About the service: Haslewood Avenue provides accommodation and personal care to adults with learning disabilities or autism spectrum disorder. The care home accommodates eight people in one adapted building.

People’s experience of using this service:

• Since our last inspection the service has made improvements.

• People liked living at the service and got on well with staff who knew them well.

• People were able to choose how to spend their time and encouraged to make decisions about their care.

• People were supported to be more independent and staff included daily skills as part of activities planning.

• People had enough to do and went out when they wanted to.

• People were supported by enough staff and told us they were always available if needed.

• Staff delivered care that was safe and met people’s needs.

• The provider had systems in place to keep people safe, provide good quality care and ensure staff were trained.

• There was a new registered manager who started after the last inspection and people and staff were positive about them.

• People’s risks were assessed and mitigated in the least restrictive way as possible.

• The service met the characteristics for a rating of "good" in all key questions.

• More information about our inspection findings is in the full report.

Rating at last inspection: At our last inspection the service was rated as requires improvement.

Why we inspected:

• All services rated "requires improvement" are re-inspected within one year of our previously published inspection report.

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor the service to ensure it provides safe and effective care. We will plan further inspections in the future.

This inspection was carried out on 30 January 2018 and 02 February 2018 and was unannounced. At their last inspection on 26 April 2016, they were found to be meeting the standards we inspected. At this inspection we found that they had continued to meet all the standards, however there were areas that required improvements.

Haslewood Avenue 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. Haslewood Avenue accommodates eight people in one adapted building. At the time of the inspection there were seven people living there.

The care service had been developed and designed by the provider 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. However, the management team spoken with on the day of inspection were not familiar with this policy.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. However, the registered manager was absent during the time of inspection and the service was being supported by an interim manager with support from a senior management team.

There were systems in place to monitor the quality of the service but these had not been used effectively. The registered manager was absent at the time of inspection and the home was being supported by an acting manager with support from a senior management team. The change to management support in the home and this meant that shortfalls were being addressed. Staff spoke positively of the recent changes.

People were supported by staff who knew how recognise and report abuse. Individual risks were assessed and staff knew how to work safely. Accidents and incidents were being reviewed by the operations manager. People’s medicines were managed safely and there were appropriate infection control processes in place.

Training was not all up to date but the provider had scheduled updates for staff. We found that staff supervision had recently commenced. A review of people’s capacity assessments and best interest decisions was in progress. People were able to choose what food they wanted to eat and they had access to healthcare professionals as needed.

People were treated with kindness and respect. We found that dignity and confidentiality were promoted. Visitors told us that they were welcome in the home.

Most people received care that met their needs and most care plans included information to ensure staff could meet people’s needs safely. However, one person needed to have their needs and care plan reviewed. There were activities provided but these were under review to ensure that they took into account people’s hobbies and interests. There were no recent complaints recorded but people were reminded how to raise concerns if they needed to.

This inspection was carried out on 26 April 2016 and was unannounced. At their last inspection on 5 June 2014, the service was found to be meeting the standards we inspected.

Haslewood Avenue provides personal care and accommodation to up to eight people. There were seven people using the service on the day of our inspection.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. In this instance the registered manager was also the provider.

People received care that met their needs and support plans gave clear guidance to staff. Staff knew people well and treated them with dignity and respect. Where possible, people were involved in the planning of their care and when they were unable, relatives and advocates were involved. Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), we found that people’s rights were respected.

People were supported to maintain a healthy diet and their health and social care needs were responded to appropriately. People had access to activities that supported their hobbies and interests. People were encouraged to raise complaints and give feedback and this was responded to appropriately.

People were supported by sufficient numbers of staff who had received the appropriate training and supervision for their role and had been through a robust recruitment process. Staff knew how to keep people safe and mitigate risks. Medicines were managed safely and accidents and incidents were reviewed to identify themes.

There were systems in place to monitor the quality of the service and shortfalls were addressed as needed. People, relatives and staff were positive about the management of the home which operated under a people first approach.

A single adult social care inspector carried out this inspection. In order to answer the questions below we spoke with four people who used the service, two relatives and four members of staff who were the registered manager, operations manager and two support workers. We also reviewed the care records in place and looked at how the service was being managed in relation to the standards we inspected.

Is the service safe?

People were protected from abuse and avoidable harm. We checked this following a relative telling us that their family member had experienced their money being taken from them. This incident occurred several years ago and was reported to the police and to the local safeguarding team. Improved procedures were put in place to ensure there was tighter monitoring of peoples' finances.

