Essex Care Consortium provides accommodation and personal care for up to 20 people who have a learning disability and may also have autistic spectrum disorder. On the day of our inspection there were 16 people living in the service which is divided into 2 separate houses accommodating between 6 to 10 people in each home supported by their own staff team.

When we last inspected the service in April 2016, we had concerns and found the service to be in breach of several regulations these are referred to throughout the report. We had therefore asked the provider to send us an action plan detailing how they were going to ensure they were meeting the outlined regulations.

The provider had sent us a detailed action plan. Therefore part of this inspection was to ensure that they had carried out the necessary actions detailed in the plan. We were happy that they had made improvements and were now meeting these regulations.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 associate Regulations about how the service is run.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) which apply to care homes. We found the provider was following the MCA code of practice.

People were safe because staff supported them to understand how to keep safe and staff knew how to manage risk effectively. There were sufficient numbers of care staff on shift with the correct skills and knowledge to keep people safe. There were appropriate arrangements in place for medicines to be stored and administered safely.

Staff had good relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected at all times. People and their relatives were involved in making decisions about their care and support.

Care plans were individual and contained information about how people preferred to communicate and their ability to make decisions.

People were encouraged to take part in activities that they enjoyed, and were supported to keep in contact with family members. When needed, they were supported to see health professionals and referrals were put through to ensure they had the appropriate care and treatment.

Relatives and staff were complimentary about the management of the service. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service.

The management team had systems in place to monitor the quality and safety of the service provided.

Essex Care Consortium Colchester is a care service providing care and accommodation for up to twenty people who have a learning disability and autism. The service was provided between two houses at the site called Birch House and Cedar House.

Cedar House provides accommodation for up to 12 people who have high dependency needs due to learning and physical disabilities.

Birch House offers residential placements for up to eight people who require a high level of support, and who are less dependent on staff for support in aspects of daily living. People living at both houses need support to achieve their potential, develop their basic skills, and access the wider community.

This is the first inspection of the service under the new ratings system. The service was last inspected on the 18 February 2014 and was found to be compliant with the regulations.

At the time of inspection, the service was caring for 16 people across two houses and had four vacancies. They employed 21 permanent staff across the two house’s, seven of which were new members of staff undertaking their probation period and care certificate induction. The provider had a number of services in the near vicinity and consequently staff from their other services sometimes covered regular staff vacancies at the Birch site. The service used agency when shifts could not be filled.

At the time of inspection 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 service was rated requirements improvement overall, with an inadequate rating in safe.

The premises were not fully maintained and the environment was not clean. Risks in the environment were not managed to reduce the possibility of harm to people. Where the registered manager identified that the service did not have enough cleaning staff they had not advertised for additional staff or informed the provider. Care staff carried out some of the cleaning but staff and relatives told us this detracted from time spent with people at the service.

We observed that staff did not always manage behaviours that challenged well, and that due to a lack of understanding of how to communicate with people with these behaviours, used PRN (as required medication) to reduce people’s agitation. However, staff managed regular medicines safely carrying out daily medication checks across both houses and the manager carried out regular medication audits to ensure that medicines were being administered correctly. Staff did have training in administrating specialist medication to manage epilepsy and this was in line with NICE guidance, (National Institute for Clinical Excellence).

The registered manager carried out a variety of Mental Capacity Assessments for people at the service. However, these were not completed in line with best practice. People at the service were not supported in making decisions about their care and treatment and those who might have advocate on their behalf were not always consulted.

Staff did not always have the skills to support people with communication difficulties and behaviours that challenged in line with best practice.

People at the service were not always treated with dignity and respect. Staff did not always have the communication skills needed to support people with communication barriers and behaviours that challenge.

Care plans were not always person centred and risk management plans for non-physical health related care needs were not thorough. However, the service worked collaboratively with health and social care professionals to meet people’s health needs. In addition, we saw that physical health care plans were robust.

The registered manager had not made appropria

People who were able to speak with us told us that they were happy at Essex Care Consortium - Colchester. Those who were less able to express their views were relaxed, appeared well cared for and had a good rapport with staff at the service.

We saw that care and treatment for each person was planned and reviewed with their involvement and consent as far as possible. Risks to the health, welfare and safety of people using the service were identified and managed.

People's medicines were managed safely by competent staff. Good records were maintained but we found that minor improvements could be made to enhance the systems already in place.

We found that staff were trained and well supported to care for people properly and to keep them safe.

People were able to express their views about the service and had access to a complaints process.

We gathered evidence of people's experiences of the service by talking with people, observing how they spent their time and noting how they interacted with other people living in the home and with staff.

During our inspection we spoke with one person who told us they liked living at Essex Care Consortium Colchester. We saw that people smiled and appeared relaxed and comfortable with staff and others living in the home.

Many of the people living at Essex Care Consortium Colchester were unable to talk with us or chose not to. We saw through gestures, facial expressions or signs that people were well cared for and happy.