This inspection took place on the 20 November 2018 and was unannounced. 8 Corainder Close is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. 8 Corainder Close is registered for five people with learning difficulties and physical disabilities. On the day of our inspection, five people were living at the service.

At the last inspection on 10 June 2016 the service was rated good. At this inspection the provider and registered manager had maintained this good rating. Historically the home has a sustained a history of compliance with legal requirements.

The home has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. People living at 8 Corainder Close could live a life as fully as they were able in a homely environment that had been created to meet their needs.

On the day of our inspection there was a registered manager in post who was available throughout the 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 was run.

People living at the service were protected from the risk of harm because the provider had processes in place to ensure their safety. Staff all knew and understood their responsibilities in relation to protecting people from abuse and had had received the training they needed to support their understanding of safeguarding adults. The registered manager had fulfilled their legal responsibilities and had reported any issues to the local safeguarding teams and CQC.

People were supported by enough well trained and competent staff who knew them extremely well. The registered manager followed robust recruitment checks to ensure that staff employed were suitable to support people using the service with all aspects of their care. People’s medication was managed safely and people were protected from the risk of infection.

People’s needs were assessed and there was clear guidance available for staff about how to meet people’s needs. This meant that staff could gain an excellent knowledge and understanding of an individual’s needs and how to provide effective support to people. Staff were supported with appropriate training for their roles.

Staff sought consent from people before caring for them and they clearly understood and followed the principles of the Mental Capacity Act, 2005 (MCA). Where people were deprived of their liberty processes had been followed to ensure that this was done lawfully. Staff understood people’s unique communication styles and ensured that the views of people with communication difficulties were captured and acted upon.

The service was extremely person-centred and staff were passionate about caring for people. We saw that without exception people at the service and relatives were treated with kindness by a staff team that were committed to providing care to people who they considered to be like family members. Staff supported people with respect and dignity, and had developed some extremely positive relationships with people.

People received care that met their individual needs, people’s views and preferences were sought and staff made exceptional efforts to provide a service that empowered people to develop and live a life that they enjoyed.

Information about people’s care was provided in formats that were accessible to people so that they could unde

This inspection took place on 11 May 2016 and was unannounced. When we last inspected this home in May 2014 we found it compliant with all the regulations we looked at.

Coriander Close is a residential home which provides support to people who have learning disabilities. The home is registered with the Commission to provide care for up to five people. At the time of our inspection there were five people living at the home. There was a registered manager at this location. 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.

People who used the service and their relatives told us that the home was safe. Staff were aware of the need to keep people safe and the provider conducted checks to ensure people were supported by staff who were suitable.

The storage, administration and recording of medication was good and there were robust systems for checking that medication had been administered in the correct way.

We saw that people were obviously happy around staff and with the support they were receiving. People had opportunities to participate in a range of activities staff knew they enjoyed.

People were supported to maintain relationships which were important to them.

People were supported to express their preferences and decisions about their care were taken by those who had the legal right to do so. When the support people received risked restricting their freedom, the registered manager had supported people in line with the appropriate legislation.

Staff were appropriately trained, skilled and supervised and they received opportunities to further develop their skills.

People were supported to have their mental and physical healthcare needs met and were encouraged to maintain a healthy lifestyle. The registered manager sought and took advice from relevant health professionals when needed.

People were provided with a good choice of food in sufficient quantities and were supported to eat meals which met their nutritional needs and personal preferences.

Staff understood the needs of the people they supported and the importance of providing care which was person centred. We saw that staff communicated well with each other and spoke highly of the manager and leadership they received.

The manager assessed and monitored the quality of care consistently through regular audits of events and practice.

One inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. People who lived there were not able to communicate verbally and so we spent time speaking with relatives and staff, reviewing records and observing people in the home.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People were cared for in an environment that was safe, clean and hygienic. Equipment at the home had been well maintained and serviced regularly. There were enough staff on duty to meet the needs of the people who lived at the home and a member of the management team was available on call in case of emergencies. A family member said, "[My relative] is very well cared for and I am very, very pleased with their care."

Staff records demonstrated that mandatory training was up to date and that staff were trained sufficiently to meet the complex needs of people who lived there. Staff were trained in caring for people with dysphasia, epilepsy, complex communication needs and learning disabilities.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

A relative told us that staff had managed their family member's condition well and that they were also happy with the level of support shown to them during visits. It was clear from our observations and from speaking with staff that they had a good understanding of people's care and support needs and that they knew them well. People were cared for by staff who were supported to deliver care safely and to an appropriate standard. Staff had received training to meet the needs of the people living at the home and told us that they were able to put their training into practice.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. Staff took into account the complex needs of people when planning activities so that they could take part safely. We found that staff had learned to interpret the needs and wishes of people by studying non-verbal communication methods and taking into account the advice of family members and medical professionals. Staff said that they were very happy with the level of professional and emotional support they received from the manager.

Is the service responsive?

People's needs had been assessed before they moved into the home and these were enhanced by the regular review of needs assessments and when needed the prompt setting up of an urgent medication plan when people moved in. People's preferences and interests were acted on by staff who used communication tools provided by involved health professionals to understand non-verbal communication. People had access to activities that were designed to stimulate them and help them to achieve personal goals such as the provision of a specialist sensory room to help them relax. We found that care was delivered using individual health action plans which helped people to make progress towards personal goals such as to maintain good health.

Is the service well led?

Staff had a good understanding of the ethos of the home and robust quality assurance processes were in place. A relative told us that the manager was friendly and had improved the quality of care significantly. Food was prepared freshly on site by staff who were trained to be able to meet the complex nutritional needs of people. Some people who lived there were given nutrition through feeding tubes, which staff had been trained to use. Staff told us that they were clear about their roles and responsibilities and that management support was of a high standard and helped them to do their job effectively.

People could not tell us their experience of the service because of their complex needs and conditions. We spent two hours in the communal areas of the home observing how people were cared for. We found that people were positively engaged with their surroundings and the people around them. People's needs were assessed to establish the care that they needed and care was planned and delivered in line with their individual care plan.

People were protected from the risks of inadequate nutrition and dehydration. Associated risks had been identified and assessed and a plan put in place to manage them. People were provided with a choice of suitable and nutritious food and drink. We found that people were supported by staff with dignity and sensitivity to take meals and drinks.

We found that the provider worked in co-operation with others when more than one provider was involved in a person's care and treatment. There were clear procedures for transferring people's care to another provider safely. The home worked closely with the local Community Learning Disability Team, District Nurses and any day services that people regularly attended.

The provider had a statement of purpose for the service that set out what it offered. This was kept under review and a recently updated copy given to the Care Quality Commission. We found that the service being delivered to people was consistent with what the statement of purpose offered.

We visited the service on 9 May 2012. People we spoke with were not able to tell us about their experience of living at the home because of their complex needs. We used a number of different methods to help us understand the experiences of people using the service. We spent three hours in the communal areas of the home observing how people were supported and cared for. We saw and heard workers and managers treat people with respect and dignity.

We met three of the people who lived in the home on the day of our visit. They each looked well cared for. Each person looked at ease with workers and managers and engaged in what was going on.