Cypress Lodge 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. Cypress Lodge accommodates up to 10 people across two separate buildings located next door to each other. Each building has separate adapted facilities.

After our last Inspection in May 2017 we asked the provider to complete an improvement action plan. This was because we had identified shortfalls in two of our key questions. Is the service Safe? And Is the service Well Led?

At our last inspection in 2017 we had found that medicine administration systems that were in place were not fully safe. Improvements were needed to ensure people always received their medicines when they needed them and that medicines were stored correctly. Staff administered medicines to people; no one self-medicated.

We had also found at that inspection in that quality assurance systems were not fully effective in ensuring people received consistently high-quality care, that the service complied with the law or that necessary improvements were carried out.

The care service 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.

There was no registered manager at the time of our visit. The acting manager was in the process of applying to be registered with CQC. 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 home had a relaxed atmosphere and people were being supported by staff who knew them well. Although the impact of inspection could have been great on the senior staff they continued to be focused on people using the service and ensured that their plans and needs were addressed.

The staff leadership were intent on continuing to make progress that had commenced after the last inspection. Comments made indicated that there was a drive to develop the service and build on the skills and abilities of staff to successfully support people to develop their independence.

The premises were plain but functional and it was clear that both homes were lived in and well used by the people who occupied them. They were not clinically tidy but instead showed evidence of being peoples own space with some personal belongs in lounge areas such as games, magazines and drinks on side tables when people were watching television or chatting.

The staff had been on training about abuse and had the knowledge and insight to know how to keep people safe. This helped people to be supported to stay safe in their home and out in the community.

People felt well supported to have choice and control of their lives. The staff team supported people in positive ways. There were policies and systems to support the staff to do this effectively.

The principles of the Mental Capacity Act were implemented in the home. There were policies and systems in the home that supported the staff and people who lived there.

People were supported to have enough to eat and drink to maintain good health and wellbeing. People were encouraged to cook meals and snacks for themselves.

People were supported flexibly in ways that ensured their individual needs and preferences were met. Care plans were personalised and guided staff to provide care and support in the way people preferred.

Activities were planned with people in an individualised way. This was to reflect the interests wishes and choices

This inspection took place on 17 and 22 May 2017 and was unannounced. It was carried out by two adult social care inspectors.

Cypress Lodge provides support for up to 10 people with learning disabilities. There are two houses that can accommodate five people in each, Cypress lodge and Willow Cottage. At the time of the inspection there were five people living at Cypress Lodge and five people living at Willow Cottage.

At the time of the inspection there was no registered manager registered to manage the service. 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 registered manager left the service in December 2015 and a registered manager from one of the provider’s other homes was overseeing the home. The provider had appointed a service manager oversee the day to day running of the home and they reported directly to the acting registered manager.

People told us staff treated them well, however they did not always feel safe with the people they lived with. The acting manager and service manager were addressing these concerns.

Some improvements were required to ensure people always received their medicines when they needed them and that medicines were stored correctly. Risks to people were not always fully assessed or planned for.

There were quality assurance processes in place to monitor care and safety and plan on-going improvements. These processes were not fully effective in identifying the shortfalls we found during our inspection or ensuring improvements were always carried out.

The provider was not notifying us of all incidents and in line with their legal responsibility. Staff felt supported by the home’s managers, although they did not always feel listened to by senior managers.

People were supported by a sufficient number of staff to keep them safe. Staff had enough training to keep people safe and meet their needs.

People were supported by staff who know how to recognise and report abuse. People received effective support to help them manage their behaviour. Staff recruitment was managed safely.

Staff knew people well and understood their care and support needs. People made choices about their own lives and their legal rights in relation to decision making and restrictions were upheld.

People’s diverse needs were well supported; they chose a range of activities and trips out. People were part of their community and were encouraged to be as independent as they could be. People received support from a range of health and social care professionals.

People were aware of the complaints procedure and felt able to raise any concerns. There were systems in place to share information and seek people's views about their care and the running of the home.

There was a management structure in the home, which provided clear lines of responsibility and accountability. All staff worked hard to provide the best level of care possible to people. The aims of the service were defined and adopted by the staff team.

We found three breaches 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.