This unannounced inspection took place on 30 November and the 1December 2016.

15 Brooklyn Road is a care home without nursing care for five people with learning disabilities and autism. People who use the service may have additional needs and present with behaviours which can be perceived as challenging others. There are two communal lounges and a kitchen/ dining room. There was 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.

One relative told us they had no worries about the service and felt it was a safe place. The staff had the knowledge to protect people from the risks of potential abuse and report any allegations of abuse. Safeguarding incidents had been thoroughly investigated and reported in writing to the commissioners and the local authority safeguarding team. The correct action was taken by the registered manager to prevent further incidents between people. We have made a recommendation the service considered it’s responsibilities around meeting regulatory requirements for notifications.

Individual risk assessments were completed which minimised risk for people helping to keep them safe and as independent as possible. All accidents and incidents were recorded and had sufficient information to ensure preventative measures were identified.

We observed staff responding to people in a calm and compassionate manner consistently demonstrating respect. Staff knew peoples individual communication skills, abilities and preferences. Staff supported people to choose activities they liked. People had taken part in activities in the community and holidays with staff. People were supported by sufficient staff and they were able to access the community with them.

Staff were aware of the Mental Capacity Act 2005 (MCA) to protect people when they needed support for certain decisions in their best interest. Care plans included people’s mental capacity assessments and identified how choice for each person was displayed by them. Most people made everyday decisions as staff knew how to effectively communicate with them. The service was working within the principles of the MCA and Deprivation of Liberty Safeguards (DoLS) and conditions on DoLS authorisations to deprive a person of their liberty were being met.

A range of social and healthcare professionals supported people. They told us the support provided to individuals clearly reflected a person centred approach and staff were knowledgeable about people’s needs. Medicines were well managed and given safely. People’s care plans identified how people liked to take their medicines. People were supported by staff that had the skills and knowledge to meet their needs. There was a choice of meals and people went shopping with staff for fresh produce they could choose.

Quality checks were completed and examples told us that action plans identified where changes were made to address any shortfalls. Relatives and health and social care professionals were asked for their opinion about the service. The registered manager was accessible and supported staff, people and their relatives through effective communication.

We spent time with four people living at Brooklyn Road. People seemed calm and content. Staff told us they felt confident supporting people when they got anxious. We saw positive comments from other professionals such as “a sincere commitment from the new manager and her staff in providing good care to service users”.

Care records were concise and contained appropriate detail about people’s needs and preferences. Staff were familiar with the content and followed the plans. Nutrition was well managed and people were encouraged to eat a balanced diet to achieve a healthy weight. People still had choices and could eat things they liked. Staff knew about people’s anxieties around food.

Medication was well managed within the home. Work had been done to reduce the covert administration of medication and was ongoing to review potentially unnecessary medication. The use of “as required” medication for anxiety was closely controlled.

Staff told us that they now felt well supported. There was a system for monitoring training and staff had received relevant training. Supervision meetings and appraisals were being undertaken to support development.

People and staff were being consulted about the quality of service provision. The issues identified were being addressed and monitored. The problems with the environment were being addressed.

Some of the people living in the home found it difficult to speak with us as a result of their learning disabilities and other complex needs. As a result, we spent more time observing the care provided than speaking with people.

We saw positive interactions between staff and people using the service. One person told us “I like living here”. People were supported to be as independent as possible and staff worked well with most people to meet their social and physical needs. We could see that people felt comfortable with staff.

The home was safe but the bathrooms were old and much of the decoration needed renewing. Some of the flooring needed replacing to ensure cleaning can be effective.

A range of activities were open to people, including access to cookery at college, cake baking, knitting or shopping in the local area. There were planned activities and these varied depending on how well people felt. People were encouraged to take part in general tasks around the home such as cooking and washing.