The inspection took place on 25 and 26 April 2017. This was an unannounced inspection. The service was last inspected on 28 November 2014 and there were no breaches of regulation at that time.

Apperley House is a care home providing accommodation and personal care for 17 adults with a learning disability, an autistic spectrum condition and/or a physical disability. Support is provided from two houses that are located on the same plot of land; Apperley House and Malvern Crossing. When we refer to Apperley House in this report, this includes both buildings as they are registered as a single location with us. There were 17 people living at Apperley House during our inspection.

There was a registered manager in post at Apperley House. 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 was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment to support people. Staff had a good awareness of safeguarding policies and procedures and felt confident to raise any issues or concerns with the management team. The registered manager had carried out the relevant checks to ensure they employed suitable people at Apperley House

People were receiving effective care and support. Staff received appropriate training which was relevant to their role. Where required, the service was adhering to the principles of the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS). The environment had been adapted to meet the needs of people living at the home. People were supported to personalise their living spaces.

The service was caring. People and their relatives spoke positively about the staff at the home. Staff demonstrated a good understanding of respect and dignity and were observed providing care which maintained peoples dignity.

The service was responsive to people’s needs. Support plans were person centred and contained sufficient detail to provide consistent, high quality care and support. People were supported to engage in a range of activities based on their preferences and interests. There was a complaints procedure in place and where complaints had been made, there was evidence these had been dealt with appropriately.

The service was well-led. There was an experienced registered manager working at the service. Staff, people and their relatives spoke positively about the registered manager and the management team. Quality assurance checks and audits were occurring regularly and where issues had been identified, action had been taken to address them. The registered manager and staff were aware of the vision and values of the service and worked hard to provide a service which was person centred for each individual.

We used a number of different methods to help us understand the experiences of people using the service. This was because the majority of people using the service had complex needs which meant they were not able tell us their experiences. One person told us they did not have any complaints and they were happy at the home. The staff we spoke with demonstrated very good knowledge of people's needs. The service had devised ways of recording the experiences of people to help with their care planning and risk assessment. We saw records of feedback from peoples families and this was all very positive.

Apperley House and Malvern Crossing had adaptations in place to assist staff in meeting people's needs and people and their representatives were able to choose colour schemes for their individual bedrooms.

Staff had access to training to make sure they were skilled and knowledgable in caring for people who used this service.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. This was an unannounced inspection.

Apperley House is a care home providing accommodation and personal care for 17 adults with a learning disability, an autistic spectrum condition and/or a physical disability. Support is provided from two houses that are located on the same plot of land; Apperley House and Malvern Crossing. When we refer to Apperley House in this report, this includes both buildings as they are registered as a single location with us.

A registered manager was employed by this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Staff had a detailed knowledge of people’s needs and preferences. Some people were unable to communicate verbally so identifying what was important to them had to be done patiently and creatively. Staff had worked hard to achieve this. Some people had very complex health needs and staff managed these effectively. Staff monitored people’s physical and psychological wellbeing and ensured support was in place to meet their changing needs. Where necessary, staff contacted health and social care professionals for guidance and support. These professionals were very positive about the way staff met people’s needs. Some of the daily notes lacked detail about the activities people had taken part in and their response to them.

People using the service and their relatives were very positive about the service they received. People were treated with kindness and respect. The atmosphere in the home was positive and fun, with plenty of laughter. Staff told us they would challenge poor practice and felt confident concerns would be addressed by the registered manager. They had helped to empower people using this service and their relatives to do the same. Staff were well trained and supported to provide good quality care.

The registered manager and provider had systems in place to monitor the quality of the service provided. This was linked to a learning culture where staff and people were encouraged to comment on the running of the service. Although learning took place following incidents, this was not always recorded effectively. The legal requirements on the service, such as protecting people’s liberty, were understood and met by the management team.