Badgers 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.

Badgers is registered to provide residential and nursing care for up to 10 people who have complex learning disabilities or mental health and physical health care needs. During our inspection we found that 12 people were living at the service and this is a breach of Section 33 of the Health and Social Care Act 2008. Therefore, the lack of oversight by the provider and registered manager means there is a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The accommodation for people is spread over a single storey building. Most people have single

bedroom accommodation although there is a double bedroom at the service where two people share the room. People have shared access to communal rooms, garden and sensory room.

The care service had not originally been developed and designed 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. However, most people living at Badgers have very complex needs learning and physical disabilities and are unable to verbally communicate their wishes.

The service had a registered manager in place. 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.

People were kept safe and safeguarding processes were in place and followed by staff when required. Incidents of a safeguarding nature were reported to the appropriate authorities and investigated. Staff understood their responsibility in safeguarding people and told us of the action they would take if they had concerns.

We saw positive relationships between staff and people. Staff treated people with compassion and kindness during their interactions. Staff we spoke with described ways in which they worked which demonstrated a caring attitude.

We found care plans were person-centred and consistent in the level of detail and information they

contained. Person-centred care planning is a way of helping someone to plan their care and support, focusing on what is important to them. Staff knew people well and delivered personalised care to people. Risk assessments related to the delivery of care and the environment were up to date. Emergency plans were in place and health and safety checks in the environment were carried out to ensure it remained safe.

The administration and management of medicines was carried out in a safe way.

Consent to care and treatment was sought in line with the Mental Capacity Act 2005 (MCA). The best interest's decision-making process had been consistently followed for people who lacked capacity to make certain decisions themselves.

People were offered a choice of meals. We saw the quality of the food available to be of a high standard. People were offered an alternative meal if they did not like the choice on offer. Records were available to highlight if people required a specific textured meal due to swallowing difficulties.

There were enough staff employed to ensure people’s needs were met safely. Safe recruitment procedures were followed during the employment of new staff. Staff told us they felt supported and had received regular supervisions and appraisals. Newly recruited staff received an induction

and training the provider had deemed to be mandatory was completed by staff.

We saw evidence of relatives, staff an

This inspection took place on the 20 January 2016 which was unannounced, the inspection team consisted of one inspector.

Badgers is a care home for up to 10 people with nursing staff for adults who have a learning disability, physical disability and complex care needs. At the time of our inspection they were nine people living in the service.

The service has 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

Suitable arrangements were in place to ensure that people received appropriate care and support to meet their needs. Staff knew the needs of the people they supported and they were treated with respect and dignity. People’s healthcare needs were well managed and they had access to a range of healthcare professionals.

People’s needs were met by sufficient numbers of staff. Suitable arrangements were in place to ensure that staff had been recruited safely and they received opportunities for training and supervision. People were safeguarded from harm; staff had received training in Mental Capacity Act (MCA) 2005 and had knowledge of Deprivation of Liberty Safeguards (DoLS). The manager was aware of how and when to make a referral. People had sufficient amounts to eat and drink to ensure that their dietary and nutrition needs were being met.

People were provided with the opportunity to participate and engage in activities of their choice which met their needs. Relatives and people who used the service knew how to make a complaint and we felt assured that all complaints were dealt with and resolved efficiently and in a timely manner. We found people with nursing needs had they needs met by qualified nursing staff, who were there to ensure that people were safe and all well cared for.

The service had a number of ways of gathering people’s views which included holding meetings with people, staff, and relatives. The manager carried out a number of quality monitoring audits to help ensure the service was running effectively and to help them make improvements.

People using the service were unable to communicate verbally their needs and wishes. From our observations of staff practice, and from discussions with staff, we found that support was provided in a person centred way by staff who had a good understanding and awareness of people’s care needs and preferences. We saw that the provider gave due consideration to people’s capacity to consent, and that the provider had taken the relevant action to ensure that they complied with the Mental Capacity Act 2005.

We saw the provider had systems in place to protect people using the service from abuse Staff told us that they had participated in regular training, which had enabled them to gain the skills and knowledge required to protect people who used the service.

We found that staff had received regular training to ensure that they had the skills and knowledge to meet the needs of people using the service. They received regular supervision from the manager and had access to a manager during the out of hour’s period in the event of an emergency. One member of staff told us”The senior staff are excellent - very supportive.”

We saw that there was a complaints policy and procedure in place, which was displayed in the entrance area. Staff were able to explain the complaints procedure and felt confident to support people using the service to complain.

People who used this service were unable to verbally communicate, but from our observations, speaking to relatives and staff we concluded that people were treated with respect, dignity and individual choices were acknowledged. Staff worked hard to listen to people and enabled them to expressed their views and be involved in making decisions about their care and treatment.

The up to date and well written care plans enabled staff to provide individualised person centred care and support. The provider had appropriate arrangements in place to manage medicines. We found there were sufficient numbers of people employed to provide a consistent staff group who knew individual people well.

We talked with a number of people who use the service and staff, this included observing them together at the time of the visit.

People using the service were not able to communicate with us verbally. They shared their views through gestures, facial expressions and body language wherever possible. People were engaged in a range of activities, relaxed and comfortable with staff and other people using the service.