The inspection took place on 9 November 2016 and was announced.

Magnolia Cottage provides a home and support for a maximum of four people with a learning disability. The home is a bungalow in keeping with others in the local community. At the time of our inspection, there were four people using the service.

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. 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 promoted people's safety. They understood their obligations to report any concerns or suspicions that people were at risk of harm or abuse. There were enough staff to meet people's needs and they were recruited in a way that contributed to protecting people from the employment of staff who were unsuitable to work in care.

Risks to people's safety and welfare were assessed with guidance for staff about managing these. Staff knew how to respond if there was a fire or an accident in the home so that people's safety was promoted. The registered manager kept the safety of the service under review. This included ensuring that staff managed medicines safely.

The level of staff turnover raised potential problems for people living in the service. The management team and relatives recognised that people needed support from consistent staff. There were some staff who had developed a good insight into people's specific individuals needs and how they communicated. However, there were many new staff who needed to develop their skills and knowledge to support people with complex needs.

The registered manager and regional director identified the need for additional support, coaching and training for staff. They had recognised the need to improve written guidance about people's care in order to support staff, particularly new staff members, to understand and meet individual needs. They had put plans in place to achieve this.

Staff were aware that any action they took to ensure people's safety and welfare should not restrict them unreasonably. Longer standing staff members understood how people communicated their consent to receiving care. They involved family members who knew people well to help participate in planning how people's needs could be met. However, staff were not consistently clear how people's capacity to make specific, individual decisions about their treatment should be looked at.

People received support to eat and drink enough to keep them well and healthy. Staff ensured they sought guidance from professionals and acted on advice from them to promote people's physical and mental wellbeing. They understood the signs that people might show if they were becoming unwell or in pain so that they could respond promptly.

Staff treated people warmly and with regard to their dignity, privacy and independence. They took action to intervene if people were upset, anxious or distressed and understood how people might express this.

There had been a period of inconsistent leadership within the service, which had affected the morale and motivation of staff. This contributed to a lack of clarity about staff roles and accountability. The new registered manager had been in post for only five weeks at the point of this inspection, but was already making improvements to the quality of care people received, how staff were supported and listened to, and how the views of relatives were considered. They had identified with the regional director, priorities for further improvement and established clear systems for checking and monitoring the service.

We spoke with people using the service. However, some were unable to discuss their care. For this reason we observed the support that staff offered while we were in the home. We found that people were politely and respectfully encouraged to participate in day to day activities within their home to maintain their skills. This included taking responsibility for cleaning their rooms, making drinks or doing laundry. They were also consulted about options for activities. We found that there were pictures, photos and objects used to make it easier for people to make choices in their daily lives and about their care. People's needs were assessed and we observed that the support that staff offered took into account risks so that they were supported safely.

There were picture menus so that people could make choices about what they wanted to eat. One person showed us this and said they had baked beans for their breakfast. People were able to access drinks freely. The fridge and cupboards were well stocked, including with fresh fruit and vegetables. Staff checked people's weights so that any concerns about nutrition could be followed up.

The home was kept clean so that risks of infection were minimised. Staff had training to help to do this. The home was also free from unpleasant smells.

We found that staff had access to training and that this was kept up to date so that they were competent and effective in their roles. We also noted that proper checks were carried out before staff started work, to ensure they did not present a risk to vulnerable people. There was a 'checklist' within staff files to ensure that the process was completed properly. We know from other services in this group that the provider had robust systems for checking that staff were properly recruited and training was kept up to date.

Most people living in the home found it difficult to tell us verbally what they thought about the standard of care they received. Also, some people were anxious about our presence and spent time in other areas of the home while we were there. Because of this, we spent some time listening to their interactions with the staff on duty.

People interacted well with staff. They were encouraged to do things such as making drinks, for themselves with staff support and prompting if necessary. Staff offered people praise and encouragement to do things and also acted promptly to distract people when they saw they were becoming anxious or agitated. We concluded from this that the staff on duty understood people's complex needs and that they followed guidance in people's plans of care.

One person told us they liked being in the home and who they would speak to if they had any concerns. They had made their own complaints booklet with support, showing who they could speak to and what to expect if they did complain.

Most people had regular contact with family members and we saw comments from relatives showing they were happy with the service people received.

We were invited in by one person living at Magnolia Cottage and a member of staff who checked our identity beforehand.

We visited the service during the early evening to speak with as many people living there as possible, although two of the four people had gone out visiting and for a meal out.

One person who had limited communication skills was able to answer questions and sign a little to ascertain some communication, although staff supported them throughout.

We looked round the premises and two people invited us to see their own rooms and staff guided us around the main communal areas. The bungalow was found to be clean and tidy, with evidence of people's personal items and photographs throughout the home.

One person was assisting a member of staff to cook the evening meal for the two remaining people and two members of staff. They showed us they chose what they all wished to eat between two options for that day. The meal consisted of a family pie and a variety of fresh seasonal vegetables. The senior support worker explained that everyone was offered a choice of meal and fresh fruit and vegetables were used more often than frozen. He told us that several days during the week people assisted staff with the preparation of the main evening meal with others helping to clear up afterwards, unless they had an evening event arranged.

During the preparation of the meal the staff gave simple instructions to the person helping with plenty of time for them to undertake the the task. It was observed throughout the visit that staff treated people courteously and with respect, explaining to them if they found it difficult to comprehend, showing the staff understood the needs of the people living at Magnolia Cottage.