We inspected this service on 27 April 2017. This inspection was announced one day before our visit to ensure people using the service and their staff support would be at home. Our last inspection took place 24 March 2015 and at that time we found the home was meeting the regulations that we looked at.

This service is registered to provide accommodation with personal care for up to seven people with a learning disability and associated autistic spectrum disorder. At the time of our inspection six men were using the service.

The service had 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.

The registered manager and management team demonstrated an open, reflective management style and provided strong values-based leadership to the staff team. There were systems in place to support, supervise and manage all staff. This ensured staff’s practice was monitored and identified when additional support or training was required. Staff were empowered to professionally develop. People were at the heart of the service. Staff understood how to communicate with people and knew what was important to them. An accredited evidenced based programme that used structured teaching and social stories, specifically designed for people with autism was in place. This enhanced people’s quality of life and their well-being because it enabled them to understand social situations and communicate their needs and preferences. Staff worked in partnership with people and their families to ensure they had a meaningful and enjoyable life.

Positive communication was encouraged and feedback from people that used the service, their representatives and the staff team was sought by the provider to further develop the service and drive improvement. Complaints were used as an opportunity for learning and improvement. People’s representatives knew how to make a complaint and were confident that their complaint would be fully investigated and action taken if necessary. The provider and registered manager regularly assessed and monitored the quality of support provided to ensure national and local standards were met and maintained. A culture of continuous improvement was in place to promote further enhancement of the service.

People’s safety was promoted by staff that understood how to support them in a way that reduced identified risks, whilst promoting their rights and choices. People were supported to take their medicine when needed and this was done in a safe way. Staff understood what constituted abuse or poor practice and systems and processes were in place to protect people from the risk of harm. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Checks were made before employment to confirm staff were of good character and suitable to work in a care environment.

Staff had time to ensure each person led a fulfilling life and were trained to meet people’s specific needs. Staff had a detailed understanding of people’s needs and preferences. Staff understood people’s individual capacity to make decisions and supported them to make their own decisions. Staff understood the issues involved in supporting people when they were unable to make these decisions. People and their relatives were closely involved in planning and reviewing the support they received.

People’s needs and preferences were met when they were supported with their dietary needs. The culture of the home empowered people to maintain their dignity and privacy. People were treated in a caring way and they were supported to maintain good health. Staff had developed strong relationships with local health

We inspected this service on 24 March 2015. This was an unannounced inspection. Our last inspection took place in July 2014 and at that time we found the home was meeting the regulations we looked at.

This service is registered to provide accommodation with personal care for up to seven people who require care and support due to severe learning disabilities and associated autistic spectrum disorder. At the time of our inspection this was an all male facility and seven people were using the service.

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.

People’s safety risks were recognised, managed and reviewed and the staff understood how to keep people safe. There were sufficient numbers of suitable staff to meet people’s needs and keep people safe. Staff received regular training that provided them with the knowledge and skills to meet people’s needs.

People’s medicines were managed safely, which meant people received the medicines in the way they preferred and when they needed them.

People who used the service were unable to make certain specific decisions about their care. In these circumstances the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were being followed.

People were supported with their daily diet and nutritional requirements. Where concerns were identified support and guidance from health care professionals was sought. People were supported to access external health care services when it was required to ensure their health and wellbeing needs were met.

People were supported to make choices about their care and daily lives; staff respected the choices people made. Staff understood and had a good knowledge of people’s communication styles and behaviours and they knew how to respond to these behaviours to reduce the risk of people coming to harm.

Care was planned and personalised. People were involved in the assessment and review of their care. Discussions with staff, observations and records demonstrated that people using the service were at the centre of the care being delivered.

Staff supported and encouraged people to access the community and maintain relationships with their families and friends.

Staff analysed people’s responses and behaviours to identify if they were happy with their care. If people showed they were unhappy, staff took action to make improvements to their care and well-being.

There was a progressive and lively atmosphere within the home, the registered manager and provider regularly assessed and monitored the quality of care to ensure standards were met and maintained.

We visited Fairmont Residential Care Ltd on a responsive inspection as we had received concerns regarding the management of medication. The inspection was unannounced which meant the service did not know we were coming.

Below is a summary of our findings based on our observations of the service and people who used the service. We spoke with the staff who supported people and we looked at records. We considered our inspection findings to answer the questions we always ask –

Is the service safe?

Medication was stored safely in various areas of the service.

Senior staff and managers received regular training in medication management, received practical assessments and had regular competency checks to ensure they were able to administer medication safely.

Is the service responsive?

Records were completed when medication was prescribed and needed to be administered at very regular times of the day. This ensured staff were aware of the specific prescribing instructions.

Is the service caring?

People who used the service were supported by staff with visits to their doctor and other health care professionals when they were needed.

Is the service effective?

People who used the service had regular medication reviews and health screening checks to ensure that they did not experience any side effects from the medication they were prescribed.

The service had a homely medication policy, which was agreed with the doctor. This ensured that people were able to have over the counter medication swiftly when they were needed.

Is the service well led?

The service has identified the need for a senior member of staff to be on the premises over the 24 hour period to ensure people are offered and can have occasional medication when they need it.

We carried out this inspection to check on the care and welfare of people who used this service.

We spoke with the manager, the provider, the quality assurance manager and three members of staff.

The new manager told us that the registered manager had recently left the post and that they had only been in post for two weeks. They told us they were in the process of applying to register as a manager of the service.

In this report the name of the last registered manager appears. They were not in post and not managing the regulatory activities at this service at the time of the inspection. Their name appears because they were still a registered manager on our register at the time of the inspection.

We spoke with three parents of people who used the service and one professional who knew the service well.

One relative told us: “I am quite happy with the service and my son seems happy here. There is good communication between us and the staff there”.

We looked at how the care and welfare needs of people who used the service were met and how this was recorded.

We looked at safeguarding procedures in place at the service. We were told how staff were trained to identify signs of abuse and how they dealt with it appropriately.

We looked at how the service supported people to manage their medication by looking at protocols, support and guidance in place.

We looked at the processes in place to ensure staff were suitably trained and supported.

At the time of our inspection there were seven people living at the home. We spoke with one person living there and two care staff. We also spent some time in communal areas observing interactions between staff and people living there.

One person told us, "I like living here. I like horses and went horseriding today."

Due to the nature of the needs of people living at the home, we were not always able to obtain their direct opinions about the home. We used other methods to better understand their opinions to include surveys and conversations with their relatives.

We found that people who used the service were supported and encouraged to express their views and make decisions about how they wanted to spend their time by using individualised communication methods.

We spoke with two relatives. They told us they had no worries about the care of people who used the service. They said that they felt people who used the service were kept safe from the risk of harm.

One relative told us, “I can’t praise the service enough. [My relative] has settled well there. They have got it spot on.”

We looked at five key outcomes to establish whether people were involved and participated in the service they received; whether care was provided appropriately; whether the service could adequately ensure people’s safety; whether there were sufficient staffing levels and whether there was a system for ensuring ongoing quality assurance within the home.