The inspection took place on 16 December 2016 and was unannounced.

33, Egmont Road provides care and accommodation for up to six people with moderate learning disabilities. On the day of the inspection five people lived at the home.

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

Staff told us they were clear about their roles and responsibilities. They had a good understanding of the ethos of the service.

Systems were in place to monitor the safety and quality of the service and to get the views of people about the service. These measures of monitoring the service has helped to make improvements were necessary.

People and their relatives told us they felt people were well cared for and safe, living at 33, Egmont Road. Staff knew how to help protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and staff knew how to minimise risks and manage identified hazards in order to help keep people safe from harm or injury.

There were sufficient levels of staff to meet people’s needs. This was endorsed by people we spoke with and their relatives.

People received their medicines appropriately and staff knew how to manage medicines safely.

Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure people are only deprived of their liberty in a safe and correct way. Appropriate policies and procedures were in place in relation to this and applications were made to the local authorities for those people who needed them. Staff supported people to make choices and decisions about their care wherever they had the capacity to do so.

People had a varied and nutritious diet and a choice of meals. They were supported to have a balanced diet which helped them to stay healthy.

Staff supported people to maintain health through regular monitoring by healthcare professionals.

Staff were consistently kind and caring and established positive relationships with people and their families.

Staff valued people, treated them with respect and promoted their rights, choice and independence.

Comprehensive care plans were in place detailing how people wished to be supported and had been produced jointly with people using the service. People had agreed what care and support they needed and were fully involved in making decisions about their support.

People were able to choose how they spent their time and what activities they participated with. People participated in a range of activities within the home or in the community and received the support they needed to help them to do this. Some people had been supported to find voluntary work and employment.

There was a complaints procedure in place and people felt confident to raise any concerns either with the staff or the registered manager if they needed to. The complaints procedure was available in different formats so that it was accessible to everyone.

People using the service and their relatives were encouraged to give feedback on the service. Relatives said the registered manager encouraged feedback and sought to develop and improve the service for people. Staff told us they felt well supported and enjoyed working in a positive environment.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. This inspection was unannounced.

33 Egmont Road is a care home for up to six people with learning disabilities. There were six people living at the home at the time of our inspection. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

People told us they were happy at the home, and our observations and discussions with relatives supported this. Staff knew people’s individual needs and how to meet them. We saw that there were good relationships between people living at the home and staff, with staff taking time to talk and interact with people.

People’s representatives were involved in developing care plans, and we saw people were supported to make decisions about their care and support. Where people did not have capacity to make certain decisions the service followed appropriate procedures to support them. We saw that staff encouraged and promoted people’s independence.

Staff were caring, and treated people with dignity and respect. People had access to the local community and had individual activities provided. There were enough qualified and skilled staff at the home to meet people’s needs.

Staff received an induction and regular training in many topics such as the Mental Capacity Act (2005), safeguarding adults, supporting choices, communication, first aid, eating and drinking, food safety, record keeping, infection control, learning disabilities, person centred active support and dealing with emergencies. This helped to ensure that they had the skills and knowledge to meet people’s needs.

There was an open culture within the home with people using the service encouraged to share their views and suggestions in different ways. There was a clear management structure in the home and staff, relatives and people using the service felt comfortable talking to the managers about their concerns and ideas for improvements. There were systems in place to monitor the safety and quality of the service provided.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). We found the location to be meeting the requirements of DoLS. The service was reviewing whether any applications needed to be made in response to the supreme court judgement in relation to DoLS.

On the day of our inspection there were six people living at 33 Egmont Road on a permanent basis. We spoke with five of the people who used the service, two care workers, the new manager and the regional director for the organisation.

People we spoke with told us about what they were doing that day, what holidays they were going on and the activities they enjoyed. One person told us “I like to see my friends and go out for meals” and another person told us they were about to go shopping and what they intended to buy and another told us about a planned holiday to the Isle of White.

We were able to observe that people's experience of the service was a positive one. During our inspection we saw staff always treated people with respect and dignity and people were supported to make informed decisions about how they lived their lives. One person told us they had gone bowling that morning and told us what they had chosen to eat for lunch.

