This inspection was unannounced and carried out on 14 September 2016. Curlew Close is a residential care home providing individualised support for people with a learning disability. At the time of our inspection there were four people using the service.

There was 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment.

People were receiving effective care and support. Staff received training which was relevant to their role. Staff received regular supervisions and appraisals. The service was adhering to the principles of the Mental Capacity Act 2005 (MCA) and where required the Deprivation of Liberty Safeguards (DoLS).

Staff told us there was an open culture and the environment was an enjoyable place to work. Staff were extremely passionate about their job roles and felt integral to the process of providing effective care to people. Family members said the management team were approachable.

The service was caring. We observed staff supporting people in a caring and patient way. Staff knew the people they supported well and were able to describe what they like to do and how they like to be supported. People were supported sensitively with an emphasis on promoting their rights to privacy, dignity, choice and independence. People were supported to undertake meaningful activities, which reflected their interests.

The service was responsive to people’s needs. Care plans were person centred to provide consistent, high quality care and support. Daily records were detailed and recorded every hour throughout the day.

The service was well led. Quality assurance checks and audits were occurring regularly and identified actions to improve the service. Staff, relatives and other professionals spoke positively about the registered manager.

An adult social care 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?

As part of this inspection we spoke with two people who use the service, two visitors, the registered manager and two care staff. We also reviewed records relating to the management of the home which included two care plans, daily care records, training records and quality monitoring records.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

The service was safe because staff had been trained to recognise and act on safeguarding concerns. As some people could not tell staff if they did not feel safe, staff monitored people’s behaviour to alert them to concerns. This meant safeguarding concerns were acted on in a timely fashion to keep people safe.

The service had used risk assessments to inform their support plans. Where possible, risks were addressed without limiting people’s freedom and independence. Support plans clearly identified how staff should provide care and strategies to avoid anxiety and distress for the person concerned. This ensured staff had comprehensive and consistent guidance to follow when supporting people.

We found the premises were clean, tidy and safe. Staff told us maintenance requests were responded to quickly. The registered manager undertook regular spot checks on the state of the premises to ensure people were not put at risk.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. Consideration of DoLS principles was reflected in people’s care plans. Relevant staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

Staff had current training in topics identified as mandatory by the provider. This included safeguarding, health and safety, fire and first aid. Training specific to the needs of the people living at the home was also provided. Staff were supported to be effective through regular meetings with the registered manager to discuss their needs and progress.

The service was effective because each person had a health action plan that helped staff to ensure their health needs were addressed. These documents were regularly updated. We saw appointment records that showed people had regular access to health and social care professionals.

Is the service caring?

We spoke with two people about the care and support they received at Curlew Close. One person told us “happy here” and another person said “I like staff”. We spoke with two relatives and one described the staff as “brilliant” and went on to say “they are all so caring up there”. Another relative was pleased the person was “out and about a lot which is what they like”. They also said the staff team was stable so staff knew people well and they were getting better at quickly spotting when their relative was unwell.

During our inspection we saw staff communicating with people in a respectful and caring way. People smiled and laughed when they interacted with staff. Wherever possible people were asked for their permission before care and support was provided. Where they were not able to give permission the appropriate steps were taken to ensure their best interests were being met. Staff were helped to do this as support plans contained information on assisting people to make decisions.

Is the service responsive?

People’s care plans contained information on their preferences and priorities. The service was responsive because these plans were reviewed at least every two months with people to ensure changes were recorded and care adapted. Staff we spoke with were knowledgeable about people’s preferences and respected their wishes.

Although there was a complaints procedure in place, staff had identified it was also necessary to ask people regularly how they felt about the service as most people could not complete a complaint form independently. One relative told us “they respond to comments immediately…when we have a problem we have a meeting and sort it out”. This showed the service responded to feedback.

Is the service well led?

The staff told us they felt the registered manager listened to them and acted on their suggestions. They felt they received good support and direction. From discussions with the registered manager it was clear that she was routinely reviewing practice and implementing learning to improve the support provided.

The service was well led because the manager regularly undertook audits to check the quality of the service being provided. She then acted on the outcomes of these audits in a timely fashion.

We spoke with two people living at the home and observed the care provided to the other two people. We also reviewed two sets of care records. We had the opportunity to speak with two members of staff in addition to the service manager.

People were involved in decisions about their care. Staff were knowledgeable about each person living at the home and care was provided in line with their care plans. The care plans were comprehensive and user friendly. People told us that they felt safe at the home and indicated that they were happy there. We observed positive interactions between staff and people living at the home.

Staff told us that they felt well supported and had access to training that was "second to none". There were robust systems in place to monitor quality across the service and ensure that actions were completed.

We spent time in the communal areas of the home observing what life was like in the home. We also spoke with people about their experiences. We contacted one relative to get their opinion of the support provided by the service.

People told us they were happy living in the home. One relative told us that their relative "is happy enough". People seemed to be engaged in a range of activities and staff were working to make more activities available following advice from the community learning disability team. Staff were supportive and helped people to be as independent as possible. People had goals that they were working towards. Care plans were kept current and provided staff with sufficient information to support people effectively.

People had a choice about what they ate and drank. One person told us "I choose my food". Staff supported everyone to be as independent as possible around food and drink preparation. People with specific dietary requirements were being catered for and guidance from professionals was being followed. Consideration was given to helping people have a healthy and balanced diet.

Medication was being appropriately handled. We found that medication record keeping was accurate and records were being reliably completed. Staff had access to the information they needed and training to support them administer medication. The registered manager told us that she would review the procedure for storing the medication cabinet key to improve security.