The inspection took place on 2 March, 2017 and was announced. As this is a very small service, and people regularly go out into the community, we announced the inspection shortly before the visit to make sure someone would be available at the home to assist in the inspection. This was the first inspection at the home since Community Integrated Care became the provider.

Clarence Gardens is a registered care home providing 24 hour respite support for up to four adults with a learning disability and/or physical disability, for a maximum of 56 days in one calendar year.

The service had a registered manager in post at the time of our inspection. 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 were protected from abuse and avoidable harm. We spoke with staff who knew the process for reporting any safeguarding concerns. They all felt the registered manager would take appropriate action without delay.

Risks associated with people’s care were identified and actions put in place to help minimise the risk from occurring. This was done in a way that maintained people’s independence.

We found that medicines were managed in a safe way and people received their medicines as prescribed. Staff were trained in the safe handling of medication and had annual competency checks to ensure their skills were kept up to date.

Through our observations and talking with relatives of people who used the service and the staff, we found there were enough staff to meet people’s needs. Staff had access to a manager who was on call out of hours.

Staff had the knowledge and skills to respond to people in an appropriate manner and ensured that people’s needs were met. Staff received training in a range of subjects including mandatory training and appropriate training to meet people's specific health needs. Staff felt fully supported to do their job well and received one to one sessions with their line manager on a regular basis.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff confirmed that they had received training in this area and were knowledgeable about the subject. The registered manager knew the process for applying for DoLS.

We saw that meals were provided in line with people’s likes and dislikes. We saw fresh fruit and vegetables were on offer at the service.

We saw that guests had access to healthcare while staying at Clarence Gardens. We saw guests had access to district nurses, dieticians and attended pre-planned appointments.

Guest’s stays were based on the compatibility of others so that people stayed with guests who were interested in similar things. This also offered guests the correct environment to help them develop and maintain positive relationships.

Staff ensured that people’s privacy and dignity was maintained. They were able to talk with us about how they achieved this.

Staff engaged well with guests and gave opportunities for them to fulfil their dreams and wishes.

We looked at care records belonging to guests and found they reflected the support people required and the support staff were offering. Prior to guests using the service an admittance review was completed to ascertain if there were any changes to the care plan, risk assessment or medication.

We saw a range of in-depth care plans were in place for each guest in regard to personal care, mental capacity, communication, nutritional needs and health care. The care plans clearly set out how to support each guest.

The service had a procedure in place for dealing with complaints and we saw that these were effectively resolved in a timely way.

Staff we spoke with felt supported by t