This inspection took place on the 7 November 2016 and was unannounced. Agnes House is registered to provide accommodation with personal care to five people with a learning disability, and autism. People supported lived in the residential home or in the bungalow situated next door. People were supported by staff at all times. At the time of our inspection three people were using the service.

There was a manager in post and he was present during 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 and associated Regulations about how the service is run.

At our last inspection in August 2015 we found that the provider was meeting the regulations we checked of the Health and Social Care Act 2008. However some improvements were needed which we found were in the process of being made at this inspection.

A person told us they felt safe and we observed people were supported safely by the staff members. Staff were aware of their responsibilities to report any concerns about people’s safety or risk of harm, and they confirmed they had received training in relation to safeguarding people from abuse. People were supported by sufficient staff in accordance with the requirements of the funding authority. People received their medicines safely. We identified some areas where improvements could be made to the medicine procedures in place.

We saw that improvements were being made to provide refresher training to staff. However this was on-going and we found that training for several staff had expired based on the provider’s renewal timescales. This included training in relation to managing people’s behaviour. This meant staff were supporting people without having received refresher training in a timely manner to ensure their skills and knowledge were updated.

Staff sought people’s consent before providing support. Where people were unable to consent to their care because they did not have the mental capacity to do this, decisions were made in their best interests. Staff knew which people had their liberty restricted to keep them safe, but they were unsure about any conditions attached to the authorisations in place.

People were treated with kindness, and respect and staff promoted people’s independence and right to privacy. People were supported to maintain good health; we saw that staff alerted health care professionals if they had any concerns about their health or well-being. People were supported to eat and drink in accordance with their preferences and dietary requirements.

There was a complaints policy in place and staff were aware of the signs to look out for which may indicate people where unhappy. Records showed how complaints had been responded to and the actions taken. We also saw that people had family or representatives to advocate for them.

People, staff and professionals told us the service was managed well and in people’s best interests. Systems were in place to gain feedback from these people to enable the service to make any required improvements. Audits were undertaken regularly to monitor the quality of the service provided.

The home consisted of two bungalows. There were four people living here on the day we inspected. We met with three people, the manager and three members of staff. We looked at the records for four people.

Some people were unable to tell us what it was like to live here. We saw care staff spending time with them and giving them individual attention. People were treated with respect and dignity and were happy and at ease with the staff.

We saw that people had personalised care plans which were regularly reviewed and updated. These included advice form health care professionals involved in their care and treatment. This meant that staff had all the information they needed to support people appropriately and safely in the way they preferred.

One person we spoke with told us that the staff had helped them to become more independent. They said, “I make my own drinks and meals when I want. I go to college to learn how to cook.”

We saw that people took part in a variety of activities such as swimming, going out to the local disco or to the shops. This meant that people were supported to lead interesting lives.

Systems were in place to ensure that people were safeguarded from harm.

Staff were trained to give them the skills and knowledge to know how to meet people’s needs and ensure their wellbeing.

People’s views were sought and were listened to. There were systems in place to monitor how the home was run to ensure people received a quality service.

The inspection took place on the 12 and 13 August 2015 and was unannounced.

Agnes House is registered to provide accommodation and support to five people with learning disability. They lived in a supported living complex and in a residential service were people were unable to live independently. Three people were using the service at the time of our inspection.

There was a registered manager in post responsible for the home and the services delivered within the community. 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 systems and processes to protect people from the risk of avoidable harm.

Staff understood the different types of abuse and knew what action they would take if they thought a person was at risk of harm.

Concerns were raised about staffing ratios where people needed more than one member of staff to support them which may leave other people unsupported and therefore at risk.

People received their medicines as prescribed.

We found that staff had not all completed training sufficiently to ensure they had the skills and knowledge to support people appropriately.

People’s consent was seen being sought before staff support was given.

We found that where people lacked mental capacity and their human rights were being restricted that the provider followed the Mental Capacity Act 2005 (MCA) legislation and ensured that the appropriate approval process was in place.

People were able to make decisions on the food and drink they had. Where concerns were identified with people’s nutrition or diet the appropriate advice was sought and action was taken.

Staff spoke to people in a manner that was compassionate and showed they cared.

People’s privacy and dignity was respected by staff.

People’s preferences, likes and dislikes were being met how they wanted. We saw that people took part in a range of activities.

The provider had a complaints process in place so people and relatives could raise concerns they had.

People’s healthcare needs were monitored regularly by health care professionals to ensure where they needed intervention this was done in a timely manner.

We saw evidence that a questionnaire was being used to gather the views of people, relatives and staff on the service provided.