Coombe House provides accommodation and nursing care and treatment of disease, disorder or injury for up to 12 people with learning disability or autistic spectrum disorder. At the time of our inspection there were 12 people living in the home. At the last inspection, in November 2014, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive care in ways which helped them to remain as safe as possible. There was enough staff to provide support to people to meet their needs. The registered manager was in the process of recruiting additional staff, so people would have more opportunities to do things they enjoyed at the time which was right for them. People were protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff received training linked to the needs of people who lived at the home. People made day to day decisions about their care and staff sought people's consent before helping them. Support was available to people if they needed help making key decisions about their life. People were supported to stay well and had access to health care services and enjoyed their mealtime experiences.

People had built strong and caring relationships with the staff who supported them and were encouraged to make their own choices and maintain their independence. People were treated with dignity.

People and their relatives’ views and suggestions were listened to when their care planned. No complaints had been made since our previous inspection, however, systems were in place to promote and manage complaints. Relatives we spoke with knew how to raise any complaints or concerns.

People, their relatives and staff were encouraged to make any suggestions to improve the care provided and develop the home further. The registered manager worked with people, their relatives and other organisations in an open way so people would enjoy the best well-being possible. Regular checks were in place to assess and monitor the quality of the service.

Coombe House provides accommodation and nursing care and treatment of disease, disorder or injury for up to 12 people with learning disability or autistic spectrum disorder. At the time of our inspection there were 12 people living in the home. At the last inspection, in November 2014, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive care in ways which helped them to remain as safe as possible. There was enough staff to provide support to people to meet their needs. The registered manager was in the process of recruiting additional staff, so people would have more opportunities to do things they enjoyed at the time which was right for them. People were protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff received training linked to the needs of people who lived at the home. People made day to day decisions about their care and staff sought people's consent before helping them. Support was available to people if they needed help making key decisions about their life. People were supported to stay well and had access to health care services and enjoyed their mealtime experiences.

People had built strong and caring relationships with the staff who supported them and were encouraged to make their own choices and maintain their independence. People were treated with dignity.

People and their relatives’ views and suggestions were listened to when their care planned. No complaints had been made since our previous inspection, however, systems were in place to promote and manage complaints. Relatives we spoke with knew how to raise any complaints or concerns.

People, their relatives and staff were encouraged to make any suggestions to improve the care provided and develop the home further. The registered manager worked with people, their relatives and other organisations in an open way so people would enjoy the best well-being possible. Regular checks were in place to assess and monitor the quality of the service.

We were unable to speak with the people that lived at Coombe House due to the complexity of their health needs. We spoke with four staff, the registered manager and four relatives of a people who lived there. We also observed how staff cared for people.

We looked at care plans for four of the people who lived at the home. They covered a range of needs and had been reviewed regularly to ensure that staff had up to date information. There were also detailed assessments about the person's health so that staff could support people to keep healthy and well. All the staff we spoke with had knowledge of the needs of the people who lived there.

People who lived at the home were supported to make choices around the care they received. A relative told us: “They (staff) are always so good at giving people choice”.

We saw that staff helped and supported people. We saw that people received care that met their individual needs.

We found that medicines had been appropriately stored and administered.

People lived in a clean environment and the provider had reduced the risk of the spread of infection.

We were not able to speak with most people during our inspection of the home because they were not able to communicate with us in a meaningful way. We observed how care workers interacted with people. People responded in a positive way to care workers suggestions.

We saw a variety of activities for people to get involved in that were focussed on individual needs as well as group activities.

Care workers were visible throughout our inspection and were on hand to provide care and support to people. We saw care workers consistently supporting and providing comfort and positive interaction. We found people were supported to move around the home. We observed a variety of personal interaction such as music, light therapy, baking and conversation. We found care workers respected people as individuals and knew a lot about their personal preferences.

People’s changing needs were regularly assessed and reviewed with the delivery of care in line with any amendments to care plans.

People were safeguarded as the provider had taken steps to ensure any potential instances of abuse could be identified and reported. Care staff we spoke to told us they felt supported by the manager and provider to take the appropriate action where required.

The provider had a system in place to make sure care workers had the required levels of training to meet people’s individual care needs. Care workers told us they assisted people who had communication difficulties in making a complaint

We carried out this review to check on the care and welfare of people who used this service. When we visited the home we met people who lived there, staff on duty, the deputy manager and the registered manager.

Many of the people who lived at Coombe House were not able to tell us much about their experience at the home due to their communication difficulties. We pathway tracked the care of three people and looked at how their care was provided and managed.

We saw that staff at Coombe House looked after people well and wrote down what help everyone needed. Staff said they were trained to help them understand how to meet people’s needs and give the support they needed.

We saw that staff interacted with people who used the service in a friendly, courteous and respectful manner. Staff demonstrated they were aware of people’s care and support needs.

We saw that people were very relaxed and at ease with staff and within their home environment. The atmosphere was calm and homely and the home was clean and tidy.

Staff told us they worked well as a team and that they received support from the registered manager.

We found that people who lived at Coombe House received effective, safe and appropriate care, treatment and support that met their needs.

Annual reviews had been carried out to obtain the views of people who used the service, other stakeholders, staff and people involved with providing care for people at Coombe House. These reviews recognised achievements and identified where improvements were needed in a formal, structured way.