Applegarth is a care home that provides support for up to six people who have a learning disability or autistic spectrum disorder and who have a sensory impairment. At the time of our inspection there were six people living in the home. At the last inspection, in September 2015, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive safe care. Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision and training that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

People developed positive relationships with the staff who were caring and treated them with respect, kindness and dignity.

People had plans of care in place that were focused on them as individuals. This allowed staff to provide consistent support in line with people’s personal preferences. People and their relatives felt they could raise a concern and the provider had implemented effective systems to manage any complaints that they may receive.

The service had a positive ethos and an open culture. The registered manager was a visible role model in the home. People, their relatives and staff told us that they felt confident that they could approach the manager and that they would listen. There were quality assurance systems in place to monitor and review the quality of the service that was provided.

This was an unannounced comprehensive inspection that took place on 1 September 2015. At the last inspection completed in May 2014, we found the provider had not met the regulations for two areas; personalised care support and treatment, and suitability of staffing. At this inspection we found the provider had made the required improvements and the regulations were being met.

Applegarth is a care home registered to accommodate up to six people who are aged over 18 and who have learning disabilities, Autistic Spectrum Disorder, or a sensory impairment. The home has six single bedrooms all with en-suite facilities, a lounge and dining room, bathroom, conservatory and kitchen. The home has a large garden that has been developed for the people who live at the service and two people have their own raised flowerbeds that they grow flowers and vegetables in. At the time of the inspection six people were living at 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.’

The feedback from the relatives was very positive. Comments included, “excellent” and, “the atmosphere is lovely”.

Staff knew how to identify and report abuse and the provider had a system in place to protect people from the risk of harm.

Staff were friendly, kind and caring and gave individual person centred care to each person. Staff told us the training the received was a good standard and enabled them to carry out their roles effectively.

People’s needs were assessed and areas of risk were assessed and reviewed to ensure peoples safety. Support was offered according to people’s likes, dislikes and preferences. Staff knew people well and understood their care needs. Staff treated people with dignity and respect.

People received their prescribed medicines when they needed them and medicines were securely stored and managed.

People were supported to take part in a wide range of activities to maintain their independence.

Staff and relatives told us they were happy to raise any concerns with the manager and felt confident they would be listened to.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

People told us they felt safe. Relatives also thought people were safe in the service.

Staff had been aware about care plans, and support plans had been written for people with particular needs. Some plans did not contain sufficient detail to promote people's welfare.

People had not always received medical treatment when they had potentially serious accidents. This meant that they were not fully safe in the service.

Is the service effective?

People’s health and care needs had been assessed and care plans were in place.

Although peoples’ needs had been assessed and included in care plans, more detail was needed in some plans to ensure people got the right care. Plans had been reviewed regularly. Relatives told us that they had not been invited to reviews of the care of their relatives.

This did not entirely confirm that the service had always been effective in meeting people’s needs.

Is the service caring?

Two people told us that staff had supported them properly. The relatives we spoke with said that staff were friendly and caring. One relative said, ‘’yes, staff are excellent.’’

We saw staff being friendly and helpful to people during the inspection.

Relatives told us they had been supplied with an annual satisfaction survey. This meant they were able to comment on the service provided.

Is the service responsive?

No one said they needed to make a complaint. Relatives told us when they told staff about anything that had concerned them, it had been put right.

Is the service well-led?

Staff told us that if they witnessed or heard of poor practice they would report their concerns to their management.

The service had systems to check that care was of good quality. This needed to be extended to ensure that all services were fully checked.

Staff received supervision to check their competence and provide them with support. There was no system in place to give staff the opportunity to provide feedback their views of the quality of the service to management, so their knowledge and experience had not been fully taken into account.

Staff told us that the manager was positive and supportive to them.

We were unable to speak with people using the service but we observed support and saw that staff were supportive, using methods agreed in support plans to ensure they were respected and that their nutritional needs were met.

We saw that the home was clean and staff understood their responsibilities in minimising the risk of cross infection.

We looked at recruitment records and saw all necessary checks were made to ensure that suitable people were recruited.

The home operates an open culture where concerns and complaints are supported to ensure that people using the service are listened to and receive the support they need in a way they want.

We were unable to speak with people using the service but we observed support and read comments made by relatives.

We saw that staff were supportive, using methods agreed in support plans to ensure the person was able to be involved in their care and give consent to their treatment.

The service currently has six people living in the home and we were unable to communicate with four of the six people as they had no verbal communication.

"I go out to the bingo once a week."

"I can get up and go to bed when I want to, the staff help me if I struggle with something."

"I like it here."