Tuscany House is owned by Care Management Group. It provides accommodation for six adults with learning Disabilities and specialises in autism. At the time of the inspection five adults were resident at the service. Whilst not everyone was able to take part in full discussions, we were able to speak with some people and observe how they interacted with staff.

There was a manager in post who was waiting to be registered by CQC. 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 inspection took place on 30 June 2016 and was unannounced.

The service had sufficient staff on duty to meet the needs of the people who used the service. The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks. These were reviewed regularly to ensure they were up to date and current. In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building. Each person had a plan which detailed the support they needed to get safely out of the building in an emergency

People received their medicines when they needed them. Staff managed medicines in a safe way and were trained in the safe administration of them. Medicines were stored securely and disposed of appropriately.

We talked to staff who demonstrated that they understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team, police and CQC.

Staff told us that they received a comprehensive induction program and ongoing training, tailored to the needs of the people they supported. Staff appeared knowledgeable and knew how to support people appropriately.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people's ability to make decisions for themselves had been completed. Staff asked people for their permission before they provided care for them. Where people's liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person's rights were protected.

People had a good choice of food and drink available to them. People received support from staff where a need had been identified. People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them.

There was positive feedback about the home and caring nature of staff from people and relatives. The staff were kind and caring and treated people with dignity and respect.

Good interactions were seen throughout the day of our inspection, such as staff sitting and encouraging people in activities of their choice. There was positive feedback about the home and caring nature of staff from people and relatives.

People looked relaxed and happy with the staff, people could have visitors from family and friends whenever they wanted . There was a strong emphasis on key principles of care such as compassion, respect and dignity. We observed that the people who used the service were treated with kindness and that their privacy and dignity was always respected.

Care plans were based around the individual preferences of people as well as their medical needs. People were not always involved in their care plans due to their complex conditions. The manager used other ways to gain information about people and their preferences by using a keyworker system of staff who knew

People who used the service spoke about activities they were involved in or made choices about, for example, going to the pub. We saw in this case they later changed their minds and were supported to go to their choice of venue.

A person who used the service wanted to go out but was not happy with using the train as was suggested by staff. They said this and were supported to use their choice of transport.

People told us their room was not too hot or cold, their taps worked and the water was not too hot and they liked their rooms and the home.

A person who used the service told us that if someone upset them they would tell the manager or staff.

We saw that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We saw examples of good practice with regard to creative strategies used to manage and avoid conflict

We found good practice and high standards in regards to the environment which was thoughtfully and suitably designed and adequately maintained.

There had been input from a psychologist in relation to the lighting and colour of the décor, with the intent to have the best effect on people with Autism.

We saw bedrooms had a keypad but people also had the option of a fob or key.

We also saw that all bedrooms had en-suite wet rooms with a shower. All but one of these had fixtures and fittings ready so the option of a bath could easily be fitted and offered, and we saw that this was offered in practice.

We found both the bath/ shower option, and the keypad/fob/traditional key option provided better access, independence, privacy, dignity and security for people.

We saw that people were given support to make a comment or complaint when they needed assistance, and people had their comments or complaints listened to and acted on, without the fear that they would be discriminated against for making a complaint.