We inspected this service on 30 January 2018. We gave the provider 24 hours notice of our inspection visit as this is a small service and people are often out during the day.

Blueberry House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service is delivered from a semi-detached house. The house is a three storey building and provides accommodation and personal care for up to three people with a learning disability or autistic spectrum disorder. Two people lived at the home on the day of our inspection visit. One of the people had moved into the home four days before our inspection.

There was a registered manager in post at the service. 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.

At the last inspection in September 2016 the service was rated as requires improvement. We found a breach of the regulations because improvements were needed in the governance of the service. We also found improvements were needed in ensuring people received consistently safe care. Following the last inspection visit, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well-led to at least good.

This inspection visit was a comprehensive inspection and during this inspection we checked to make sure improvements had been made. We found improvements had been made and the rating in all key areas is now ‘Good’.

Since our previous inspection in September 2016 we have reviewed and refined our assessment framework, which was published in October 2017. Under the new framework certain key areas have moved, such as support for people when behaviour challenges, which has moved from Effective to Safe. Therefore, for this inspection, we have inspected all key questions under the new framework, and also reviewed the previous key questions to make sure all areas were inspected to validate the ratings.

The care service had 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.

People felt safe and cared for at Blueberry House. There were two staff on duty at all times so people received support when they needed it and were able to participate in activities as they wished to. Staff knew what to do if they had any concerns about people’s health or wellbeing and understood their responsibilities to challenge poor practice. Staff were knowledgeable about risks to people’s health and wellbeing and the support they needed to manage those risks.

The environment was clean and well-maintained and people had the equipment they needed to keep them safe.

The provider had ensured managers and staff had the skill, experience and support to enable them to meet people's needs effectively. People were supported to attend routine and emergency healthcare appointments and received their medicines as prescribed.

Staff worked with people to give them maximum choice and control over their lives. Where the level of supervision of people amounted to a deprivation of liberty, the appropriate applications had been submitted to the authorising authority.

Staff were kind and caring and provided an environment where people were enabled to live their lives, pursue their interests and maintain their independence. People were supported to take part in social activities

This inspection took place on 29 and 30 September 2016 and was unannounced. This was the first inspection of this service which had been registered in 7 July 2016 and commenced providing support in August 2016.

The home is registered to provide care for up to two people, in a small house in a residential area. At the time of our inspection only one person was living at the home. The home planned to offer support to young adults with learning disabilities and autistic spectrum disorders.

The registered manager had stopped working at the home and a new manager had started. They were in the process of applying to become the registered manager. The manager had a good level of understanding in relation to the requirements of the law and the responsibilities of their role. They had been in post under one month before our visit and were in the process of identifying what needed to improve before taking actions to achieve this. 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 not always protected from possible errors in relation to their medicines because the arrangements for the administration and recording of medication needed to be improved. People were not kept safe within the physical environment of the home because the provider had not acquired the aids and adaptations needed by people in order to keep them safe.

People's needs had been assessed and care plans developed to inform staff how to support people appropriately. Staff we spoke with were knowledgeable about how to protect people from risks associated with their specific conditions. Staff were aware of the need to keep people safe and they knew how to report allegations or suspicions of poor practice.

There were sufficient staff to meet people's needs. Staff told us that they were given the opportunity to develop their knowledge and skills in order to carry out their roles effectively.

People were supported to eat and drink enough by staff who knew how provide such support helping them to keep well and to meet their tastes and preferences. People were supported to have their emotional and physical healthcare needs met. The manager sought and took advice from relevant health professionals when needed.

People told us that they were happy at this home. We observed some caring staff practice, and staff we spoke with demonstrated a positive regard for the people they were supporting. People were consulted about their preferences and people were treated with dignity and respect.

You can see the action we told the provider to take at the back of the full version of this report.