This inspection took place on 31 December 2016 and was unannounced. We gave the service one day’s notice. This was because it was a care home for younger adults who are often out during the day .The previous inspection of Bows was on 20 June 2013. There were no breaches of the legal requirements at that time.

Bows is a care home for up to five young people. The accommodation is a detached bungalow in the town of Trowbridge. Bows is home for up to five young adults with a learning disability. All of the young adults have a severe learning disability. Three of the people who live at the home go to college with staff support two mornings per week.

There was a registered manager for 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.

There were system were in place that helped minimise risk to ensure people were safe. There were enough staff to support people and take action to reduce the risks of people experiencing harm. Staff had been trained about how to provide safe care and how to protect people if they had any concerns about their wellbeing.

People were helped by staff to manage their medicines safely. People were well supported to stay healthy and to have positive relationships. Individual support plans were produced with people and their relatives involvement .Care plans were reviewed regularly to make sure they were up to date and reflected people’s current range of care and support needs.

People were supported by staff that were well trained and properly supported. Staff went on regular training courses and were developed and supported in their work. This helped them to improve and develop their skills and competencies. Staff were properly supervised to help to ensure they were competent in their work. Staff spoke positively about working as a team and the good morale that existed among them.

Staff worked hard to promote people’s independence and support them to take part in activities they enjoyed. People told us they liked going out for example to attend College and other social events. Staff were kind and caring and the interactions we saw between people and staff were warm and respectful.

The two people currently living at Bows were not at the home on the day of our inspection. We did speak with two relatives, and a member of staff. The registered manager was present during our inspection and we met the responsible individual at the end of our visit.

The views of people and our findings were summed up through what relatives and staff told us.

Relatives told us staff knew people’s needs and ensured people were treated with privacy and dignity. Staff explained how they offered people choices, this showed an understanding of how people communicated. We found staff had a wide knowledge of people’s interests and abilities, which was used to support people to maintain activities relevant to them, such as attending social clubs, swimming and shopping in the local town.

Comments from relatives included: “Bows has a lovely calm and homely feel. A real home from home. The staff are very professional and caring, I cannot praise them enough.” Another relative said “staff ensure privacy and dignity is maintained. We are more than happy with the care and support provided and staff keep us informed of anything relevant regarding the health and welfare of our relative.” They said “the staff are experienced and know my relative very well. I am confident any concerns would be dealt with promptly and effectively.” Another relative said “we are delighted with the level of care and support our relative receives, they are very happy and content here, and show this by their actions when we visit them.”

Both relatives explained they had plenty of opportunities to express their views regarding the care or treatment their relative received, and they felt listened to. They also agreed the staff have a good understanding of their relative’s needs and had developed effective, professional relationships.

Staff told us they were confident in their understanding of, and ability to work with people’s behaviours. They were clear about their safeguarding responsibilities and how they would respond to any suspicion of abuse.

Staff told us they worked well together and regular meetings and effective handover of information between shifts ensured they were kept up to date with changes. Staff told us they enjoyed going to work. Staff told us the training they received was very good and enabled them to support people with specific healthcare needs such as epilepsy.