The inspection was carried out on 07 February 2017, and was an unannounced inspection.

Avenues South East - 320 Hempstead Road is a residential home providing care and support for four people with learning disabilities, autism and limited verbal communication. The service is part of a group managed by the Avenues Trust. At the time of our visit, four people lived at Avenues South East - 320 Hempstead Road.

At the last Care Quality Commission (CQC) inspection on 22 July 2014, the service was rated Good in all domains and overall.

At this inspection we found the service remained Good.

People continued to be safe at Avenues South East - 320 Hempstead Road. People were protected against the risk of abuse. We observed that people felt safe in the service. Staff recognised the signs of abuse or neglect and what to look out for. Medicines were managed safely and people received them as prescribed.

Staff knew how to protect people from the risk of abuse or harm. They followed appropriate guidance to minimise identified risks to people's health, safety and welfare. There were enough staff to keep people safe. The provider 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 were caring and treated people with dignity and respect ensuring 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.

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.

Further information is in the detailed findings below.

The inspection was unannounced. 320 Hempstead Road is a residential home providing care and support for four people with learning disabilities, autism and limited verbal communication. The home is part of a group managed by the Avenues Trust. At the time of our visit, four people lived at Avenues South East, 320 Hempstead Road.

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 home and shares the legal responsibility for meeting the requirements of the law with the provider.

People were protected from the risk of abuse. The provider had taken steps to identify the possibility of abuse and prevent abuse from happening. There was a safeguarding adult protection policy in place, which detailed what actions to be taken by the provider to help keep people safe. All staff had been trained in safeguarding adults and they gave clear explanations of the different types of abuse to be aware of; and who explained that they knew which action to take in the event of any suspicion of abuse.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Each person’s care plan contained individual risk assessments in which risks to their safety were identified. These clearly detailed the support needs, views, wishes, likes, dislikes and routines of people. Staff updated their knowledge about people’s care needs daily. They regularly updated their training needs and received appraisals and one to one supervisions were carried out monthly.

People were supported to be able to eat and drink sufficient amounts to meet their needs. They were provided with a choice of suitable and nutritious food and drink.

People were registered with appropriate healthcare professionals and people were supported by staff or relatives to attend all of their health appointments.

People were supported by kind and attentive staff. Staff showed patience and gave encouragement when supporting people. They were knowledgeable about how to support each person in ways that were right for them.

People’s health and care needs were assessed with them. People, families and professionals were involved in writing their plans of care. People’s needs were taken into account with the use of pictures and Makaton sign language to facilitate those with communication difficulties.

Staff communicated effectively with people and responded appropriately to their requests and offered people choices. People were encouraged and supported to take part in a variety of appropriate activities inside and outside the home. Each person had an individual weekly activity plan.

People were made aware of the complaints system. This was provided in a format that met their needs. Staff told us that they were aware of the complaints policy and procedure. They knew what to do if someone approached them with a concern or complaint and had confidence that the manager would take any complaint seriously.

There was an open and positive culture which focussed on people. The office was located in the centre of the home so that the manager and staff were accessible to people and visitors. The manager had an open door policy, and actively encouraged people to voice any concerns.

People were comfortable with the management team and staff in the home. Staff spoke positively about the way the home was run. They told us the manager was approachable and the management team often chatted with them and asked them how things were.

The home worked well with other agencies and services to make sure people received their care in a joined up way. The provider was a certificated gold member of British Institute of Learning Disabilities (BILD). The provider told us in their provider information return made that they had accreditation schemes with Skills for Care and Social Care Institute for Excellence (SCIE).

The home had a quality assurance system, records showed that identified shortfalls were addressed promptly.

We found that people living at this home were supported in a way that promoted their independence. Staff encouraged people to take part in the running of the home for example. People were regularly offered opportunities to express their views through meetings with their keyworkers.

We were not able to ask people for their views during our visit due to their communication difficulties. However, we observed the way staff interacted with people and saw that they had a good understanding of how people communicated their preferences. Staff were therefore able to ensure that they gained consent before providing care and support.

We looked at the physical environment of the home and found that it was appropriately maintained, secure and comfortable for the people living there. We saw that the bedrooms were spacious and they had been decorated in a personalised way. Staff told is that people living at the service were able to choose how they wanted their rooms decorated. Rooms were decorated to reflect personal interests.

We reviewed the management of medicines in the home and found that systems were in place for the safe supply, storage and administration of medicines. We saw that regular audits were taking place and any issues would therefore be detected as soon as possible.

We looked at the way in which the service managed complaints. We found that the policy in place was detailed and staff were aware of the processes for managing complaints appropriately.

People who use the service communicated to us that they were happy at the service and were involved in making decisions about their daily lives. Some people told us that they liked the staff and enjoyed helping out around the house.

People expressed that they felt safe in the home. They told us that they had their own space when they needed it.

We observed staff interacting with people who used the service. People were at ease with staff and went to them when they needed assistance.