We saw that policies and procedures had been put in place to ensure the safety and well-being of people using the service and we saw evidence of a quality assurance system regularly monitored by the provider.

During the inspection we talked with three people using the service and four members of staff, including the manager. We found that people appeared well cared for. They told us they were happy with the care they received in the home and with the way they were supported by staff. Staff reported that they were appropriately supported by management and there were enough of them on duty to care for people safely.

People were involved in their care and their independence was promoted. Each person was engaged in activities according to their wishes for them to lead as fulfilling a life as possible. Care records were in an easy read format to make these more accessible to people. People had signed their support plans to show their involvement when these were developed but had not always signed their risk assessments.

People’s progress notes were detailed about the care they received. Some records required to demonstrate that people were receiving safe and appropriate care were not always available. Records about people’s weight and their appointments with healthcare professionals were not available, so staff had the necessary information to support them where required.

There were plans in place to improve the décor of the home but actions had not always been taken in a timely manner when issues were identified to ensure the comfort and wellbeing of people. We found that action had not been taken to keep two rooms warm, where the radiators were not working.

On balance the feedback we received from the people who use the service was very positive about their experiences of living at 33 Egmont Road. Typical comments people we met made, included: “I like living here”, “Its better than my last home”, “The best thing about living here is the staff and going shopping”, “Its all good here and I can see my friends when I want”, and “I do like it here, although it’s a bit noisy sometimes”.

During our visit we always observed staff treat the people who lived at 33 Egmont Road with the utmost respect and courtesy. People we met were always very complimentary about the staff that worked at their home and always appeared at ease in their company. Typical feedback we received, included “Staff are always nice to me here”, Staff treat us well”, “Staff always knock on my bedroom door”, and “I have got my own key to lock my bedroom door, but sometimes I forget to do it”.

Everyone we met told us they felt safe living at 33 Egmont Road and were able to talk to staff if they were unhappy about anything. Typical feedback we received, included: “Yes, I do feel safe living here”, “If I am unhappy I would tell the manager”, and “Staff listen to us”. People we met also told us staff always helped them if they were not feeling well and always went with them to see the doctor, the nurses and the dentist. Comments we received, included: “I saw my doctor when I was not well” and “I had to go to hospital when I hurt myself and staff came with me”.

We also observed staff actively encouraging and supporting the people who use the service to do as much for themselves as they were willing and capable of doing so safely. For example, staff would always prompt people who use the service to make their own hot drinks, their lunch, and put their dirty dishes in the dishwasher. All the staff we spoke to were also very clear that supporting the people who use the service to maintain and develop their independent living skills was an essential part of their role as support workers at 33 Egmont Road. Typical feedback we received from everyone we met, included: “Staff help me cook lasagne and toad-in-the-hole”, “I make all my own drinks here”, “and I bring my laundry down every week and cook some food myself with help from staff”.

During our visit we saw that everyone who lives at 33 Egmont Road was actively and encouraged by staff to participate in all manner of interesting and meaningful occupational and recreational activities both at their home and in the wider community. The home is clearly continuing to enable the people who use the service to live active and fulfilling lives. Typical comments we received from people who use the service, included: “I go shopping for my own clothes and I like swimming, going to the cinema, and bowling”, “I got out a lot… never bored”, “My relatives come and see me sometimes”, “I go to college every week where I do dancing, cooking and drawing”,and “I like watching films in my bedroom and we have parties here sometimes”.

The feedback we received from people about the quality and choice of the meals provided was also very complimentary. Typical comments, included: “The food is nice here…I have chicken curry when we have a takeaway”, “I am going to have a cheese and pickle sandwich for my lunch, which I will make myself”, and “Staff ask you at meetings what you like and then you choose what you are going to eat”.

During a tour of the premises we saw the service looked very clean and smelt fresh throughout. All the people we spoke with who live at 33 Egmont Road told us they were generally happy with the way their home was decorated and furnished. Typical comments we received, included: “My bedroom is good…it’s got everything I need in it and I choose to spend a lot of my time there watching films”, “I have got my own TV and computer in my room”, “My bedroom is alright, but it would be nice if it was painted a colour I picked”.