We carried out an announced inspection of the service on 9 November 2016.

Cavendish provides accommodation and personal care for up to six people living with a learning disability and or autistic spectrum disorder. At the time of our inspection there were six people living at the service.

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.

People received a safe service. Staff were aware of the safeguarding adult procedures to protect people from abuse and avoidable harm and had received appropriate training. Risks were known by staff and managed appropriately. Accidents and incidents were recorded and appropriate action had been taken to reduce further risks. People received their medicines as prescribed and these were managed correctly. Some concerns were identified with regard to safety of the environment. The provider took immediate action to make the required improvements.

Staff received an induction, training and appropriate support. There were sufficient experienced, skilled and trained staff available to meet people’s needs. People’s dependency needs had been reviewed and were monitored for any changes. Staff were recruited through safe recruitment practices.

People were involved in the menu planning and their nutritional needs had been assessed and planned for. People’s healthcare needs had been assessed and were regularly monitored. People received appropriate support to maintain their health and access community health services including specialist healthcare support.

The registered manager applied the principles of the Mental Capacity Act 2005 (MCA) and Deprivations of Liberty Safeguards (DoLS), so that people’s rights were protected. People were asked for their consent before care and support was provided and this was respected.

Staff were kind, caring and respectful towards the people they supported. They had a clear understanding of people’s individual needs, preferences and routines. The registered manager was exploring ways of involving people more in how the service was provided and developed.

People were involved in their care and support as fully as possible. There was a complaint policy and procedure available and confidentiality was maintained. People did not have access to independent advocacy services, however the registered manger assured us this support would be provided if required.

People were supported to participate in activities, interests and hobbies of their choice and independence was promoted.

The provider had systems in place that monitored the quality and safety of the service. There was a registered manager in place and relatives and staff were positive about their leadership of the service.

People who used the service could be confident that their human rights were respected and taken into account because the provider had systems in place that gained and reviewed consent from people who used services, and acted on people’s wishes.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We spoke to two people who used the service and they told us that they were well supported, one said “I am happy here, I go out on my own to meet friends” another said “The staff have been wonderful, they have encouraged me to do more for myself, I make lots of choices.”

We found that people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We found that appropriate arrangements were in place in relation to obtaining medicine and records were kept of all medicine ordered, received and disposed.

We found that staff were well supported by the registered manager. One said “I can raise issues with my manager and they are responsive” and another said “I enjoy my job; I get opportunities to update my skills”. Staff told us that they regularly participate in staff meetings and supervisions. Staff received appropriate training.

We found that people who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

Most of the people who used the service were out during our visit undertaking a variety of activities including attending college, undertaking voluntary work and attending a cookery class at the RNIB. On their return we spoke with two people who used the service, however due to communication difficulties we were unable to discuss things at length. All the people we spoke with either said or indicated that they were “happy” living in Cavendish. One person told us that they were pleased with the progress they had made since moving to Cavendish, and were being supported to investigate the possibility of living more independently in the community. Some of the people who used the service had more complex needs which meant that they were not able to tell us about their experiences of using the service; we therefore used our observations to help inform our judgements. We observed staff interacting with people who used the service in a respectful manner, calling people by their first names and promoting their dignity and privacy. People who used the service appeared relaxed, content and at ease in their surroundings. Records demonstrated that staff had been well trained, knew how to recognise safeguarding situations and how to report concerns to the local authority safeguarding team. The provider also demonstrated robust procedures for effectively monitoring the quality of the service to ensure that people received safe and appropriate care and support.

Not all of the six people who lived at the service were at home during our visit. Records showed that some people were out taking part in activities in the local community, such as attending college, or a fitness class. We were also unable to verbally communicate with one of the people who used the service; we therefore used observation to help inform our judgements. Three out of the six people using services told us that they were happy and content at Cavendish. They said that they were well cared for and that staff were friendly and supportive. One person said, “I lived in another home before, it wasn’t so good, but since coming here I have been really, really happy and my confidence has grown. A carer who visited Cavendish on the day we visited said, “A home is as good as the manager or the person in charge. The manager here is very good indeed. I have absolutely no complaints.”