We carried out an unannounced inspection of Highbury Gardens on 12 December 2018. This was the first inspection since the service registered with the Care Quality Commission in March 2016.

Highbury Gardens is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

It is a care home for up to six people with learning disabilities and mental health needs. 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 in the home can live as ordinary a life as any citizen. Three people were living in the home at the time of our inspection.

We have made a recommendation for the provider to look at the Accessible Information Standard (AIS) which is required to make sure people with a disability or sensory loss are given information they can understand and the communication support they need. This was because staff were not fully aware of the AIS and relatives felt communication techniques with their family members in the home could be improved.

Staff knew how to keep people safe. Risks to them were identified and there was guidance in place for staff to minimise these risks. We made a recommendation around medicine risk assessments for people because further information was required to ensure staff had sufficient guidance in them to understand possible side effects. However, medicines were administered to people safely and when needed by staff who followed the correct procedures.

There were enough staff on duty to support people. Recruitment processes were safe, which ensured that staff were suitable to work with people who needed support.

Equipment in the service was safe to use and there were procedures to control infections. People lived in an environment that was clean, safe, regularly maintained and suitable for their needs. The home was decorated in bright colours which helped to create a relaxed atmosphere. Adaptations and features were in place for people such as an outdoor hot tub and trampoline.

Accidents and incidents in the home were recorded and analysed to ensure they were minimised in the future. People were supported by staff who had received training to ensure they had the skills to support them.

People’s nutritional needs were met and they were able to have meals of their choice. Staff and the management team worked with health and social care professionals, such as speech and language therapists and GPs, to ensure that people remained healthy and well.

People were supported to remain as independent as possible. The service was compliant with the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People and relatives were involved in decisions about their care and in the development and review of their care plans. Care plans were personalised according to each person's needs.

Staff were responsive to people’s needs. People were supported by staff who knew them well. The staff were caring and treated people with respect. People’s privacy and dignity were maintained.

We saw that staff supported people patiently and were attentive to their needs. People were able to engage in activities and social events that they enjoyed. They were able to provide feedback and make suggestions about what they wanted from the service.

Staff felt supported by the registered manager and told us the service was well-led and there was a positive culture. The registered manager ensured the service was monitored regularly. Audits and quality assurance checks took place weekly and the provider undertook periodic inspections of the home. People could provide feedback and make suggestions about what they w