The inspection took place on 16 March 2018 and was announced.

Alma Grove 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.

The provider is registered to accommodate up to four people living with learning disabilities. People were supported with personal care needs. At the time of our inspection four people were living at the service. Each person had needs relating to personal care and daily living.

Alma Grove is managed by The Brandon Trust, a national organisation that provides social and health care services.

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.

At the last inspection on 25 November 2015 we rated the service Good.

At this inspection on 16 March 2018 we found the service remained Good.

People received their medicines as prescribed and had regular access to healthcare professionals when needed. Medicines were ordered, stored and administered safely and in line with national guidance.

People were cared for by dedicated, attentive and enthusiastic staff. The care team were well trained and the registered manager and team leader ensured each individual remained up to date with the latest care standards. We saw during our observations people were happy and had access to recreation and activities important to them.

We were unable to speak to more than one person due to the nature of people's health conditions. However, we saw evidence people were happy, well cared for and had involvement from their relatives when they wanted it.

Where people's needs changed staff demonstrated a proactive and comprehensive response to enable them to adapt the service and their care strategies. This included working with the multidisciplinary healthcare team to coordinate holistic, individualised care.

Environment and fire safety management was comprehensive and the building was kept safe through regular health and safety inspections. However timely action was not always taken in response to fire risk assessment recommendations. Not all areas of the home were consistently clean and free from dirt and dust. The registered manager said they would immediately implement improvements to address this.

The provider understood their responsibilities under the Mental Capacity Act (2005) and ensured they had consent before providing care. Where people's mental health needs increased, the care team had involved appropriate specialists and undertaken extensive additional training to make sure they could continue to deliver a high standard of care.

The service was well led. There were effective systems in place for governance and quality assurance, including information sharing and learning opportunities between managers and a rolling programme of audits. Staff told us they were well supported and had access to on-going, specialist training and development opportunities.

This inspection took place on 25 November 2015 and was unannounced. The service is registered to provide accommodation for up to three people who are living with a learning disability. At the time of the inspection there were three people using the service.

At the last inspection on 21 August 2013, the service was meeting the regulations we inspected.

The service has 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.

Staff had processes in place to guide them to safeguard and protect people from abuse. Staff demonstrated their awareness of the signs of abuse and the actions they would take to escalate an allegation of abuse. People’s risk assessments identified their needs and the management of them by staff. Risk management plans in place gave guidance to staff to reduce their recurrence, while encouraging safe, positive risk taking for people.

There were sufficient numbers of staff to meet people’s care needs. The level of staff was flexible to meet the needs of people throughout the day.

Medicines were managed safely for people. Effective systems for the management, administration, storage, and disposal of medicines were in place.

Staff appraisal, training, and supervision supported them in their role. Staff understood best practice guidance and training used and implemented them to meet the needs of people. The registered manager supported staff so that they were effective in their role to care for people and deliver quality care.

People gave consent to care and support provided by staff. The registered manager had an understanding of the principles the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Staff had an awareness of people’s nutritional needs for the maintenance of their health. The service provided meals in order to meet people’s preferences, in response to their individual needs. People had a choice in meals they wanted and in sufficient quantities.

People had access to health care services to meet their needs and professional guidance implemented to maintain their health.

Staff knew people well, were aware of their personal histories, and understood their likes and dislikes. People and their relatives were involved in making decisions about how they received care. Staff incorporated innovative and creative ways to involve people in planning their care. Care and support delivered to people centred on their individual needs, preferences, and choices. Staff provided exceptional care and support to people in a way, which respected their dignity and privacy.

People and their relatives contributed to regular reviews of their care and support. People undertook activities of their choice, which helped them towards independence. People maintained relationships that mattered to them with support from staff if needed.

People and their relatives were aware of how to raise a complaint and make a comment about the service if they wished.

The registered manager demonstrated clear leadership and established with staff, a positive culture within the staff team. Staff were involved in the development of the service to drive improvements. Staff were proud to work for the service, were motivated to provide good quality care, and applied best practice to help improve people’s lives.

The registered manager informed the Care quality Commission of notifiable incidents, which occurred at the service. The registered manager monitored, and reviewed the service to improve the quality of care to people. Improvement plans were developed, and staff made implemented these changes to provide an effective quality of care.

During our inspection we reviewed records for the service. Records showed that quality assurance systems were in place and quality audits have been completed. We spoke with three staff members and two people who lived at the service. They undertook a quality audit. The provider had identified needs using quality monitoring systems. They had developed an action plan which addressed the identified needs, and the required improvements had been made.

The house at Alma Road was clean and tidy but was need of general repair and redecoration. We were told that the house was due for complete refurbishment and the work was due to start at by end of February. People were to be moved to a different location whilst the work is undertaken.

We saw that people were cared for and relaxed with staff. Their rooms were pleasant and reflected their own preferences and interests.

People were supported in their daily lives; for example to visit the local library, to go to a day centre and in going out to the café for lunch.