This was an announced inspection carried out on 12 April 2017. We contacted the registered provider 24 hours before our inspection as some people using this service needed to be informed of our visit in advance as they would otherwise have found an unannounced inspection difficult to manage.

Gledholt is an enhanced community residential home providing outcome focused care for adults with learning disabilities, who may have behaviours that challenge and associated complex needs. The service has two buildings at the same location, with one of those designed for two people to live more independently as part of their ‘step on’ from Gledholt.

At the time of our inspection 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 felt safe, although one person expressed concerns about a member of staff which we discussed with the registered manager. They were aware of this and were taking action. We found some areas of medicine management required improvement and have made recommendations in the body of our report.

Based on feedback from people and staff as well as our observations during this inspection, we identified there were adequate staffing levels to meet people’s needs. Recruitment was appropriately managed, although a risk assessment which should have been completed was not in place.

We found the home was clean and tidy and records showed regularly scheduled maintenance had been completed. This included all relevant fire safety checks. Risks to people had been identified, managed and reviewed. Staff had access to this information which described risks and action which should be taken to manage this appropriately.

Staff completed an induction and received ongoing support through a programme of supervision and training. Staff appraisals had already started before our inspection.

Mental capacity assessments and Deprivation of Liberty Safeguards (DoLS) were documented in care records. Staff were able to explain how the Mental Capacity Act (2005) applied to their work, but were less sure about who was affected by DoLS. We recommended the registered manager clarify this with staff.

People were supported by staff to access a range of healthcare professionals. Visiting healthcare professionals spoke positively about this service. People were involved in meal planning and preparing meals.

People told us they liked the staff and felt confident approaching them. Staff were familiar with people’s care preferences and we observed a good rapport between staff and people they supported. People told us staff respected their privacy and dignity. People’s cultural, religious and sensory needs were met by staff at Gledholt.

Care plans identified how people preferred to live more independently and contained ‘pathways’ which showed how they would achieve this with support from Gledholt and other professionals. Regular review meetings with people, staff and other professionals took place.

Complaints were suitably managed. We recommended the registered manager add the date to their response letters. People were supported to take part in the community for voluntary work, paid jobs and for leisure purposes.

People and staff told us they liked the registered manager and could approach them with any concerns. Daily meetings between people and staff were taking place which helped people plan their days and later reflect on their experience.

Quality management systems were effective as they identified actions which we found had been completed within identified timescales.