16 Vista Road provides care and accommodation for up to 3 people who have a learning disability. There were three people living at service on the day of the inspection. At the last inspection, the service was rated good. At this inspection we found the service remained Good.

The registered manager was present during our inspection. 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.

There were enough staff on shift to meet the needs of people who used the service and people were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible; the policies and systems in the service support this practice.

Staff understood how to keep people safe and could describe the correct steps they would take if they were concerned that abuse had taken place. Accidents and incidents were appropriately recorded and investigated and risk assessments were in place for people who used the service.

The registered manager and staff involved people to make decisions about the service they received and obtained people’s feedback on how the service should be run. People told us that staff understood their needs and preferences well, and they received effective care and support from well-trained staff.

Staff had developed caring relationships with the people they supported. Family members told us that there was a positive atmosphere and people were encouraged to take part in the activities they wanted to pursue. A wide range of activities were on offer to people.

Medicines were managed safely and staff members understood their responsibilities. The registered manager undertook regular audits and improvements were carried out when these were needed. The quality of the service was monitored and assessed consistently.

People who used the service, family members, and visitors were encouraged to make comments, complaints, or compliments about the service.

Further information is in the detailed findings below.

This inspection took place on 22 April 2015.

16 Vista Road provides care and accommodation without nursing for up to three people who have learning disabilities. There were three people living in the service on the day of our inspection.

At our last inspection on 27 August 2014 we had concerns about staff recruitment. At this inspection we found that recruitment processes had been improved to protect people against the risks of being supported by unsuitable staff.

Staff had the necessary skills and knowledge to meet people’s assessed needs safely. They were well trained and supported.

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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were not able to share their views with us verbally but they used facial expressions, gestures and body language to communicate with us. They indicated that they felt safe and were comfortable with staff. Staff had a good understanding of how to protect people from the risk of harm. They had been trained and had access to guidance and information to support them with the process.

Risks to people’s health and safety had been assessed and the service had care plans and risk assessments in place to ensure people were cared for safely. People received their medication as prescribed. There were safe systems in place for receiving, administering and disposing of medicines.

The manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and they had made applications appropriately when needed. DoLS are a code of practice to supplement the main Mental Capacity Act 2005. These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals.

People were supported to have sufficient amounts of food and drink to meet their needs. People’s care needs had been assessed and catered for. The care plans provided staff with sufficient information about how to meet people’s individual needs and preferences and how to care for them safely. The service monitored people’s healthcare needs and sought advice and guidance from healthcare professionals when needed.

Staff were kind and caring and treated people respectfully. People participated in a range of activities that met their needs. People were made to feel welcome and were able to receive visitors at a time of their choosing. Staff ensured that people’s privacy and dignity was maintained at all times.

The service had an effective quality monitoring system to ensure that people received good care and the service continually improved for people. There was an effective system in place to deal with any complaints or concerns.

We carried out a responsive inspection after receiving concerns about some of the staffs behaviour when supporting people in the local community.

On the day of our inspection there were three people living in the service. All three people were not able to share their views with us verbally. They used facial expressions, gestures and body language to communicate with us. We also spoke with the manager and three members of staff.

We thought about what we found and asked the questions that we always ask; Is the service safe, effective, caring, responsive and well-led?

This is a summary of what we found:

Is the service safe?

When we arrived at the service we were asked to sign the visitor’s book and our identity was checked. This meant that people were protected from unwanted visitors such as others who posed a risk to their safety.

Staff had received training in safeguarding vulnerable adults from abuse (SOVA), the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). This meant that staff had been given the information that they needed to recognise the signs of abuse, how to report suspected abuse and how to support people who are unable to make certain decisions without support.

All personal records were stored safely and securely for the protection of people’s confidential personal information.

Is the service effective?

Although all three people who used the service did not communicate verbally they appeared relaxed and happy in staff’s company and responded positively when asked if the service met their needs.

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure their safety and welfare. The care records were well written and had been regularly reviewed and updated. This meant that the service was effective and staff knew how to meet people’s needs.

Is the service caring?

We saw staff interacting with two of the three people who used the service during our visit on 27 August 2014 and their interaction was good. Staff spoke respectfully to people in a kind and caring manner. We saw that staff allowed people sufficient time to respond to any requests.

People responded positively when we asked if the staff were caring. This showed that people were cared for by kind and caring staff.

Is the service responsive?

People were supported to see other professionals such as a general practitioner, chiropodist, optician and district nurse when necessary. This showed that people’s general health care needs were met and that the service was responsive to people’s changing needs.

Is the service well-led?

The service had a manager in post who was in the process of registering with the CQC.

Staff had received a thorough induction to the service and they had received regular supervision and annual appraisals. Staff’s competence to administer medication had been regularly assessed and recorded. This meant that staff had been fully supported to carry out their role.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We also observed staff interactions with people throughout the day.

We saw that people's care and treatment was planned and reviewed with their and their relative’s involvement, wherever possible. Risks to people's health, welfare and safety were identified and well managed. Our inspection showed us that the service was generally safe, responsive and caring. We spoke with one relative who told us, "I can pop in whenever I like and I know them.”

The provider worked in co-operation with other providers to ensure the health, safety and welfare of people when more than one provider was involved in their care.

We found that there were systems in place to ensure that the premises were clean, and that people were protected against the risks associated with infections.

The provider had ensured that there was sufficient, well maintained equipment to meet the needs of people using the service

Staff were selected and recruited in a way that ensured they were suitably qualified and fit for the job.

We saw that records relating to people using the service, staff and day to day running of the service were accurate. However records relating to people were not stored securely and could be easily accessed by anyone visiting the service.

When we visited 16 Vista Road we spoke with the manager and two members of staff who told us that the people using the service were unable to give consent for most areas of their care and treatment.

When we looked at the support plans for people, we found that Mental Capacity Act 2005 forms had been completed correctly and relatives, where available had been involved in the decisions made around consent. We found that the care and treatment given was of a good standard and one relative spoken with said, "I am very happy with the care that this home gives to my relative. The food is good and they like it there."

We looked at safeguarding procedures and found that staff had received regular training and updates and were aware of the procedures to follow. People we spoke with told us that it was a safe place for their relative.

We also looked at whether staff were supported in their roles and found that they had received supervision, training and appraisal. There was a clear, organised induction process and an openness culture amongst staff and management in order to achieve improvements.

When we looked at the complaints procedures we found that the policy was clear and informative and contained appropriate timescales for bringing issues raised to an outcome. This included identifying where there might be areas for improvement and learning.

People who use this service were, because of their disabilities, unable to engage in two way conversation with us. Therefore people could not tell us if they were included in day to day decision making within the home. However comments made to us by relatives and visitors indicated that they were satisfied with the way the home was being run by the provider, and with the way staff supported people who lived there. They told us that they thought the food was good and that the home had always been clean and tidy when they had visited. They also told us that they thought their relative was well cared for and seemed very happy to be living at 16 Vista Road.