The inspection took place on 9 January 2018 and was unannounced. The last comprehensive inspection took place in September 2015 when the registered provider was meeting the regulations. You can read the report from our last inspections, by selecting the 'all reports' link for ’88 Travis Gardens’ on our website at www.cqc.org.uk.

88 Travis Gardens is a care home for people living with a learning disability. The home is situated in Hexthorpe near Doncaster. The service can accommodate up to eight people. The service is provided by Rotherham, Doncaster and South Humber NHS Foundation Trust.

At the time of our inspection 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 were safe from the risk of harm and staff had the knowledge to recognise abuse. Risks associated with people’s care were identified and actions had been put in place to help reduce any hazards. The service had a safe recruitment procedure in place to ensure appropriate staff were employed. There were sufficient staff available to meet people’s needs in a timely manner. People’s medicines were managed in a safe way. People received their medicines as prescribed.

People were supported to eat and drink sufficient amounts to maintain a balanced diet. Snacks and drinks were available throughout the day. Staff were trained to carry out their role and felt they had the necessary skills to do their job. Healthcare professionals were accessed as required. The service was meeting the principles of the Mental Capacity Act 2005.

We observed staff interacting with people who used the service and found they treated people with kindness, respect and compassion. Staff were extremely caring and offered appropriate support to express their views and make decisions about their care. People’s privacy and dignity was maintained and their independence was promoted. Staff used a range of communication skills to ensure people were able to express their views and feel involved in their care.

People received personalised care which was based on their individual needs. A range of social activities and stimulation was provided. The registered provider had a complaints procedure which was displayed in the home.

Audits took place to ensure the service was working in line with the registered providers policies and procedures. A range of meetings took place to enable people to voice their opinions and be involved in the development of the service.

The inspection took place on 29 September 2015 and was unannounced. Our last inspection of this service took place in November 2013 when no breaches of legal requirements were identified.

88 Travis Gardens is a care home for people with a learning disability situated in Hexthorpe, Doncaster which is registered for eight people. The service is provided by Rotherham Doncaster and South Humber NHS Foundation Trust (the Trust). At the time of our inspection there were seven people living in the home.

The service had a registered manager in post at the time of our 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.

The staff we spoke with were aware of their role in safeguarding people from abuse and neglect. They told us they had received training in safeguarding both adults and children.

We saw risk assessments had been devised to help minimise and monitor risk, while encouraging people to be as independent as possible. Staff were very aware of the particular risks associated with each person’s individual needs and behaviour.

There were enough staff to keep people safe and to meet their needs. Most staff had worked in the team for a good length of time, so they knew people and their needs and preferences well.

People’s medicines were well managed for the most part. However, there were some staff signatures missing from people’s medication administration records (MARs). This had not been picked up by the monitoring and audit systems in place.

There were nice pictures of people, and interactive items on the walls, which were colourful, stylish and age appropriate in their appearance. We found all areas to be clean and free from offensive smells.

People’s needs had been identified, and from our observations, people’s needs were met by staff. There was a lot of emphasis on observations, especially for signs of any discomfort, as people could not always communicate their needs verbally. There was very positive interaction between people and the staff supporting them. Staff used touch, as well as words and tone to communicate with people, to good effect. Staff spoke to people with understanding, warmth and respect and gave people lots of opportunities to make choices. The staff we spoke with knew each person’s needs and preferences in great detail, and used this knowledge to provide tailored support to people.

We found the service to be meeting the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good knowledge of this.

People were supported to eat and drink sufficient to maintain a balanced diet. People were supported to maintain good health and have access to healthcare services. We looked at people’s records and found they had received support from healthcare professionals when required.

The staff were very caring and very creative in finding ways to support people to have choice, to indicate what they liked and did not like, and to try different experiences. We saw the results of various food tasting evenings that staff had organised and these results were presented in colourful, accessible ways to enhance people’s engagement and understanding.

People’s individual plans included information about who was important to them, such as their family and friends and we saw that people took part in lots of activities in the home and in the community.

The service had a complaints procedure, which was available in an ‘easy read’ version to help people to understand how to raise any concerns they might have.

There was evidence that people were consulted about the service provided. We saw that house meetings took place and the Trust had arranged for an advocate to help people to comment on their experience of the service.

The Trust regularly asked other stakeholders to fill in surveys about the quality of the service and people’s feedback was included in plans for future improvements. There had recently been a coffee morning at 88 Travis Gardens and people’s relatives had been invited, to give them an opportunity to share their views about the service more informally.

There were effective systems in place for monitoring the quality and safety of the service. Where improvements were needed, these were addressed and followed up to ensure continuous improvement.

The staff members we spoke with said they really liked working in the home and that it was an exceptionally good team to work in. The staff told us staff meetings took place each month and they were confident to discuss ideas and raise issues with managers at any time.

We used a number of different methods to help us understand the experiences of people who used the service. This was because the people who used the service had complex needs which meant they were not able to tell us their experiences.

We spoke with the relatives of two people who used the service.

They said their relatives' dignity, privacy and independence were respected.

They said they were satisfied with the care offered in the home.

They felt their relatives were safe from abuse.

They felt staff were well trained although one person said newer staff didn't seem as knowledgeable as those who had been there longer.

They said staff often asked them how they felt about the care, whilst one person said they had completed satisfaction surveys.

Due to their complex needs people who used the service were not able to share their views with us. We therefore spoke with the relative of a person who used the service. We also observed care being undertaken.

A person we spoke with told us that staff involved their relative in their care through talking with them. We found that where people had the capacity to do so they were asked for their consent. Where people did not have the capacity to consent the provider acted in accordance with legal requirements.

The relative of a person who used the service told us they were satisfied with the quality of the food that was provided. We saw evidence of people being given choices as to what they wished to eat. We found that a nutritious and balanced diet was made available. We also observed staff as they assisted people to eat their lunchtime meal.

The relative of a person who used the service told us they were happy with the standard of cleanliness of the home. We found there were systems in place to manage the prevention and control of infection.

The relative we spoke with told us there were now enough staff on duty. We found there were sufficient staff on duty to meet people’s needs.

A relative we spoke with told us they had no concerns about the service. However, they said they knew who to contact if they wished to make a complaint or raise a concern. We found there was an effective complaints procedure in place.