We inspected the service on 7 July 2016 and the visit was unannounced.

Hamilton Court is a registered care service offering accommodation and support for up to seven adults who have a learning disability. At the time of our inspection six people were using the service. The accommodation is offered over two floors. There is a communal lounge, dining area and conservatory on the ground floor along with some of the bedrooms, and the remaining bedrooms are on the first floor. There is a large accessible garden for people to use should they wish to.

At the time of our inspection there was a manager in place. This person was in the process of registering to become the registered manager. It is a requirement that the service has 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 felt safe with the support offered. Staff understood their responsibilities to support people to keep safe and to protect them from abuse and avoidable harm. The manager dealt with accidents and incidents appropriately. Risks to people’s health and well-being had been assessed. For example, where people could have shown behaviour that challenged, staff had guidance available which they followed.

People received support from staff who had been checked before they started to work for the provider. This had helped the provider to make safer recruitment decisions about the suitability of prospective staff. Relatives were satisfied with the number of staff available to support their family members and we found that staffing levels were suitable to help people to remain safe.

People received their medicines as prescribed in a safe way. Staff were trained in how to handle people’s medicines and knew what to do if an error was made. Medicines were stored appropriately and guidance was available and followed by staff about how people preferred to take them.

People were receiving support from staff who had the appropriate skills and knowledge. This was because staff received regular training. Staff had received an induction when they started to work for the provider so that they knew about their responsibilities. Staff met regularly with their supervisor to discuss their work and to receive feedback to support them to provide effective support to people.

People were supported in line with the Mental Capacity Act 2005 (MCA). People consented to their support where they could. The provider had assessed people’s mental capacity where this was necessary and made decisions in people’s best interests. Staff received training in the MCA, understood their responsibilities and were aware of the need to make applications to the appropriate body where they had sought to deprive a person of their liberties.

People chose what they ate and drank and were satisfied with what was offered to them. People had access to healthcare services when required, such as to their doctor. People made decisions about their health where they could and staff knew how to monitor their well-being.

People received support from staff who showed compassion and kindness. Staff protected their dignity and privacy and showed respect for people. This included the safe storage of their care records. Staff communicated in ways that were important to people and the provider had made information easier to read where this was needed. For example, pictures were used to aid people’s understanding. People were supported to be as independent as they wanted to be by staff who knew their abilities and preferences. Some people had been involved in decisions about their support and where this was not possible, people had information on advocacy services that could help them to speak

As people were preparing to leave for their day time activity we did not have opportunity to speak with them. However we observed staff interaction and saw that people were relaxed in their company and their was a calm and easy atmosphere within the service.

We looked at how people were involved in the service and support plans described how people were to be involved and staff confirmed that this happened.

People received the food and drink to ensure they remained healthy staff told us how they supported people in accessing a choice of foods.

The service is kept clean and staff have access to personal protective equipment to reduce the risk of cross infection.

Medications is handled safely by trained staff ensuring people receive their medication as prescribed.

There are sufficient trained and knowledgable staff.

People are supported to complain if they wish following the local authority's complaints procedure.

During our visit we observed people interacting with staff, getting ready to go out, and resting in the lounges.

We spoke with two people who lived at the home. Both people said they were happy living at Hamilton Court. One person told us they liked their room, enjoyed the garden and the food was nice. Another person had recently been supported to make choices about the decoration of their bedroom and were awaiting new furnishings. Some people were unable to give their views about the service due to their disabilities.

We observed people undertaking their morning routines as they prepared to go out for the day. We saw a staff member respond well to a person who displayed challenging behaviour. This meant the person was reassured, their attention diverted, and their needs met.

People told us that they are happy with their care that staff give them choices in how they spend their day and they are involved in decision making in the service. We saw that staff worked well with people using the service that people were happy and relaxed with staff. We saw minutes of independently chaired residents meetings where people using the service were asked about activities they wanted to take part in and were able to make decisions about how their environment looked such as the new kitchen.

People using the service told us that they felt safe and well cared for by staff and they thought staff were: "Really nice." Staff were able to tell us what they would do if the suspected abuse and the service has a robust safeguarding procedure that staff are made aware of in team meetings. Relatives spoken with thought the service was really good and felt their loved ones were well cared for: "I think very highly of this service."

We saw a well maintained, homely environment that reflected the needs of the people who used it. There are systems in place to ensure that repair and on going maintenance is carried out: People using the service told us they liked the home : "I really like my room."

Staff told us that they received on going training and support from management to help them do their jobs. We saw training records that showed that staff received regular mandatory training updates as well as more specialist training to support them in their role.