There were risk assessments in place to guide staff in taking appropriate actions to ensure that the support provided to people who used this service kept them safe from harm.

A person who used this service said, "I feel safe living here."

A relative of a person who used this service told us that their family member sometimes bruised herself when moving about in her wheelchair. However, they felt confident that this bruising could be explained and, in fact, their family member was always able to advise them on how the bruising had occurred.

Is the service effective?

Peoples' support achieved good outcomes for them and promoted a good quality of life. This was evidenced by a person who received support telling us, "I am happy living here.” They also told us that they use their local community a lot. When we asked for an example, they told us, "I go out to the coffee shop which I really like.”

We also spent time with people who had no verbal communication to ensure that they appeared happy with the support they were receiving. We observed very positive and respectful interactions between staff and people who used this service.

A relative did say that in the past there had been a high level of staff changes, but this was now much better with a more stable staff team. They felt that more staff could be employed to ensure each person had enough support to undertake more activities, however, they understood that this depended upon sufficient funding being available.

Is the service caring?

All of our observations of interactions between staff and people who used this service showed that people were treated with compassion, kindness and respect and that peoples' dignity was upheld and considered at all times. For example, we observed a person needing to receive some personal care during our inspection when they were seated in the lounge. The person was asked quietly and very respectfully if the staff member could help them.

A person we spoke to told us that if they were not happy with their support, they felt they could speak to staff. They said, "I think staff would help me.”

Feedback from relatives confirmed that people were treated very well by this service. Staff were described as, "Very nice" and we were told of staff who gave up their own time to support people.

Is the service responsive?

The service was organised so that it responded to peoples' changing needs. We saw evidence of this in discussions of peoples' needs at staff meetings. There was also evidence of learning from accidents and incidents that changed the way in which the service supported people.

The service was generally well organised to meet peoples' needs. Staff told us that they felt they were well equipped to undertake their role through training and guidance.

A relative told us that they did feel the service could communicate more frequently with them regarding their family member's health needs.

Is the service well led?

All of the staff members we spoke to told us that they felt very supported by the registered manager and that they had improved the service provided since they had been in post. One staff member said, "I have had lots of support in the staff team. The registered manager has time to listen to me.” They went on to say, "This is a really lovely home. I am really happy here.” This feedback was echoed by the staff member with whom we carried out most of our inspection.

We observed that the service was generally well organised and managed. This was shown by the systems and processes which underpin good practice being in place. We found that two members of staff needed to undertake refresher training in infection control; this was undertaken quickly by the registered manager.

We concluded that this service had an open and fair culture because staff were very willing to speak with us and to share their views. Although the registered manager was not present for our inspection, they were willing to engage in assisting with it and providing all of the requested information.

During our inspection on 05 April 2013, we were unable to directly gain the views of most people using the service due to their complex needs, which meant they were not able to tell us about their experiences. Therefore, we used a number of different methods to help us understand the experiences of people using the service. We observed the interactions between people using the service, the staff working at the home and those who provided activities to the people who lived there. We listened to everyday events and activities during the course of our visit.

People using the service initiated interactions, approached staff with confidence and were responded to in a warm and respectful way.

We found that the provider had systems in place to gain and review consent from people who used services. They took account of their views and involved people who knew and understood the person using the service.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Records showed that staff were provided with the training that they needed to meet people's needs.

You can see our judgements on the front page of this report.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences.

We observed the interactions between people using the service and the staff working at the home and listened to everyday events and activities during the course of our visit. People using the service initiated interactions, approached staff with confidence and were responded to in a warm and respectful way.

We found that the provider did not have systems in place to gain and review consent from people who used services, or to involve people who knew and understood the person using the service.

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare.

The premises was clean, fresh and safely maintained.

Records showed that staff were provided with the training that they needed to meet people's needs. During the visit we observed that staff interacted with the people using the service in a caring, respectful and professional manner.

Family members of people living in the home told us they were satisfied with the level of care and support provided. Family members with whom we spoke made positive comments about how well the staff provide choices for people and how they support people to maximise their independence.

Comments we received included “We are very pleased with the way they look after (relative), they have always looked after them well, and they are always clean and tidy when we seem them.” Another person said “I am quite happy with (relative’s) care, they are happy, we often meet up with them for meals or they come to our house. They are very happy to return to Haslewood Avenue and seem content there.”

Family members of people living in the home told us they felt that their relatives were safe living there.

During our visit on 03 February 2011, people told us that they were happy with the care they received and indicated to us that they felt well cared for and well supported. We were told by the people who use the service that the atmosphere in the home and staff morale had improved since the arrival of the acting manager.