Forestview 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. Forestview can accommodate eight people .At the time of our inspection there were seven people living in the home and one person receiving short term respite care. The home is a bungalow with a communal lounge and dining room, with an accessible kitchen. The bedrooms are spacious with shared bathrooms. The service is one of many, run by the White Horse Care Trust, within Wiltshire and Swindon.

At the last inspection in January 2016, the service was rated as ‘Good’. At this inspection we found the service was ‘Requires Improvement’.

A registered manager was employed by the service but was not 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. Our inspection was supported by two deputy managers and an area care manager who has responsibility for overseeing the services within the Trust.

Forestview has been developed and designed in line with the values that underpin the Registering the Right Support, Building 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.

During our last inspection we found the service was responsive to people’s needs and wishes. However during this inspection we found that some care plans had not been updated and monitoring records were not always completed.

Quality audits and monitoring to ensure improvements to the service were identified and acted upon had been completed. However, the areas identified at this inspection had not been prioritised and completed.

There were sufficient staff to meet people’s needs who had been through a satisfactory recruitment process. Staff felt supported in their roles, they had access to refresher training to keep their knowledge and skills up to date. Staff were knowledgeable about people, their backgrounds and individual needs. They treated people with respect and in a kind and caring manner. Staff understood how to keep people safe and were confident any concerns they raised would be listened to and the appropriate action taken in response.

Accidents and incidents were recorded and checked by the deputy managers to see what steps, if any, could be taken to prevent them from happening again. Staff were trained in the safe management of people’s behaviours which may cause harm to themselves or others.

People using the service needed support with their communication and were not able to tell us their views about the care and support they received. We observed that people were happy and relaxed in the presence of staff. Those people who were able to did not hesitate to seek support which staff responded to.

People were able to make choices about what they ate and drank. They had access to sufficient food and drink. People were able to choose each day what they wanted to eat. Choices were varied to ensure people maintained a balanced diet.

Staff worked alongside other health and social care professionals to ensure people’s healthcare needs were met. People’s medicines were stored securely and administered safely.

People were encouraged and supported to be involved in making daily choices where they were able. Mental capacity assessments were completed as required and in line with legal requirements.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. You can see what action we

Forestview provides accommodation including personal care for up to 8 people with a learning disability and associated health needs. The service is one of many, run by the White Horse Care Trust, within Wiltshire and Swindon. At the time of our inspection 8 people were living in the home. The home is on one level with a communal lounge, dining and kitchen area.

The inspection took place on 05 January 2016. This was an unannounced inspection. During our last inspection in January 2014 we found the provider satisfied the legal requirements in all of the areas that we looked at.

A registered manager was employed by 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.

People living at Forestview were not able to verbally tell us what they thought about the care and support they received. Relatives spoke positively about the high standard of care and support their family member received.

During the inspection, there were sufficient staff available to support people effectively. Staff spent time with people and responded to their requests for support. People were not rushed and not left waiting for assistance. Staff told us that cover was available when staff took annual or sick leave. The registered manager explained that they would also provide cover when necessary.

Throughout the inspection we saw people being treated with kindness and compassion. People looked comfortable with staff and did not hesitate to seek assistance or support when required. Staff knew the people they were caring for, and treated people as individuals.

Staff knew how to identify if people were at risk of abuse and what actions they needed to take should they suspect abuse was taking place. The registered manager dealt with and responded to all safeguarding concerns.

People were supported to eat a balanced diet. There were arrangements for people to access specialist diets where required. There were snacks and drinks available throughout the day during our inspection. People’s health needs were monitored and they had access to health care professionals as required.

People’s medicines were stored and managed safely. Staff signed to say when people had received their medicines as prescribed. There were protocols in place for people who may require ‘as and when necessary’ medicines.

Where required people had specialist or adaptive equipment in place to support staff to meet their care needs. People had equipment, such as walking frames, where required to support them to maintain their independence.

Arrangements were in place for keeping the home clean and hygienic to ensure people were protected from the risk of infections. During our visit we observed that bedrooms, bathrooms and communal areas were clean, tidy and free from odours.

There were systems in place to respond to any emergencies. Staff had access to a 24 hour on call system to enable them to seek advice in an emergency.

The registered manager and provider had systems in place to monitor the quality of service people received. People, where able, their relatives and staff were encouraged to contribute to the development of the service.

One staff member said “You can give a choice. ‘I say would you like the red or beige jumper?’”. A relative of someone living at the home said “they respect their privacy”.

One relative of a person living at the home said “It doesn’t matter which staff are on, they’re all very friendly and helpful and attentive to people’s needs”. Another relative said “staff are wonderful”.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for in a clean, hygienic environment.

One relative said “I could raise any issues; I have a good rapport with the staff. They often ask if there is anything I want changed”.

We weren't able to speak to people using the service because of their complex needs. We used a number of different methods to help us understand the experiences of people using the service. We observed staff interacting with people; we spoke with staff and four relatives. One relative said "it is absolutely wonderful, nothing is too much trouble for them."

We looked at three care plans and saw people’s capacity to make decisions had been considered and recorded. We saw care plans contained information about people’s daily routines and how they preferred to be supported.

Two relatives we spoke with said they felt there were enough staff on duty to ensure their family member was able to participate in activities.

We saw in a relatives satisfaction survey, completed in 2012, all respondents confirmed they were aware of the procedure to follow if they needed to make a complaint or raise a concern.

We spent time with the people who lived at the home but they had limited capacity to provide meaningful feedback about the service. We observed that people were clean, well presented and appropriately dressed, and they were happy and relaxed in the company of staff that they knew.

We spoke to two relatives on the telephone. One relative said “it is a fantastic home; all the staff are wonderful and I cannot fault them.” They were confident that their family members’ needs were met and that they well cared for at Forestview. They commented on the homely and relaxed atmosphere and told us they were always made to feel welcome at the home. They said that their relatives were always clean and well groomed, and suitably occupied and stimulated with activities, both in and outside of the home. They said that they trusted the staff to make appropriate decisions for their relatives because they understood their needs and preferences.