20 Stratton Road 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.

The home is part of Innovations Wiltshire Limited and is in a residential area in the town of Pewsey. It is registered to provide personal care for up to three people with a learning disability. At the time of the inspection three people were living at the service.

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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff understood their responsibilities to keep people safe. Risk assessments had been carried out and care plans guided staff how to keep people safe. Safe recruitment processes were followed and there was enough staff on duty to meet people’s needs. Medicines were managed safely. Incidents and accidents were reported and reviewed.

Staff had been trained to carry out their roles and had regular supervision sessions. People were supported to eat healthily and had access to ongoing healthcare. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There was a friendly, family atmosphere. People told us staff supported them in the way they wanted. We saw and heard positive interactions between people and staff; there was lots of laughing and banter.

Care plans were detailed and person centred. There was a complaints policy in place and people knew how to raise any issues. Regular feedback was sought from people.

There were robust quality assurance processes in place. Staff said they felt well supported and that the provider was a good employer.

Further information is in the detailed findings below.

20 Stratton Road is a three bedded home located in the village of Pewsey. It is registered to provide personal care and support to three people with a learning disability and mental health needs.

The inspection took place over two days on the 3 and 4 February 2016. The inspection was unannounced. During our last inspection in October 2013 we found the provider had satisfied the legal requirements in all of the areas that we looked at.

The service had a registered manager; however they did not participate in the inspection as they were no longer in post for this service. The home manager was in the process to apply to be the registered manager and was responsible for the day to day running of the service.

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 were supported by kind, caring staff that knew them well and understood their care and support needs. Relatives spoke positively about the care and support their family member received. People were involved in their support planning and were supported to take part in social activities both within the home and community.

People were supported to maintain relationships with people that mattered to them. Relatives were kept informed of their loved ones health and well-being and any changes in their needs.

Medicines were stored and administered safely. Where people managed their own medicines, risk assessments were in place.

People were kept safe by staff who recognised signs of potential harm or abuse and knew what to do when safeguarding concerns were raised. Staff felt confident concerns raised would be listened to and acted upon by the home manager.

People were supported to have sufficient to eat and drink and maintain a balanced diet that promoted healthy eating. People had access to dietary and nutritional specialists to help meet their assessed needs.

There were sufficient staff to meet people’s needs. The registered manager and provider had systems in place to ensure safe recruitment practices were followed.

Staff and the home manager had an understanding of the Mental Capacity Act (2005). Staff were knowledgeable about the rights of people to make their own choices and decisions. This was reflected in the way staff supported and encouraged people to make decisions when delivering care and support.

Staff understood their roles and responsibilities in relation to infection control and hygiene. During our inspection we saw the home was clean, tidy and free from odours.

The provider and home manager had systems in place to monitor the quality of service. Relatives of people using the service were encouraged to share their views on the care and support their family member received.

There were systems in place to respond to any emergencies. Staff had access to a 24 hour on call system to enable them to seek advice in an emergency.

When we inspected there were three people living in the home. We spoke with the three people who used the service, two of their relatives and three staff. We also made our own observations during the visit.

People who used the service told us they liked the way staff looked after them. People felt the staff supported them and met their needs. One person who used the service said "yeah, it’s nice here" whilst another told us “I like the staff here.”

People told us that staff treated them with kindness. One person said “they are kind and nice to me.” We saw staff speaking and responding to people in a kind and respectful manner.

The care records showed us that people's health needs had been assessed. These records included information from health and social care professionals which helped ensure people got the care and treatment they needed.

The staff records showed that supervision was informative and helpful to staff. The home trained their staff and had the procedures which protected people from any form of abuse. Relatives told us they did not have any concerns but knew they could speak to the manager or other staff if they had any concerns. One person said “I would go to the manager.”

The service and the building were monitored and risk assessed to ensure they were suitable for the people who used them.

The evidence we collected showed us the service kept people safe and met their care needs.

There were three people living at 20 Stratton Road when we visited. Each person had a learning disability. We were able to talk with two people and ask a range of direct questions about their care. We also observed staff interacting with all three people at the home. After our visit we talked by telephone with a family member of one of the people who lived at the home. They told us they were happy with the care and support given to their relative. They said: "I think [the person] is doing very well there."

The people who we talked with told us they were happy living at the home. They said they liked the staff and they were looked after well. We were told people knew the staff supporting them well. They said staff did not make anyone do anything they did not want to do. People were able to make their own minds up. If a person did not have the capacity to make a decision for themselves, staff would act in the person's best interests. Staff involved people who spoke for the person in any major decisions.

We observed care delivered with warmth and affection. We saw people appeared happy and settled in the home and staff supported them to be as independent as possible. We judged people were given their medicines safely. The service had enough staff with the right skills and experience to support people. People's records and those to run the home were kept confidential and held securely.

People told us they liked living at 20 Stratton Road. They said they liked their bedroom, which contained a range of personal possessions. People told us they regularly went to the pub or out for a meal. They liked to play skittles and enjoyed a social club where they met their friends. People regularly went into the village with staff for basic provisions such as bread and milk. They helped with the larger food shop in a nearby town. People told us how staff helped them make a shopping list. They said they liked to push the supermarket trolley and search for items they needed.

People were very much involved in the running of the home. They opened the door to visitors and answered the telephone when it rang. People made their own sandwiches for lunch and helped cook their evening meal. They helped with household tasks such loading the dishwasher, vacuuming, polishing and laying the table. People were able to make choices about their daily routines. They devised the menus with staff support and told us about a forthcoming holiday they had planned.

People told us they liked the staff and they were comfortable and relaxed in their presence. There were good interactions between people and the staff on duty. Many interactions involved banter which people responded to well. Staff were very aware of people’s interests and the support they required to meet their needs effectively.