The inspection visit took place on 12 December 2016. We gave the provider 48 hours’ notice of our inspection because many of the people who use the service go out and we wanted them to know we would be available for them to speak with us.

Acorn Close is a residential care home providing accommodation for up to 23 people living with learning disabilities who require personal or nursing care. The home is purpose built with accommodation on two floors. There are three sections to Acorn Close, each with accommodation and communal lounges and kitchen / dining areas. People can access all communal areas. At the time of our inspection 21 people were using the service.

The service had a registered manager. 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 who used the service were safe. They were supported and cared for by staff that had been recruited under recruitment procedures that ensured only staff that were suited to work at the service were employed. Staff were trained in how to protect people from abuse and avoidable harm. They put their training into practice.

People’s care plans included risk assessments of activities associated with their personal care routines and activities people enjoyed. The risk assessments provided information for staff that enabled them to support people without restricting their independence.

The registered manager decided staffing levels by assessing the dependency levels of people using the service. This meant people were supported with their personal care needs. However, the registered manager told us that on a few occasions people had not been able to go out when they wanted because staff were not available to support them.

People were supported to receive the medicines by staff who were trained in medicines management. Medicines were stored safely and unused medicines were collected by the pharmacy that supplied them.

Care workers were supported through supervision and training. People who used the service told us told us they felt staff were well trained and competent.

The registered manager understood their responsibilities under the Mental Capacity Act (MCA) 2015. Staff had awareness of the MCA and understood they could provide care and support only if a person consented to it and if the proper safeguards were put in place to protect their rights. No person at Acorn Close was subject to Deprivation of Liberty Safeguards.

Staff understood the importance of people having health diets and eating and drinking. They supported people make meals. They also supported people to access health services when they needed them.

People were involved in decisions about their care and support. They received the information they needed about the service and about their care and support.

People contributed to the assessment of their needs and to reviews of their care plans. Their care plans were centred on their individual needs. People knew how to raise concerns if they felt they had to and they were confident they would be taken seriously by the provider.

The service had effective arrangements for monitoring the quality of the service. These included a range of audits carried out by the registered manager and regular visits by a regional manager who carried out checks. People’s views about their experience of the service were sought and acted upon.

We spoke with six people who lived at Acorn Close to ask for their views on the care that they received. We also spoke with four members of staff.

We found people were able to make informed decisions about their care and support. We found the provider had formal systems and procedures in place for assessing people’s mental capacity and obtaining, and acting in accordance with, the consent of people using the service.

We found people experienced care and support that met their needs and protected their rights. One person told us: “The staff and the meals are good. The staff look after me well." Care and support was delivered in a way that met people’s needs and ensured their safety and welfare.

We found there were effective systems in place to reduce the risk and spread of infection.

We found staff were supported in their work and were confident that they were able to provide the care required. Members of staff told us there was good support, supervision and training in place. When we asked one member of staff about working at Acorn Close they told us: “I like it. It’s a great job and I would recommend it to anyone. It makes you feel warm inside when you have helped the service users.”

People using the service we spoke with told us they were aware of the provider’s complaints policy and how to make a complaint.

People told us they felt safe and supported. They also told us that the provider encouraged them to become as independent as they could but remained supportive at all times. We found peoples wishes and experiences were recognised and respected at all times.

Staff told us how much they enjoyed working in the home and how the management supported them. They praised the training and professional development they received and found this supported them in their role.

The management regularly reviewed the quality of the service provided and used this information to improve the standard of care delivered to people who used the service.

Some of the people who lived at the home had limited communication; we were unable to ascertain what a number people felt about their experiences.

We spoke to staff who told us the medication system was “a lot better” explaining the three trolley system meant it was more convenient for people using the services as they didn’t have to wait.

Staff also told us about the training they had recently received. They also spoke about the support they received through meetings and personal supervision, and added they felt the staffing numbers were appropriate for the current group of people using the service.

Because some of the people who lived at the home had limited communication, we were unable to ascertain what a number of people felt about their experiences.

We used this visit to specifically look at how medicines were administered, how staff were recruited and what quality initiatives were used to ensure people were safe in the home.

Staff told us they were offered supervision and refresher training on a regular basis.

Because some of the people who live at Acorn Close have limited communication, we were unable to ascertain what a number people felt about their experiences. Of those who commented they said they ‘liked the home and it’s much better than my last place’. ‘The staff are friendly and they take me out’ with another indicating they were enabled to go out of the home alone, and return within a set time.