20 Dairy Close provides support for up to four people who have a learning disability. At the time of our inspection there were four people living at the service. At the last inspection, in September 2015, the service was rated Good in all domains. At this inspection we found that the service remained Good.

There was a registered manager at the service. 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 continued to receive safe care and we found there were enough staff to provide support to people that met their needs. We found that people were consistently protected from the risk of harm and received their medicines safely. The provider had safe recruitment procedures in place to ensure that staff were of a good character and suitable to support people who used the service.

People continued to be supported to make decisions about their care and staff sought people’s consent before they carried out support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s nutritional needs were met by staff. People were able to choose what they wanted to eat and drink. People had access to health care services and advice sought was followed by staff to ensure people’s health and wellbeing was maintained. Staff received training to enable them to support people effectively.

People were treated with dignity and staff were caring and kind. People’s privacy was respected and upheld, people were able to have time to themselves in their private rooms. Staff encouraged people’s independence and respected people’s choices. Staff understood people’s individual communication needs and relationships with relatives were maintained.

People were supported with interests and hobbies that were important to them. People and their relatives were involved in the planning and review of their care. Staff knew people well, which meant people were supported in line with their preferences. People understood how to complain if they needed to because complaints procedures were in a format that people understood.

Effective systems were in place to assess and monitor the quality of the service people received. People and staff were encouraged to provide feedback about the service. The registered manager was approachable and supportive to both people and staff.

We inspected 20 Dairy Close on 28 September 2015. The inspection was unannounced.

The service is registered to provide accommodation and personal care for up to four people. People who used the service had a learning disability. At the time of our inspection there were four people who used the service.

The service had 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 and associated Regulations about how the service is run. The registered manager was unavailable at the time of our inspection, but we were able to speak with the deputy manager.

People were kept safe because staff understood how to recognise possible signs of abuse and the actions they needed to take if people were at risk of harm. People’s risks were assessed in a way that kept them safe whilst promoting their independence.

People who used the service received their medicines safely. Systems were in place that ensured people were protected from risks associated with medicines management.

We found that there were enough suitably qualified staff available to meet people’s needs in a timely manner. The registered manager made changes to staffing levels when people’s needs changed.

Staff were trained to carry out their role and the provider had safe recruitment procedures that ensured people were supported by suitable staff.

Staff had a good knowledge of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The MCA and the DoLS set out the requirements that ensure where appropriate decisions are made in people’s best interests where they are unable to do this for themselves. People’s capacity had been assessed and staff knew how to support people in a way that was in their best interests. We found that where people were able they consented to their care and treatment.

People were supported with their individual nutritional needs and were able to access other health services with support from staff.

People told us and we saw staff were kind and compassionate. Staff treated people with respect, gave choices and listened to what people wanted.

People’s preferences in care were recorded throughout the care plans and we saw that people were supported to be involved in hobbies and interests that were important to them.

The provider had a complaints procedure that was available to people in a format that they understood.

Staff told us that the registered manager was approachable and led the team well. Staff had clear values and were enthusiastic about their role and what their support meant for people.

People, relatives and staff were encouraged to provide feedback on the service provided. The registered manager had systems in place to assess and monitor the quality of the service provided.

During the inspection we spoke with two people who used the service and their representatives, staff who provided support and the registered manager. We did this understand the experiences of people who lived at the home.

We found that the provider had systems in place to gain consent for care and treatment from people who used the service. We observed staff supporting people with decisions in a way that people understood. Staff we spoke with understood their responsibilities with regards to the Mental Capacity Act 2005.

People we spoke with told us that they were happy with the care they received from staff. One person told us. “It’s great. I can choose what I want to do”. We observed that staff treated people in a caring and respectful manner and were responsive to people’s needs and wishes.

The provider had a system in place to ensure that medicines were administered and recorded safely and people who used the service were protected from the risk of harm associated with the management of medicines.

Staff we spoke with told us that they carried out an induction before they provided support to people who used the service. Staff told us they received regular appraisals and training to carry out their role and felt supported by the registered manager.

The provider had an effective complaints system in place which was accessible to people who used the service. People we spoke with told us they knew how to complain if they needed to.

We met with people who lived at the home and all the staff on duty. We spoke with three people living at the home and two members of staff. We also spoke with three relatives. We saw that people who used the service were involved in the planning and reviewing of their care and support needs. Relatives we spoke with told us, "I have always been involved, if I can attend reviews they keep me informed" and "I always attend the six monthly meetings and I am asked my views".

The records viewed were centred around the individual and we observed staff treating people who used the service with dignity and respect. Staff we spoke with told us how they made sure that people were given choices and how they were supported to maintain their independence.

We spoke with staff who had a good understanding of the different types of abuse and the procedures to follow if they felt that someone was at risk of harm. One person who used the service told us, "Staff treat me good".

The provider had undertaken the necessary checks when recruiting staff to ensure that they were suitable to provide support to people who used the service. Staff we spoke with told us that they had received an induction and training at the start of their employment.

The provider had effective systems in place to gain the views of people who used the service and acted upon any suggestions or concerns that had been raised.

We carried out this inspection visit because we had not visited for sometime and we did not have any recent information about the service. We needed to assess whether the service was meeting the essential standards of quality and safety.

Four people live in this bungalow that provides good facilities. We were told that all areas had been recently upgraded and redecorated. The home looked very bright, pleasant and comfortable.

Two people using the service showed us their bedrooms, clearly having some pride in ownership. All bedrooms are for single use and were exceptionally well personalised. People’s names were on bedroom doors together with many photographs and pictures and most with a ‘please knock and wait’ notice.

Care plans in pictorial form were in people’s bedrooms, giving them possession and also invovement in the plans as they were reviewed and changed. Staff were heard to ask if they could take them to update them during our visit.

Each person was keen to tell us about life at Dairy Close, what their interests were and how they spent their day.

We observed good sensitive, respectful and positive exchanges between staff and people using the service. People were asked before any actions were taken by staff, for example people were asked what they wanted for breakfast, whether they wanted a bath and what activity they would like for the day.

We spoke with a former carer of a person who does not have family visits. This carer had continued regular visits during the eight years the person had been at Dairy Close and told us that the person was “happier and healthier than in their previous placement”. They also said that staff were very supportive and interested in the person and had no complaints or concerns about how they were cared for.