We carried out this announced inspection on 8 February 2017. At our last inspection in December 2014 we rated this service “good”. At this inspection we rated this service “good”.

Cambuslodge provides a supported living service to five people with learning disabilities and mental health needs. The service is located in a terraced house, and consists of five bedrooms, a staff office, a large kitchen and dining room, lounge and two shared bathrooms.

The service had a registered manager who had been in post since 2001. 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 supported to plan their care through a system of person-centred reviews. This enabled people to speak up on their health, support and daily activities. There were systems in place to support people to speak up through keyworking and residents meetings, including using accessible formats such as photographs. People who used the service were involved in the day to day running of the house, including household tasks.

Where people had complained, managers had investigated the complaint and taken appropriate measures, but people were also encouraged to speak up and make complaints about other services when they were not satisfied. Managers used the review system to ensure that people and their relatives were satisfied with their care.

The provider carried out suitable checks to ensure that staff were suitable for their roles and that there were enough staff on duty. Staff received good levels of training, appraisal and supervision to ensure that they had the skills to carry out their roles, and managers gave feedback to people on their performance.

People’s rights were protected by ensuring that they had consented to their care and that they had the capacity to do so. The provider ensured they could demonstrate they were working in people’s best interests if they were unable to make a decision for themselves. People were supported to eat healthily, and staff provided support to people to attend health appointments and maintain good health.

Risks to people were managed in a person-centred way which promoted their independence, and there were measures for staff to follow to ensure that people were safe and independent. Risks to people were regularly reviewed by staff. Medicines were safely stored and administered, and checked by staff and an external auditor. Daily handovers were used to ensure the service was safe and that people were happy and had received the appropriate support.

People had extensive activity programmes which included trips and holidays run by the provider. They were also involved in activities in the community, and the provider maintained good communication with the activity providers. People and their relatives told us that they were treated with respect and made choices about their daily lives and we saw friendly interactions between people who used the service and the staff team. One person told us “We get good care.”

We conducted an unannounced inspection of Cambuslodge on 8 December 2014. The service provides care and support for up to five people with mental health problems or learning disabilities. There were five people using the service when we visited.

At our last inspection on 19 December 2013 the service met the regulations we inspected.

The service had a registered manager in post. 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.

Safeguarding adults from abuse procedures were robust and staff understood how to safeguard the people they supported. The registered manager and staff had received training on safeguarding adults and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.

Risk assessments were based on people’s individual needs and lifestyle choices. We saw evidence that people were involved in decisions relating to risks they wanted to take in order to increase their independence.

There were enough, safely recruited staff available to meet people’s needs. Staffing numbers were adjusted depending on people’s requirements.

Medicines were managed safely. Records were kept when medicines were administered, and appropriate checks were undertaken by a second member of staff. Records were clear and accurate and regular auditing of medicines was undertaken.

Staff were trained in the Mental Capacity Act 2005 which is a law to protect people who do not have the capacity to make decisions for themselves. Staff were also trained in the Deprivation of Liberty Safeguards which are part of the Mental Capacity Act and exist to make sure that people’s freedom is not inappropriately restricted where they lack the capacity to make certain decisions. Staff demonstrated a good understanding of their responsibilities.

People and their relatives were involved in decisions about their care and how their needs were met. People had care plans in place that reflected their assessed needs and staff followed these.

Recruitment procedures ensured that only people who were deemed suitable worked within the service. There was an induction programme for new staff, which prepared them for their role. Staff were provided with a range of ongoing training to help them carry out their duties. Staff received regular supervision and appraisal to support them to meet people’s needs.

People were supported to eat and drink a balanced diet that they enjoyed and their nutritional needs were monitored. People were supported effectively with their health needs and had access to a range of healthcare professionals. People were involved in making decisions about what kind of support they wanted.

People told us staff treated them in a caring and respectful way. People’s privacy and dignity was respected and we observed positive interactions between people and staff throughout our visit. Staff demonstrated a detailed understanding of people’s life histories and their individual preferences and choices.

Staff and people who used the service felt able to speak with the registered manager and provided feedback on the service. They knew how to make complaints and there was an effective complaints policy and procedure in place. We found complaints were dealt with appropriately and in accordance with the policy.

The service carried out regular audits to monitor the quality of the service and to plan improvements. Where concerns were identified action plans were put in place to rectify these.

People's care records and risk assessments were current and fit for purpose. People who used the service and their relatives were happy with their care. One person told us "It is super here. The people and staff are so friendly and have made me very welcome." One relative said "It is an amazing place with wonderfully caring staff." Another relative told us "I am thrilled that they have supported him to become so independent."

The provider had policies in place to support the dietary needs of people who used the service. People had access to nutritious food and had their personal food preferences respected. Staff supported people to take part in food preparation and encouraged them to remain healthy through appropriate dietary choices.

The service was clean and tidy. Support workers were responsible for cleanliness and encouraged people who used the service to take part in basic domestic duties as part of life skills training. The service had an up to date infection control policy and we saw that staff and people who used the service observed good hand hygiene practice.

The premises were well maintained and safe. The environment was suitable for the care needs of the people who used the service. Each person had their own private bedroom with access to communal leisure and eating areas.

The provider used effective recruitment processes to select candidates for vacant posts. Appropriate pre-employment checks safeguarded people who used the service.

People told us they were happy with the care and staff. One person said ''they help me’’ and ''I like the people’’. They told us about a range of activities they were involved in such as cooking, dance, college, holidays and employment, and we saw an activity plan for the week for each person. We saw staff interacting with people in very warm and respectful manner, and we saw that people were happy, engaged and comfortable in the presence of staff.

People told us that they really enjoyed living at Cambuslodge. They were supported in all their daily tasks and were enabled to participate in a range of activities including volunteering, going to college and socialising with friends. We saw staff interacting with people in a very warm and respectful manner. We saw that people were happy, engaged and comfortable in the presence of staff, visitors and other people who live at Cambuslodge.