This inspection took place on 1 and 7 August 2017. The first day was unannounced. Cloverdale House is registered to provide care and accommodation to 11 people. There were nine people living there when we inspected. People cared for were all younger adults. Most people were living with autistic spectrum conditions. Some people had other care needs, including learning disability and epilepsy. Some people needed support with behaviours which may challenge.

Cloverdale House is situated on a quiet residential road in Hove. Accommodation is provided over several floors; there were communal rooms on the ground floor.

Cloverdale House was last inspected on 24 May 2016. At that inspection, they were rated as requiring improvement. The provider was also not meeting the requirements of Regulation 12 of the HSCA 2008 (Regulated Activities) Regulations 2014. By this inspection, the provider had taken action and had fully addressed the Regulation.

A registered manager had been appointed since the last 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. The provider for Cloverdale House is Aitch Care Homes (London) Limited, who provide similar services across a range of areas in the south and east of England.

At the last inspection, people's medicines were not managed so that they received them properly and safely. The provider had addressed this. There were effective systems to ensure people received their medicines. Medicines were stored safely and full records kept. Staff understood their responsibilities for supporting people with taking their medicines.

People’s risk was assessed and where risk was identified, they had a care plan drawn up to reduce their risk. Staff followed care plans when supporting people. Staff followed procedures to protect people from risk in the general environment, including fire safety.

Staffing levels had improved and people told us the staff team was now stable. This meant people had improved opportunities to decide how they wanted to spend their days, as well as ensuring their safety. Newly appointed staff had been recruited appropriately to ensure they were safe to work with people.

Staff understood their responsibilities for safeguarding people from risk of abuse. Where people lacked mental capacity appropriate procedures were followed, in accordance with the Mental Capacity Act 2005 (MCA). Where people were subject to a Deprivation of Liberties (DoLS) safeguard, staff were aware of actions to take.

Staff showed a caring, respectful attitude to people. Staff encouraged people’s independence and helped them to make choices. People were supported in engaging with life in the home and the local area, as well as with their families. People were encouraged to choose what they wanted to eat and drink and were supported with healthy choices in eating and drinking.

People were involved in drawing up plans about their care. Staff followed these care plans. Staff supported the people who were living with behaviours which may challenge in an appropriate and supportive way. Where people had additional care needs, including medical needs, people had clear care plans and there was evidence of regular liaison with external healthcare professionals.

Staff were trained in meeting people’s needs. Staff said the registered manager had further developed ways of supporting them in their role, including by supervision.

People could raise concerns and complaints with managers. The provider’s quality audit systems ensured where matters were identified action was taken to ensure people’s safety and well-being.

We inspected Cloverdale House on the 24 and 25 May 2016. The inspection was unannounced.

Cloverdale House is registered to provide personal care and support for a maximum of 11 adults with learning disabilities and additional complex needs such as autism, epilepsy and behaviours that challenge. Accommodation is provided over three floors and consists of ten single rooms with ensuite facilities and one bed sitting room with an ensuite wet room. Cloverdale House is an older style building close to the seafront, town centre shops and amenities with transport links close by. On the day of our inspection there were 10 people living at the service with a variety of complex learning disability and physical needs requiring high levels of supervision and support in order to live full and active lives.

The service was last inspected on 24 April 2015 and some concerns were identified. We found one breach of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 where staff did not have the required levels of skill and knowledge to assess or meet the needs of people. The provider was asked to submit an action plan to address this and we looked at the effectiveness of this action plan as part of this inspection. At this inspection We found that improvements had been made in the required area. However we identified a further breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Cloverdale House requires 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. The service had not had a registered manager in post since February 2016, however, there was a newly appointed manager who had submitted their application to become registered manager and their application was in progress.

People did not always receive their medicines as prescribed. The safe management of medicines was not always consistent and there were times when there was no suitably trained staff available to administer ‘as required’ medicines. This was identified as a breach of regulation.

