The inspection was carried out on 14 November 2017, and was an unannounced inspection.

Avenues South East - 2a Higham Road is a residential home providing care and support for three people with learning disabilities. The service is part of a group of homes managed by the Avenues Trust. People who lived in the home had autism and communication difficulties.

At the last Care Quality Commission (CQC) inspection on 03 November 2015, the service was rated Good in Safe, Effective, Caring, Responsive domains and Requires Improvement in Well Led with overall Good rating.

We recommended to the provider to seek advice and guidance from a reputable source, about how to keep records well organised and consistent. This was because we found that they had not quickly identified and responded to gaps, inconsistencies and contradictions in records which required addressing.

At this inspection we found the service remained good.

The registered manager provided good leadership. They checked staff were focussed on people experiencing good quality care and support. People and staff were encouraged to provide feedback about how the service could be improved. This was used to make changes and improvements that people wanted. Records were consistent and robust.

People continued to be safe at Avenues South East - 2a Higham Road. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. Staff recognised the signs of abuse and what to look out for. There were systems in place to support staff and people to stay safe.

Medicines were managed safely and people received them as prescribed.

There were enough staff to keep people safe. The registered manager had appropriate arrangements in place to check the suitability and fitness of new staff.

Each person had an up to date, personalised support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly. Staff received regular training and supervision to help them to meet people's needs effectively.

People were supported to eat and drink enough to meet their needs. They also received the support they needed to stay healthy and to access healthcare services. Staff encouraged people to actively participate in activities, pursue their interests and to maintain relationships with people that mattered to them.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The provider and staff understood their responsibilities under the Mental Capacity Act 2005.

Staff showed they were caring and they treated people with dignity and respect and ensured people's privacy was maintained particularly when being supported with their personal care needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

The registered manager ensured the complaints procedure was made available in an accessible format if people wished to make a complaint. Regular checks and reviews of the service continued to be made to ensure people experienced good quality safe care and support.

One inspector visited the home, during this visit we were able to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards.

Is the service effective?

There was an advocacy service available if people needed it, this meant that when required people could access additional support.

Specialist dietary needs had been identified in care plans where required. People said that they had been involved in writing them and they reflected their current needs.

Is the service caring?

The home provides a specialist service in a homely environment to three ladies. People told us this was a lovely place to live and that they were well supported by the provider. People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.

People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. The result stated that people were generally happy with the service provided. We saw comments such as “It is excellent here”.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly.

People knew how to make a complaint if they were unhappy. For example, one person said, “If I have a problem, I will talk with the manager and she will listen”.

Is the service well-led?

The service has a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

During the inspection, we spoke with people who used the services, staff and the manager. We reviewed care records and records about the management of the home. We looked around the home and made observations about staff interactions with people.

We saw that each person had a care plan which contained information that was personal to them and each person had set goals that they would like to achieve. People who lived at the home had active lifestyles and were able to access the community on a regular basis. We observed lots of positive interactions between staff and people who used the service.

We looked around the home and saw that provisions had been made to accommodate any impairments that people had.

We looked at how the provider assessed the quality of the service that was provided. We saw that they sent out questionnaires to people’s relatives and healthcare professionals and carried out regular quality audits. We also saw that people had good relationships with staff and were asked for feedback throughout the day.

We saw that there was a complaints procedure which was available in a format that people who used the service were able to understand. The manager kept a record of complaints and compliments which were received by the service.

We looked at care records, complaints and compliments records, records about maintenance and monitoring the quality of the service. We saw that they were reviewed regularly and updated when they needed to be.

We visited the service and spoke with people who use the service, their relatives and staff. We looked at care records and other records that the service kept.

People we spoke with who use the service showed us around the home and their bedrooms which they had personalised with photos and personal objects that they related to. People told us about what they liked to do around the house such as cooking and laundry.

People’s relatives told us that they were very pleased with the quality of the service that their relative received at the home. They said that they had seen their relative improve their lifestyle and develop their independence since they had lived at the home.

We inspected this home on 03 November 2015. This was an unannounced inspection.

Avenues South East - 2a Higham Road is a residential home providing care and support for three people with learning disabilities. The service is part of a group of homes managed by the Avenues Trust. People who lived in the home had autism and communication difficulties.

There was a registered manager at the home. 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 registered manager and provider regularly assessed and monitored the quality of care to ensure standards were met and maintained. However, they had not quickly identified and responded to gaps, inconsistencies and contradictions in records which required addressing. We have made a recommendation about this.

People were protected against the risk of abuse; they felt safe and staff recognised the signs of abuse or neglect and what to look out for. Staff understood their role and responsibilities to report any concerns and were confident in doing so.

The home had risk assessments in place to identify and reduce risks that may be involved when meeting people’s needs. There were risk assessments related to people’s mental health and details of how the risks could be reduced. This enabled the staff to take immediate action to minimise or prevent harm to people.

There were sufficient numbers of suitable staff to meet people’s needs and promote people’s safety. Staff had been provided with relevant training and they attended regular supervision and team meetings. Staff were aware of their roles and responsibilities and the lines of accountability within the home.

The registered manager followed safe recruitment practices to help ensure staff were suitable for their job role. Staff described the management as very open, supportive and approachable. Staff talked positively about their jobs.

Maintenance checks and servicing were regularly carried out to ensure the equipment was safe.

Staff had developed positive relationships with the people who used the service. Staff were kind and respectful; we saw that they were aware of how to respect people’s privacy and dignity. People told us that they made their own choices and decisions, which were respected by staff but they found staff provided really helpful advice.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty safeguards and the home complied with these requirements.

The systems for the management of medicines were followed by staff and we found that people received their medicines safely. People had good access to health and social care professionals when required.

People were involved in assessment and care planning processes. Their support needs, likes and lifestyle preferences had been carefully considered and were reflected within the care and support plans available.

People were always motivated, encouraged and supported to be actively engaged in activities inside and outside of the home. For example, people went out to their local community for activities and travel on holidays.

Health action plans were in place and people had their physical health needs regularly monitored. Regular reviews were held and people were supported to attend appointments with various health and social care professionals, to ensure they received treatment and support as required.

Staff meetings took place on a regular basis. Minutes were taken and any actions required were recorded and acted on. People’s feedback was sought and used to improve their care. People knew how to make a complaint. Complaints were managed in accordance with the provider’s complaints policy.