This inspection took place on 17 December 2018 and was unannounced.

Danzey Green is a care home registered for a maximum of 12 people with learning disabilities and autism. The home comprises of a row of three bungalows. Staff have access to each bungalow via the back doors and the secure garden. Whilst the service is registered for 12 people, the registered manager informed us, the maximum number of people they would admit to the home was nine.

Each bungalow consisted of four bedrooms, a kitchen/diner, a communal bathroom, a toilet, and a living room.

The home was registered with the CQC prior to the CQC’s publication of ‘Registering the Right Support’ guidance for homes for people with learning disabilities and autism. However, the service provided at Danzey Green is in-line with best practice identified in our publication. Eight people lived at the home at the time of our inspection visit.

At our last inspection we rated the service as ‘good’. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service continued to be safe. Each bungalow was clean and tidy and staff understood infection control practice. Staff understood the risks to people’s health and wellbeing and took action to lessen each risk. There were enough staff on duty to meet people’s needs; and checks had been made on staff before working for the service to make sure they were safe to work with people. People received their medicines as prescribed.

The service continued to be effective. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The principles of the Mental Capacity Act (MCA) were followed. People had access to different health and social care professionals. People received food they enjoyed, and were involved in menu planning. Staff had received the training they needed to provide effective care.

The service continued to be caring. People received care from staff who were kind, and treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. The service supported people to maintain relationships with their family.

The service continued to be responsive. People’s needs were assessed and planned for with the involvement of the person. Care plans helped staff understand people’s care and support needs. People had opportunities to pursue their interests and hobbies, and social activities were offered. There was a complaint procedure although no complaints had been made to the service since our last inspection. Staff knew how to support people well with end of life care.

The service continued to be well-led. The registered manager worked hard to ensure a good quality of service was maintained. The registered manager provided good support to the staff group, and to people who lived at the home. Checks were made to ensure the service met its obligations to provide safe accommodation to people and to deliver care and support which met people’s individual needs.

The inspection took place on 2 June 2016 and was unannounced.

41- 45 Danzey Green provides care and accommodation for up to 12 people with learning and physical disabilities in three separate bungalows. At the time of our visit 9 people lived at the home.

An experienced registered manager was 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.

There were enough suitably trained staff to keep people safe. They had received training in keeping people safe and understood their responsibility to report any observed or suspected abuse. Staff were knowledgeable about the risks associated with peoples care and support. Risk assessments and management plans were in place to manage the identified risks. Medicines were managed safely so people received their medication as prescribed.

New staff received an induction and recruitment checks were carried out prior to staff starting work at the home to make sure they were suitable for employment.

Staff understood their responsibilities under the Mental Capacity Act and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not inappropriately restrict their freedom.

The home had a friendly and relaxed atmosphere. Staff told us they enjoyed working there. We saw staff were responsive to people’s needs and had good knowledge of how they preferred their support to be provided. They were patient, attentive and treated people with kindness.

Staff respected and understood people’s need for privacy and promoted their independence. People chose to take part in daily activities in the home and their local community.

People were involved in menu planning and their nutritional needs were met. People were supported to maintain their health and well-being and staff knew when to refer to other health professionals.

People knew how to make a complaint. A system was in place to manage complaints received about the service.

Staff had a good understanding of their responsibilities and staff felt supported by the provider’s management team.

Effective systems to monitor the quality of the service were in place. People's views on the service provided were sought and listened to.

We visited this service and talked with people to gain a balanced overview of what people experienced, what they thought and how they were cared for and supported. There were nine people living in the home at the time of our visit. We saw all of the people during our visit.

We spoke with four members of staff and the manager. People using the service had limited verbal communication skills. We observed how people were cared for and how staff interacted with them to get a view of the care they experienced. We spoke with three relatives of people living in the home.

We considered all of the evidence we had gathered under the outcomes that we inspected. We used that information to answer five key questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We observed the interactions between the people who lived in the home and staff. People looked at ease in their surroundings. Staff spoke with them in a calm and friendly manner. Relatives we spoke with felt that people were safe in the home and that they would know if their family member was not happy.

Recruitment practice was safe and thorough. No staff had been subject to disciplinary action. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLS) which applies to care homes and hospitals. No applications had been made. The manager understood how this legislation applied to people and protected their rights.

