We carried out this inspection on 30 June 2017.

Downing Close provides care for a maximum of eight people across two bungalows. At the time of our inspection there were six people who lived at the service. These people were adults with learning disabilities. At our last inspection in January 2015, the service was rated good. At this inspection we found the service remained good.

The service had a registered manager. 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 had been registered since July 2015.

Care plans contained information for staff to help them provide personalised care and reflected people’s care needs. People and families were involved in reviews of the care provided with staff and other professionals involved in supporting people.

Relatives told us people were safe living at the home. Staff had a good understanding of what constituted abuse and knew what actions to take if they had any concerns. Staff were effective in identifying risks to people’s safety and in managing these risks.

There were enough staff to care for the people they supported. Checks were carried out prior to staff starting work to reduce the risks of unsuitable staff working at the service. Staff received a comprehensive induction into the organisation, and a programme of training to support them in meeting people’s needs effectively.

People and relatives told us staff were caring and had the right skills and experience to provide the care required. People were supported with dignity and respect and given choices in relation to how they spent their time. Staff encouraged people to be as independent as possible.

People received their medicines from trained staff, and medicines were administered safely. Manager’s ensured staff remained competent to do this.

Staff understood the principles of the Mental Capacity Act (2005) and how to support people with decision making. The registered manager had arranged for the correct assessments if they felt people were being deprived of their liberty.

People were supported with their nutritional needs and were involved in preparing meals where possible. People were assisted to manage their health needs, and staff referred them to health professionals when required.

People had enough social activities to keep them occupied with day trips out and holidays, and staff supported people with their individual interests.

Relatives and staff were positive about the management of the service. Staff told us they could raise any concerns or issues with the management team, who were approachable and responsive. There were formal opportunities for staff to do this at meetings and one to ones. Relatives knew how to complain and felt able to raise any concerns about the service.

There were processes to monitor the quality of the service provided. There were other checks which ensured staff worked in line with policies and procedures. Checks of the environment were completed and staff knew the correct procedures to take in an emergency.

Further information is in the detailed findings below:

This inspection took place on 5 January 2015. It was an unannounced inspection.

Downing Close provides accommodation with personal care for up to eight people. The accommodation is in two adjacent houses situated within a group of NHS community service buildings. At the time of our visit there were three people living in each house.

The home has a registered manager. 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 care provided at Downing Close is in small ‘family’ units. Staff were respectful of being in people’s homes and the relaxed support they provided complemented the home environment. We saw people responded positively when approached by staff. One member of staff told us, “I love it. I wouldn’t want to work anywhere else.”

People living at Downing Close had little or no verbal communication. Staff demonstrated a good understanding of their responsibility to be observant for non-verbal signs that a person was unhappy or concerned. Staff told us that if they thought the signs were an indicator of potential abuse, they would have no hesitation in reporting their concerns to the management team.

There were sufficient numbers of staff on duty to meet people’s needs and keep them safe both at home and out in the community. Staff had received training that supported them to meet the specific needs of the people living in the home. Staff told us they felt supported in their role and were confident to make suggestions about how the quality of service provided could be improved.

The provider was meeting the requirements set out in the Deprivation of Liberty Safeguards (DoLS). Where potential restrictions on people’s liberty had been identified such as being unable to leave the home unsupervised, the appropriate applications had been made to the local authority.

Care records provided clear and up to date information for staff to follow so they could assist people with the care and support they needed in a way people preferred. Staff worked with external healthcare providers such as psychologists to develop guidelines to support people’s mental health and manage any challenging behaviours. People’s medication was well managed so they received their medicines as prescribed.

People living in the home took part in various activities so they had an interesting and meaningful lifestyle. People were encouraged and supported to maintain relationships with family and within the wider community.

We visited Downing Close on 4 July 2013. There were seven people living in the home at the time of this visit. We spoke with one of the people living there, three staff members and a visiting relative. We spent time observing the interactions between people and the staff. We saw staff treated people kindly and with respect. Staff understood people’s communication and responded to what people wanted.

A visiting relative to Downing Close told us, “The home is wonderful. The first time X was happy for years when they came here. I’m very happy with the attention and care X receives. It’s the best home they have been in.” Records showed appointments with health professionals such as opticians, chiropodists, dentists and doctors were made for people at regular intervals.

Care plans showed risks associated with the care of people were assessed and reviewed so staff knew how to support people to remain safe and well. The visiting relative said, "This is the only home where I've felt peace of mind for X. I've never had to raise any concerns. They've always been fair and straightforward."

New staff received an induction which included mandatory training. A member of staff told us, "It is a lovely house and the clients are lovely to support. It's a nice environment to work in and the staff team support each other well."

Records relating to both people and staff were up to date and well ordered.

We carried out this inspection to check on the care and welfare of people using the service. We visited Downing Close on 19 July 2012. There were seven people living in the home at the time of this visit. No one knew we would be visiting. We spoke to one of the people who lived there, two staff members and the manager. We spent time observing how people were supported by staff. We looked at the records of three of the people who lived there and sampled staff records.

Both houses were clean and well maintained. Each person had their own bedroom. People were dressed individually and support had been given to their personal care. Guidelines were in place to assist staff in supporting people to make decisions.

Care plans were detailed and contained risk assessments to ensure care was delivered as safely as possible.

There were sufficient numbers of staff to support the people who lived at Downing Close. A lack of permanent staff members over recent months meant the service had had to rely on both bank and agency staff. Approval had been given to recruit new staff and appointments were being made. Current staff were supported in their role with regular training.

People's medication was administered safely and in the way prescribed.

People who lived at Downing Close and those important to them were asked for their views. Regular audits monitored the quality of the service provided.

When we visited the service on 18 November 2011 we saw that people were comfortably housed in ordinary residential property and well groomed with support workers around them at all times. People were taken out by support workers during the day and encouraged to make choices and decisions about how their day was run. We asked one person if they were happy and well. They gave us the 'thumbs up' sign.