The inspection was carried out on 31 August 2017. The inspection visit was announced as it was a small service and people at the service were often out. We wanted to be sure someone would be available to host our visit.

Coriander Road is registered to provide accommodation and personal care for up to four people with learning disabilities. On the day of our inspection there were three people using the service.

At the last Care Quality Commission (CQC) inspection on 2 September 2015, the service was rated Good in all domains.

At this inspection we found the service remained Good.

People were protected from harm and staff were clear of their role to keep people safe and protect them from harm. There were enough staff to meet people’s needs. The provider followed safe recruitment practices.

Risks associated with people’s care needs and the environment had been assessed and measures put in place to prevent avoidable harm.

People received their medicines as required and medicines were managed and administered safely.

Staff had received training, support and guidance to meet the needs of the people who used the service.

People were supported in line with the requirements of the Mental Capacity Act. People’s mental capacity to consent to their care had been assessed where there was a reasonable belief that they may not be able to make a specific decision.

Systems were in place to monitor the health and wellbeing of people who used the service. People’s health needs were met and when necessary, outside health professionals were contacted for support. People were supported to have enough to eat and drink. Where people had dietary requirements, these were met and staff understood how to provide these.

Staff had a clear understanding of their role and how to support people who used the service as individuals. Staff knew people well and treated them with kindness and compassion. People’s dignity was maintained and promoted.

People’s independence was promoted. Staff communicated with people in a way that maximised their understanding and aided them to make choices.

People were supported to follow their interests and engage in activities that they enjoyed and were meaningful to them.

Staff felt supported by the registered manager. The registered manager supervised staff and regularly checked their competency to carry out their role.

There were a range of audit systems in place to measure the quality and care delivered so that improvements could be made.

The registered manager was aware of their responsibility to report events that occurred within the service to CQC and external agencies.

This inspection took place on 2 September 2015 and was unannounced.

Coriander Road is registered to provide residential care and support for four people with a learning disability who present behaviours which challenge us and may in addition be diagnosed with autism. At the time of our inspection there were three people using the service.

The service comprises of two semi-detached properties, with inter connecting doors. Each house has a lounge, kitchen diner and bedrooms, with the lounge providing access to the rear garden.

Coriander Road 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 2008 and associated Regulations about how the service is run.

Staff told us that training helped them to understand the needs of people, which includes their right to make decisions about their day to day lives. Staff were confident that if they had any concerns about people’s safety, health or welfare then they knew what action to take, which would include reporting their concerns to the registered manager or to an external agency.

People were supported by knowledgeable staff that had a good understanding as to people’s needs. Staff provided tailored individual support to keep people safe and to provide support when their behaviour became challenging.

People received their medicines in a timely manner and the medicine they were prescribed was regularly reviewed by a doctor.

People were protected under the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). We found DoLS to be in place for two people. We found that mental capacity assessments had been carried out for key aspects of people’s care.

People were supported to have sufficient to eat and drink and recommendations from health care professionals were followed. People were supported to access a range of health care appointments by staff to ensure their health was monitored and maintained.

Plans of care contained information as to the support and care people required to meet their needs. Staff met with people and other interested parties to review and update plans of care to ensure that people’s needs were responsively met and changes to people’s needs identified.

The attitude of the registered manager and staff showed they were enthusiastic about their work and committed to providing the best possible care for all those who used the service. All were aware of each person’s individual needs. Staff appeared caring and friendly and talked about their work and were well informed about those using the service. The role of staff included raising concerns on behalf of those using the service who were not able to raise concerns themselves.

There were effective systems in place for the maintenance of the building and equipment which ensured people lived in an environment that was well maintained and safe. Audits and checks were effectively used to ensure people’s safety and needs were being met, as well as improvements being made as required. People’s representatives and staff had the opportunity to influence the service which enabled the provider to review and develop the service.

We did not speak with people who used the service as part of this follow up inspection. Please see our previous reports for details of people's experiences of the service.

Our inspection of 23 September 2013 found that people were not always protected against the risks associated with medicines. At this inspection we found that sufficient improvements had been made to achieve compliance with the regulation.

We did not speak with people who used the service as part of this inspection. Please see out previous report for details of people's experiences of this service.

Our inspection of 23 May 2013 found that people were not protected against the risks associated with the unsafe use and management of medicines. This was because the home had not kept complete records about the amount of medication that was kept on the premises.

At this inspection we found the service had taken action to record the amount of medication. However we found discrepancies within these records. In addition, we found that a medication error had not been dealt with appropriately. This meant that people were not protected from the risks associated with medicines

We were unable to speak with people who used the service as part of our inspection. This was because three people were out of the home participating in activities when we visited. One person was at home during the morning; however we were unable to communicate with them due to their complex needs.

We did speak with the relative of one person who used the service. They told us ““they make sure [the persons’] got a good life”.

We spoke with a support worker and found they had a good understanding of the needs of people who used the service and were enthusiastic about their role.

We looked at the support plans and records of two people who used the service and found support plans were detailed and thorough and provided clear guidance to staff about how the persons’ care should be delivered. Staff were aware of consent and capacity issues which meant that people’s legal rights were upheld.

People were not protected against the risks associated with the unsafe use and management of medicines. This was because the home had not kept complete records about the amount of medication that was kept on the premises.

Staff had been appropriately screened to ensure they were suitable to work with vulnerable people and received training appropriate for their role.

Records were stored securely and could be located promptly when required.

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Our inspection of 9 July 2012 found that the service did not have an effective system in place to assess and monitor the quality of service that people received. Although issues and concerns about the service were being identified as part of the quality assurance process, they were not always being acted on and resolved in a timely manner.

Please see our previous report for further details and for information on people's experiences of using the service.

At this inspection we found that the provider had made the necessary improvements to become compliant with this standard.

People using the service were not able to tell us about their experiences directly because they had complex needs.

We gathered evidence of people’s experiences of the service by reviewing comments made by family and friends in a recent survey. Comments included, “ I would say that the people who support her work really hard to help her to have a good life” and, “ my son is happy living at Coriander Road and is treated with respect at all times”.

We were unable to communicate with people using the service; however, from brief observations we noticed that people seemed confident and happy with staff.