The service had robust safeguarding procedures in place. Staff were alert to the signs of abuse or potential abuse. They understood their obligation to report any concerns. The provider regularly monitored the quality of service provision.

Is the service effective?

It was clear from our observations and from speaking with staff that they had a good understanding of people’s care and support needs and that they knew them well. We saw that people's care plans and risk assessments were reviewed on a regular basis to ensure that their changing needs were planned for.

We saw that actions were taken to protect people's health as needed. The staff and managers of the home worked with other agencies and health care providers to ensure people’s changing needs were met. One relative told us about an agency for people with sight loss that staff had asked for advice and support for their relative.

Visitors confirmed they were able to see people in private and that visiting times were flexible.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. Staff had developed a range of communication methods to ensure they could enable people to make choices and decisions on a daily basis.

People appeared settled and happy. The relatives we spoke with told us the home offered a good service. One person said, “Absolutely delighted with the care.” Another person said, “ We were lucky to find this home. She is happy there.”

People were supported to maintain relationships that were important to them.

Is the service responsive?

People’s needs had been assessed before they moved into the home. People met with their key workers regularly to ensure they remained satisfied with their support and had taken part in activities that were important to them. Records confirmed people’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

People regularly completed a range of activities in and outside the service. The home had its own transport which helped keep people involved with their local community.

Records showed that staff responded quickly to changes in people’s health. We saw that people had access to a variety of health care providers to ensure their needs could be met.

Is the service well-led?

The registered manager had been in post for a number of years. The manager was experienced and caring and provided good leadership based on how best to meet the needs of people in an individualised way.

The service worked well with other agencies and services to make sure people received their care in a joined up way.

There were systems in place so that people who lived in the home could share their views about how the home was run. The manager was able to give us examples of actions taken and changes that had been made as a result of listening to the people living in the home.

The service had a quality assurance system. Records showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

We visited Danzey Green care home on Tuesday 21 May 2013. Danzey Green comprises of three bungalows. We spent time at each bungalow observing the support people were given. We also talked to people who lived at Danzey Green and the staff who supported them.

We observed very good interactions between staff and people living in the home. Staff knew the needs of people very well, and understood what people were communicating to them.

People told us they enjoyed living at Danzey Green. They were observed participating in a range of activities that suited their needs.

We looked at the care records of two people living at Danzey Green. These provided good information about the care and support needs of each person. They helped staff understand how to meet people’s needs.

We looked at the equipment staff used to support people in their care. We were satisfied that staff knew how to use the equipment and that it was well maintained.

We looked at how the service supported its staff. Staff told us they had received training to help them with their work. They told us they received good support from the manager and they worked well in supporting each other.

We looked at the quality assurance systems at the service. We were satisfied the organisation had systems in place to monitor the quality of care and support provided to people living at Danzey Green.

We spoke with people who lived in two of the three bungalows. They told us they liked living at the home, they liked the staff, and they liked the activities they took part in. One person told us they liked shopping, getting their nails painted and having hand and head massages. With support from staff another told us they liked going for a drive and going to the pictures.

We found where people were able to give consent to care and treatment they were supported to do so. Where people did not have the capacity to give consent, staff understood they needed to arrange ‘best interest’ meetings with those who knew and understood the person.

We saw good care planning records which showed the changing needs of the people living at the service, and they gave staff clear guidance on how to meet them. The records were written in a person centred format.

We saw food and drink provided to people supported their nutritional and hydration needs. Where able, people chose their menus on a weekly basis.

We looked at the management of medicines. Staff were trained to administer medication, and on the whole medication was given correctly and at the right time. An error made by the pharmacy the service uses had not been identified and this had led to one person being given their medication at the wrong time. This was rectified on the day of our visit.

We found there were sufficient staff to meet the assessed needs of people at Danzey Green.

We found that the people living at Danzey Green were happy. People told us that they liked living in the home and that it was their home. People were proud of their bedrooms, which was decorated in the style and colour that they wanted. People knew the names of the care staff looking after them and referred to care staff by their first name. People told us that they liked the care staff. Comments people made included “The staff are nice to me.” People told us if they were unhappy, they would speak to their carer.