This inspection took place on Friday 18 May 2018 and was announced. This was to ensure people who lived at 70 Conway Drive and the staff who supported them were available to talk with us during our visit.

The service is a small care home for two people with learning disabilities. 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.

The care service has been developed and designed in line with the values that underpin the Registering 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.

The home 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.

At our last inspection in February 2017 the home was rated 'requires improvements'. During this visit we found improvements had been made.

People who lived at 70 Conway drive had fulfilling lives, with staff supporting them to be as independent as possible.

Staff were caring and kind to people and treated them with dignity and respect.

There were enough staff on duty to ensure people received good support to undertake their activities both within and outside of the home.

Staff recruitment processes reduced the risk of the provider recruiting unsuitable staff. Staff understood how to protect people from abuse.

The home was clean and tidy, and the premises were kept safe by regular checks of water, gas and electrical systems; and testing of fire systems.

People received their medicines as prescribed and attended healthcare appointments when they needed them.

People contributed to menu planning and had meals they enjoyed.

Staff worked in-line with the Mental Capacity Act 2008 and Deprivation of Liberty Safeguards. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff received training to support them provide safe and effective care to people.

Staff were responsive to people’s needs, and care records provided detailed information about people’s likes, dislikes, needs and wants. Risks related to people’s care had been identified and acted on.

The provider promoted equality and diversity and ensured people had information in appropriate formats to help them make decisions and to give them more control in their lives.

Relatives told us they felt assured management listen to their concerns and would act on any complaints. Complaints received had been addressed via the provider’s complaint process.

The provider and management team were open to new ideas, and were supportive of their staff group. They ensured they met their legal requirements to notify the CQC of events in the home; and displayed their current inspection rating in the home and on their website.

The service was inspected on 8 and 10 February 2017. The first day of our inspection visit was unannounced. We visited the provider’s office on 14 February 2017 to review staff training and recruitment processes.

The service provides accommodation and personal care support to two people.

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 and their relatives told us that they felt safe. Staff were aware of their responsibility to keep people safe. However concerns had not been reported to outside agencies when they had been identified.

Risk associated with activities of people’s care had not always been adequately assessed and guidance provided to staff to keep people safe from the risk of harm.

Safe recruitment practices were being followed. Staff had received training and supervision to meet the needs of the people who used the service. Staff told us that they felt supported.

People received their medicines as required. Medicines were administered safely by staff who were appropriately trained and competent to do so.

People were not supported in line with the requirements of the Mental Capacity Act (MCA). People’s capacity to consent to their care had not always been assessed when there was a reasonable belief that they may not be able to make a specific decision.

People were supported to maintain a balanced diet. People’s health needs were met and when necessary, outside health professionals were contacted for support.

People were supported by staff who understood that they should be treated with dignity and respect. We saw that people were encouraged to be involved in making choices about the things that were important to them.

People’s independence was promoted and encouraged. People were supported to engage in activities that they enjoyed and to maintain links with people who were important to them

People received support that was centred on them as individuals. People were asked for feedback about the service that they received.

People’s relatives felt that the service was well-led. They knew how to complain should they have needed to.

Staff felt supported. They were clear on their role and the expectations of them. There were systems in place to challenge poor staff practice and take action where concerns had been raised.

Systems were in place to monitor the quality of the service being provided however, these were not always effective.

We inspected the service on 17 and 18 December 2015. It was an unannounced inspection.

Freedom Care Limited – 70 Conway drive provides accommodation for two people. Both were present on the day of our inspection.

There was 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 told us that they felt safe and well supported by staff. Staff understood how to keep people safe and were able to report concerns if required. Safeguarding concerns were not always reported to the local safeguarding authority as required.

People were involved in the planning and reviewing of the care that they received. Their achievements were celebrated and outcomes were positive. People were supported to engage in activities that were meaningful to them and that they enjoyed.

Risks associated with daily living were assessed. Staff received guidance on how to minimise risks. The environment was homely and well maintained but some health and safety checks had not been consistently carried out. Fire safety checks were carried out and there were procedures in place for staff to follow however recommendations from the fire department had not been followed up.

The service did not always follow safe recruitment practice. We saw that there were occasions when the relevant pre-employment checks had not been carried out.

People’s independence was promoted and decision making encouraged. Staff knew people well and treated them with kindness and compassion. People enjoyed the meals provided and where they had dietary requirements, these were met. People were supported to maintain their health and wellbeing. They received their regular medicines as prescribed and had access to health professionals as required.

Where people required support to make decisions, the service did not always follow the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).

Staff were able to demonstrate that they had an understanding of the Mental Capacity Act (2005) and how it might apply to the people who used the service. People using the service were not always asked their consent. CCTV had been installed in the home without due consultation.

Staff received training and support to enable them to meet the needs of people using the service although training records were not always kept up to date. The manager and staff team were clear of their role in ensuring best interest decisions were made for people if required. Staff had a clear understanding of their role and how to support people who use the service as individuals.

Staff felt supported by the registered manager. People who used the service felt they could talk to the manager and had faith that they would address issues if required. The provider had sought the opinions of family members and staff and acted upon their findings. However they had not done so when installing CCTV in the service.

There were not always appropriate systems in place to monitor activities and to learn from mistakes. Where shortfall had been identified these had not always been acted upon in a timely manner.

We spoke with two people who use the service. Although the people we spoke to had limited verbal communication they were all able to indicate that they were happy with the care and support they received at Freedom Care – 70 Conway Drive. We also spoke to four staff members.

We found people were able to make informed decisions about their care and support. One person told us it is “good here.” Another person told us it is “okay.”

We found people experienced care and support that met their needs and protected their rights. We found people’s care needs had been assessed. Care and support was delivered in a way that met people’s needs and ensured their safety and welfare.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We found the provider had robust systems in place relating to the management of medicines.

Staff were supported in their work and were confident that they were able to provide the care required.

We found systems were in place to regularly obtain people's views about the care and service they receive. We found the provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service.

We spoke with both people using the service and they told us they were supported to make choices and maintain their independence as much as they were able. One person told us they were looking forward to going to the pantomime and they showed us the Christmas tree they had decorated that morning. They also told us they did their own shopping and were involved in cleaning and cooking at the home.

People we spoke with told us they were satisfied with the care and support that had been provided. One person told us: - “everything is good”.

We found some care plans were detailed and thorough and provided clear guidance to staff about how people’s care and support should be delivered. However, records did not contain sufficient and up to date information about when restraint techniques and PRN medication should be used by staff. (PRN is latin for pro re nata and means medication that is given when needed).

Staff were aware of the appropriate reporting processes should an allegation of abuse be raised, ensuring people were protected from abuse at all times. However, the provider may find it useful to note that it does not have a policy regarding the use of restraint.

We found there was limited evidence that the manager and provider were assessing and monitoring the quality of the service provided to ensure people were protected from the risk of inappropriate or unsafe care.

Both people using the service told us that they liked living at 70 Conway Drive. They told us that they enjoyed the activities they took part in. Staff told us that they felt supported by the management team.