The inspection took place on 19 October 2016 and was unannounced.

Byards Keep is registered to provide accommodation with personal care for up to eight people with learning disabilities or autism. The home provides accommodation for six people in the main house with accommodation on the first floor and communal areas on the ground floor. In addition, there are two self-contained flats attached to the home. There were seven people living at the home when we inspected.

There was a registered manager for 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 had put people at the centre of the care they received and worked with staff to ensure that people’s individual needs were met. Care plans fully reflected the care people needed to ensure their physical and emotional well-being and staff’s knowledge of people’s care needs was good. People living at the home and their families were fully involved in planning their care needs and people were engaged in planning their day to day activities and outings.

Staff were kind and caring and spent time with people building their confidence and their trust in the staff. This allowed people to access the community and to enjoy planned outings. In addition the added confidence meant that accessing healthcare was less scary for people as they had confidence that staff would ensure they were safe. Risks to people were identified and care was planned to keep people safe and people had access to appropriate healthcare when needed.

There were enough staff to meet people’s needs. Staff training and the ongoing support staff received from the registered manager meant that the care provide was calmly delivered, safe and effective. Safe recruitment practices ensure that staff were safe to work with people living at the home.

Staff had received training to keep people safe from abuse and the registered manager investigated any concerns raised. There were clear care plans in place around any need for restraint and staff training in diversion and distraction meant that restraint used was minimal and always to keep people safe from harm. Medicines were administered safely and information was available to support staff to administered medicines consistently and appropriately. People’s ability to eat safely and maintain a healthy weight were identified and monitored along with people’s emotional needs around access to food.

The registered manager was approachable and took action when any concerns or complaints were raised. They had gathered the views of people living at the home and their families and taken notice of their views to improve the quality of care people received. Systems used to monitor the quality of care provided were effective and the provider and registered manager kept up to date with changes in legislation and best practice.

Five people were living in the home when we visited. Three people lived in the main house and two people lived in small apartments attached to the main house.

We spoke with two people but others had complex needs which meant they were not able to describe their experiences to us. We therefore used a number of different ways to help us understand everyone’s experiences. For example, we looked at records, including personal care plans, we spoke to the manager and staff who were supporting people and we observed how they provided that support.

People were given support to make choices and decisions for themselves wherever they could do so, and staff clearly understood each person’s way of communicating their needs, wishes and choices. We saw that people were supported in a way that reflected their care plans.

Where they were able to people told us things like, “Go and talk to the staff if I was not happy” and “Staff look after me, I like them.”

During this inspection there were six people using the service. We spoke with three people who used the service, a visiting health care professional, three relatives and seven members of staff including the manager, deputy manager, support workers, and the maintenance person.

We looked at service information, records and carried out a tour of the building.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. A relative we spoke with told us, “I am very impressed. (Name) is getting on quite well. The carers are excellent. Very good.” Another relative told us,”(Name) has come on so much. We have loved it. She does really well.”

Byards Keep was responsive to the needs of the people who used the service.

Byards Keep had a nominated infection control lead. A member of staff confirmed this and told us, “We have an infection control champion. Any infection control concerns are reported to (name).”

We found Byards Keep to be well led. Staff we spoke with told us, “We are well led since (name) came. She is very kind and will help where needed. She is very approachable. She has experience. It is a lot more settled now.” We spoke with relatives of people who used the service. Comments included, “The home is well led. The staff are pleasant. There always seems to be a lot of staff. Staff are very nice and very welcoming.”

Staff we spoke with described Byards Keep as warm, welcoming, friendly atmosphere and a very person centred approach. Another member of staff told us, “It is fun here. It is all about the people who live here. Making sure they get joy and fulfilment in everything they do.”