflect these.

People were protected from the risks of abuse. People who use the service told us they felt safe and knew what to do if they had any concerns about their safety and welfare. Staff were able to tell us about abuse and how to report incidents of abuse. This meant people were protected from harm.

We looked at staffing levels and found people were cared for by sufficient staff who had sufficient skills to care for people using the service.

People expressed their views and were involved in making decisions about their care and treatment. Two of the five people we asked told us they were happy living in the home. We found that people were comfortable with staff and we observed positive interactions and engagements between them. We saw staff encouraging people to make their own lunch and people were able to choose what they wanted to eat.

People were supported in promoting their independence and community involvement. One person confirmed they were supported to make decisions about their lives and could choose how they spent their free time. They showed us their activity plan for the week and described how they enjoyed going out and meeting friends.

A person who assisted us to look at his care records told us they had seen their support plans and understood why information was written about them. They said they knew they could meet with staff to talk about the support they received in the home. Two people told us they liked the staff team. One person said “I feel able to talk to the staff and they are always here to talk to”.