This inspection took place on 12, 16 and 22 March 2018 and was unannounced. Which meant the provider and staff did not know we would be visiting.

Inverthorne 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. Inverthorne is registered to provide residential care and support for up to four adults with a learning disability or autistic spectrum disorder. At the time of our inspection three people were living at the home.

A registered manager was in place. 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 2008 and associated Regulations about how the service is run.

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 the last inspection, the service was rated good. At this inspection we found the service remained Good.

We were not able to speak to all of the people who used the service because some of the people had complex needs, which meant they were not able to tell us their experiences, so we asked their relatives for their views.

Relatives told us their family members were safe. Processes were in place to ensure people were protected from abuse. Staff had received safeguarding training and were confident actions would be taken if they ever had to raise concerns.

The provider continued to have a robust recruitment and selection procedure in place and carried out relevant checks prior to staff starting employment.

Medicines continued to be managed safely. Medicines records we viewed were accurate and up to date including records for the receipt, return and administration of medicines. The provider ensured checks were in place to maintain the safety of the home. Systems were in place to ensure people would remain safe in the event of an emergency.

Accidents and incidents were appropriately recorded. Where risks were identified they were assessed and managed to minimise the risk to the person.

Sufficient suitable staff were deployed to meet people’s needs. Relatives told us staff had the appropriate skills and knowledge to support their relative. Training was up to date. Staff had the opportunity to discuss their development at regularly held supervisions and at an annual appraisal.

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.

People were supported to have a balanced diet. People were supported to make their own choices and to be as independent as possible. The service engaged with multi agencies to ensure people received joined up care.

People were treated with dignity and respect. An established staff team was in place with extensive knowledge about the people they supported. Care plans were comprehensive and detailed people’s needs and how they wished to be supported. Reviews were regularly completed.

People were supported to be independent and active as possible, follow their interests and take part in social activities. Relatives told us they were made welcome at the home and were updated regularly.

The provider had systems to audit the running of the service. Staff and relatives were complimentary about the registered manager. Staff, people and relatives were regularly asked for their feedback about the service.

Further information is in the detailed findings

This inspection took place on 26 January 2016. The last inspection of this home was carried out on 3 October 2013. The service met the regulations we inspected against at that time.

Inverthorne provides care and support for four people who have autism spectrum condition. The care home is a semi-detached family house in a residential area near the city centre. The service is situated in between two similar small care homes and all three services are managed by the same 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.

Relatives and staff felt the service was safe for the people who lived there. A few months ago there had been a safeguarding incident in the home which allegedly involved some staff members. The provider had taken the appropriate action to deal with this and had strengthened the staff training and procedures in safeguarding people.

There were enough staff to assist people in the house or to go out to activities in the community. The recruitment of staff included the right checks and clearances so only suitable staff were employed. Potential risks to people’s safety were assessed and managed. People’s medicines were managed in a safe way, although it would be better if staff were consistent in recording whether ‘when required’ medicines had not been needed.

Relatives said the service provided specialist support for people with autism spectrum condition. Staff were well trained in autism to help them understand the individual challenges faced by the people who lived there. New staff received induction training when they started work. One staff commented, “We get loads of training – the company is spot-on with training.”

Staff had training in the Mental Capacity Act 2005 for people who lacked capacity to make a decision and deprivation of liberty safeguards to make sure they were not restricted unnecessarily. People’s lack of capacity to consent to care was clearly outlined in their care records.

People were supported to maintain a balanced and healthy diet. One staff member commented, “Most meals are home-made from scratch and we try to make sure people have a healthy diet.” People health and well-being was kept under continuous review by the service with input from external healthcare professionals.

Staff engaged with each person in a way that met their communication needs. A relative said a support worker had “an excellent rapport” with their family member. A care professional also commented on the “very good relationship” with relatives and some “very committed” staff.

All the staff members we spoke with talked about people in a caring manner. Staff comments included, “I’d do anything for them” and “all the staff I work with are caring and the people are lovely”. We saw the interactions between staff and people were supportive and friendly.

People had been individually assessed and their care was planned to make sure they got the right support to meet their specific needs. A relative told us, “[My family member] has an individual care programme which is on-going as their needs change.” People enjoyed a range of vocational and social activities outside of the home. Staff were knowledgeable about each person’s individuality and relatives felt the service was tailored to meet their family member’s needs.

Staff were familiar with how people might show if they were unhappy with a situation. Relatives had up to date information about how to make a complaint or comment. They said they would feel comfortable about telling the registered manager if they had any concerns. There had been no complaints about this service in the past year.

Relatives and staff felt the organisation was well run and the home

We have not been able to speak to all of the people using the service because some of the people had complex needs, which meant they were not able to tell us their experiences.

However, people were seen to be relaxed and comfortable with staff.

We were supported in this inspection by an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. We asked the expert by experience to spend time with the people using the service to find out their views about what it was like to live there.

During the inspection, the staff members on duty were observed speaking to people in a kind and respectful way. We also observed that the people were clean and well groomed.

We found that people who were using the service were receiving the care and support they needed.

We found that people who were using the service were provided with appropriate opportunities, encouragement and support in relation to promoting community involvement.

We found that the people who were using the service were protected from abuse as the provider had procedures in place for the staff to follow if they suspected anyone was at risk of abuse.

The complaints procedures had been made available to the people who used the service and their relatives. This was provided in a format that met their needs.

During our visit, all interactions we observed between the staff and the people living at the home were open, respectful and courteous.

We saw that staff provided whatever was wanted in a way that demonstrated a good knowledge of each individual person. Where appropriate, we saw staff providing support and encouragement to enable people to do things as independently as possible.

We observed people being spoken with and supported in a sensitive, respectful and professional manner. We saw that staff included people living at the home in the day to day running of the home and that, whenever possible, it was the people living at the home that made decisions on what happened through the day and when. We saw that people's needs were met in a calm and unhurried way, with enough staff available to meet any needs as they arose.

We met two of the people who live here, as well as members of the staff team and the registered manager.

The people we met were not able to tell us their views but we observed how they were being cared for and saw that they were happy, relaxed and comfortable as they went about the home. We also saw them talking with staff and that there were good relationships between them as staff gave them support with activities such as preparing drinks and food.