There were individual risk assessments in place and management plans to reduce risk had been reviewed. Support plans were personalised and there was detailed guidance for staff on how to support people. However, staff did not consistently follow the guidance given in the support plans which could put people at risk of harm and this is an area that needs improvement.

Staffing levels were not always maintained. The provider had calculated the number of staff required on a daily basis but rotas demonstrated, and staff told us, that these staffing levels were not always achieved and this is an area that needs improvement.

Staff had received training in safeguarding adults and had a good understanding of their role in keeping people safe, how to recognise abuse and report any concerns. Recruitment practices were robust and ensured that any staff employed were safe to work with people.

One person told us they had, “No problems with safety.” The environment and equipment were subject to regular checks, there was an emergency plan in place to include detailed Personal Emergency Evacuation Plans (PEEPs). Accidents and incidents reports were reviewed and there was a system in place to monitor and track actions taken to reduce risk of recurrence.

There was a training matrix in place and staff had received training specific to the needs of people for example catheter care and epilepsy awareness. Induction training had been subject to review and improved. Staff received regular supervision from senior members of the team.

People said they enjoyed the

We inspected Cloverdale House on 17 April 2015. This was an unannounced inspection. Cloverdale House is a care home providing social and residential care for 11 young people with learning disabilities and additional diverse and complex support needs, including autism, epilepsy, Downs Syndrome, mental health issues and behaviour that may challenge others. On the day of our inspection there were 11 people living in the home, who required varying levels of support.

The service supported people with diverse conditions, personalities and often complex care and support needs.There was a high turnover of managers and staff which had resulted in some inconsistency in the level of individual support provided. People received care from staff who were not always appropriately trained or confident to meet their individual needs. People were not always compatible with one another and often expressed behaviour which challenged others and created tensions within the service.

There has been no registered manager in post since December 2014. An acting manager, who was experienced and knowledgeable in the care of people with learning disabilities, had recently been appointed in December 2014. They confirmed that their application to register with CQC was currently being processed. 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 2008and associated Regulations about how the service is run.

People’s needs were assessed and their care plans provided staff with clear guidance about how they wanted their individual needs met. Care plans we looked at were person centred and contained appropriate risk assessments. However the plans were disorganised and the lack of structure meant that information was not always readily accessible. They were regularly reviewed and amended as necessary to ensure they reflected people’s changing support needs.

There were procedures in place to keep people safe and there were sufficient staff on duty to meet people’s needs.Staff told us they had completed training in safe working practices. However we had concerns that some staff lacked the necessary skills and knowledge to meet people’s diverse care and support needs. We saw people were supported with patience, consideration and kindness and their privacy and dignity was respected.

Safe recruitment procedures were followed and appropriate pre-employment checks had been made including written references, Disclosure and Barring Service (DBS) checks, and evidence of identity had also been obtained.

Medicines were stored and administered safely and handled by staff who had received appropriate training to help ensure safe practice.

People’s nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where risks to people had been identified, these had been appropriately monitored and referrals made to relevant professionals, where necessary.

Staff received Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) training to make sure they knew how to protect people’s rights. The manager told us that to ensure the service acted in people’s best interests, they maintained regular contact with social workers, health professionals, relatives and advocates. Following individual assessments, the manager had recently made DOLs applications to the local Authority, for 10 people, and was awaiting responses.

Activities reflected people’s individual interests and preferences. We saw people were enabled and supported to access facilities and amenities in the local community.

There was a formal complaints process. The provider recognised not all people could necessarily raise formal complaints and their feedback was sought through other means, including regular involvement with their keyworker. People were encouraged and supported to express their views about their care and staff were responsive to their comments.

The organisation’s values were embedded within the service and staff practice. The manager told us they monitored awareness and understanding of the culture of the service by observation, discussion and working alongside staff. Staff said they were encouraged to question practice and changes had taken place as a result.

The manager assessed and monitored the quality of service provision through regular audits, including health and safety and medication. Satisfaction questionnaires were used to obtain the views of people who lived in the home, their relatives and other stakeholders.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of this report.