This unannounced inspection of Alpha House took place on 6 November 2018. Alpha House 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. Alpha House accommodates three people with learning disabilities in one building. Two people live in shared accommodation whilst another has self-contained facilities within the building. There were three people using the service when we visited.

The service is in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last rating inspection in February 2016, the service was rated Good. At this inspection we found the service remained Good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

A registered manager was 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.

Staff understood their responsibility to report any concerns and were aware of the action to take if they suspected abuse had occurred. People were supported to manage their risks by staff who were aware of the need to protect people from avoidable harm. There were sufficient numbers of staff available to meet people's care and support needs. The provider recruited staff safely.

People received their medicines as prescribed. Medicine stocks tallied with those determined by the medication administration record. The environment was maintained and generally clean but some areas were in need of attention. Systems were in place to monitor infection control.

Staff had the skills and knowledge to carry out their roles and were supported by a system of induction, relevant training, one-to-one supervision and appraisals.

Staff understood their responsibilities under the Mental Capacity Act 2005. People's capacity had been assessed and when required best interest's meetings had been held and recorded.

People had a choice of meals and were supported to maintain a balanced diet in line with their choices, preferences and any healthcare needs. People's health was assessed and monitored. Staff took prompt action when they noticed any changes or decline in health. Staff worked closely with health professionals and followed guidance given to them to ensure people received safe and effective care.

Staff maintained people's dignity and encouraged choice and independence. Staff supported people to maintain friendships and relationships. People's friends and family could visit when they wanted and without restriction.

People were encouraged to follow their interests and develop daily living skills. There were a range of activities which took place within and outside the home.

Information about how to complain was displayed in the service. People and their relatives were asked their opinions of the service and responses were collated to form action plans. Staff meetings were held regularly and their feedback valued. Staff told us that they felt supported by the registered manager and that the service was a good place to work.

Audits were in place to monitor the quality of the service people received. The registered manager reviewed any recorded accident and incidents. These were analysed to identify any patterns or trends and plans were put in place to reduce the risk of them happening again in the future.

Services that provide health and social

The inspection of Alpha House took place on 25 February and 8 March 2016. The visit on 25 February was unannounced and the visit on 8 March was announced. We previously inspected the service on 7 October 2013 and at that time we found the provider was meeting the regulations we inspected.

Alpha House provides accommodation, care and support for three adults with learning disabilities and complex needs/ behaviour that challenges.

The service is required to have 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. The service had a registered manager.

Staff had a good understanding about safeguarding adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

Effective recruitment and selection processes were in place and medicines were managed in a safe way for people.

There were enough staff to provide a good level of interaction. Staff had received an induction, supervision, appraisal and role specific training. This ensured they had the knowledge and skills to support the people who lived there.

People’s capacity was considered when decisions needed to be made and advocacy support provided when necessary to support and enable people to express their views. This helped ensure people’s rights were protected when decisions needed to be made.

People were supported to eat a balanced diet and meals were planned on an individual basis.

Staff were caring and supported people in a way that maintained their dignity and privacy. People were supported to be as independent as possible throughout their daily lives.

Individual needs were assessed and met through the development of detailed personalised care plans and risk assessments. People and their representatives were involved in care planning and reviews. People’s needs were reviewed as soon as their situation changed.

People engaged in social activities which were person centred. Care plans illustrated consideration of people’s social life which included measures to protect them from social isolation.

Systems were in place to ensure complaints were encouraged, explored and responded to in good time and people told us staff were always approachable.

The culture of the organisation was open and transparent. The registered manager was visible in the service and knew the needs of the people who used the service.

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of the people were met and that the service provided was to a high standard.

We used a number of different methods to help us understand the experience of people using the service, because some people we met had complex needs which meant that they were not able to tell us their experiences or give us their opinions about the home.

We saw that care planning and delivery was of a high standard. We observed a relaxed atmosphere with warm, supportive and friendly interactions between staff and the people who lived at the home.

Staff told us they enjoyed working at the home and there were enough staff to support each individual. From talking with staff it was clear they had very detailed knowledge of people's needs, likes and preferences.

Medicines were managed safely and quality audits were in place to make sure that the home was safe and people received good quality support and care.

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

People living at the service looked settled and content in their surroundings. We saw written evidence which showed that people were able to take part in individual interests and keep in contact with friends and relatives.