This comprehensive inspection took place over two days on the 27 September and 2 October 2017.

Jameson House residential care home that provides personal care and support registered for up to five people who have a learning disability and/or autistic spectrum disorder. People using the service live in a single house located within a residential community setting. People living in care homes receive accommodation and personal care 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. At the time of our inspection there were four people living at the service.

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

A Registered Manager was in post. 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.

The registered provider was also the registered manager. They had clear aims and objectives with vision for the service with ongoing work to embed the values of providing personalised care, promoting independence, choice, rights and empowerment. We saw that the registered manager and staff put these values into practice.

This service was provided in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include supporting people with choice, promotion of independence and inclusion. People with learning disabilities and autism using the service are supported to live as ordinary a life as any other citizen.

People were treated with dignity and respect and staff interacted with people in a kind, caring and sensitive manner. Staff demonstrated a good knowledge of their roles and responsibilities in recognising abuse and safeguarding procedures with steps they should take to protect people.

The registered provider had a system in place to ensure appropriate recruitment checks had been carried out before staff started working at the service. There were sufficient numbers of skilled, well trained and qualified staff on duty. Staff told us that they felt well supported in their role and we saw that staff had received regular supervision and training relevant to the roles they were employed to perform.

We found that detailed assessments had been carried out prior to admission to the service. Care plans had been developed around each individual’s needs and preferences. We saw that there were comprehensive risk assessments in place and plans to guide staff in how the risks identified were to be managed and mitigated. People were supported with taking informed, every day risks and encouraged to take part in daily activities and outings. We saw that appropriate assessments had been carried out where people living at the service were not able to make decisions for themselves, to help ensure their rights were protected.

People’s medicines had been stored safely. There were clear personalised protocols in place to guide staff as to how people liked to take their medicines and identified allergies.

People looked happy and relaxed with staff. Where people lacked capacity to air their views verbally, staff supported people with opportunities to communicate through pictorial aids and visual prompts appropriate for the individual. Relative’s told us they were able to raise concerns and there were systems in place to ensure people could be confident they would be listened to and appropriate action taken.

People were supported to be able to eat and drink sufficient amounts to meet their needs and were offered choice. Where assessed as appropriate people were supported to increase their independence and gain

This inspection was unannounced and carried out on 20 February 2015.

Jameson House is a residential care home that provides personal care and support for up to five young adults who have a learning disability and/or autistic spectrum disorder. At the time of our inspection there were three young people who used the service.

A registered manager was in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. As like registered providers they 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 service was last inspected on 8 October 2013 and at that time requirements in the Health and Social Care Act 2008 and associated Regulations were met.

People were protected from bullying, harassment, avoidable harm and potential abuse. This was done consistently so that people were safe whether they were in the service itself or out in the community. Management and staff had a positive attitude towards managing risk and keeping people safe. Potential risks of harm to the individual or others in their daily lives were assessed and identified. Detailed management strategies provided guidance for staff on what actions to take to minimise the risk and provide appropriate and individualised support to people that enabled them to participate in activities of their choice and access the community safely.

The provider had a thorough recruitment and selection process in place to check that staff were suitable to work with people who used the service. People were supported by sufficient numbers of staff. Staffing levels were flexible and supported people to follow their interests and take part in social activities and, where appropriate, education and work opportunities.

Medication was stored safely and administered correctly. The provider had robust systems in place to detect medication errors and took action promptly to rectify any errors found.

Staff had developed good relationships with people living at the service and respected their diverse needs. They were caring and respectful and had the required knowledge and skills they needed to meet people’s needs appropriately and safely. Staff knew each person’s individual care and support needs well. People’s privacy and dignity was respected and upheld and they were supported to express their views and choices by whatever means they were able to. Staff clearly understood each person’s way of communicating their needs and anxieties.

Management and staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions in some areas of their care, treatment and support.

People had a choice of balanced, healthy and nutritious meals and were able to eat their meal where they wanted. Nutritional assessments were in place which identified what food and drink people needed to keep them well and what they liked to eat.

People received personalised care specific to their individual needs; their independence was encouraged and their hobbies and leisure interests were supported. They received continuing specialist help with an existing medical condition and had prompt access to healthcare professionals when they became unwell. Each person had a health action plan which detailed how they were being supported to manage and maintain their health.

The provider had arrangements in place to routinely listen and learn from people’s experiences, concerns and complaints. There was a strong emphasis on promoting good practice in the service and there was a well-developed understanding of equality, diversity and human rights and management and staff put these into practice. The registered manager was very knowledgeable and inspired confidence in the staff team, and led by example.

Quality assurance systems were robust to ensure the service delivered was of a high quality and safe and continued to improve.

Due to the complex nature of people’s learning disabilities and communication we used different methods to help us understand the experiences of people who used the service. Where people were unable to tell us about their experiences, we used observation and noted people’s responses to staff. We saw that people appeared calm and relaxed in the presence of staff and actively sought them out.

We observed that staff were attentive to people`s needs and treated them with respect and dignity calling them by their name. We saw that staff sought people`s agreement before providing any support and assistance.

We saw that staff were knowledgeable about people’s needs and promoted their independence. During our discussions with staff we found that they had a good understanding and awareness of people’s care needs and preferences.

We saw that the building was comfortable, clean and well maintained. We saw that equipment had been checked and serviced within expected timescales.

We saw that there was a complaints policy and procedure in place which was in an easy read format to meet the needs of people who used the service. The staff were able to explain the complaints procedure. One person who used the service told us if they were unhappy “I would tell the manager.”

We were not able to speak to all the people using the service because some had complex needs which meant they were not able to tell us about their experiences or they did not want to speak with us. To help us understand the experiences of people living in the home we gathered evidence by talking in general with one person and by observing care and interactions between staff and the people living there. The person we spoke with told us that they were very happy living at Jameson House and that all the staff were very kind and helpful.

We saw that Jameson House provided a relaxed and homely environment to people. Staff were friendly and respectful in their approach and interacted with people using the service in a confident and considerate manner. During the course of our visit we saw that people were supported to express their views and choices by whatever means they were able to, and staff clearly understood each person’s way of communicating their needs.