The inspection took place on 19 January 2019 and was unannounced. The previous inspection took place on 14 and 22 April 2016 and the service was rated as Good.

Lammasmead 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 service registered to provide residential accommodation and personal care for up three people living with a learning disability. At the time of our inspection three people were living at the home.

We have written this inspection report in a shorter format because our overall rating of the service as Good has not changed since our last inspection.

People told us they liked living at Lammasmead and felt safe. People continued to receive a safe service. Staff protected people as far as possible from discrimination, abuse and harm. Risk assessments were in place and had been regularly reviewed so staff were aware of what action to take to reduce risks to people.

Medicines were safely stored and administered.

People told us and we saw that staff were kind to them. Care records were in place, up to date and holistic, and we saw staff understood people’s preferences and routines. There were enough staff to meet people’s needs and the staff team was longstanding so there was continuity of care provided to people.

The service had systems in place to prevent the spread of infection and the service was clean. People told us they liked the food and had choices of what they ate.

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.

The provider had a complaints system in place and we could see they responded to complaints promptly. The service learnt from accidents and incidents and the registered manager and provider undertook regular audits to ensure the quality of the service was good.

Lammasmead is registered to provide residential accommodation and personal care for up three older living with a learning disability. At the time of our inspection three people were living at the home.

The inspection took place on 14 and 22 April 2016 and was unannounced which meant the provider or manager did not know we were coming. At the last inspection on 22 May 2013 we found the service met the required standards and also found at this inspection the required standards were similarly being met.

The home did not have a registered manager in post. The manager had been in post since March 2016 and was in the process of applying to CQC to register. 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. Shortly after our previous inspection, the provider changed their legal entity requiring a new provider registration following a reorganisation of the company.

CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection we found that applications had been made to the local authority in relation to people who lived at Lammasmead and a number of these were pending an outcome.

People told us they felt safe living at Lammasmead. Staff were aware of how to keep people safe and risks to people’s safety and well-being were identified and managed. Where people’s needs changed staff ensured these were responded to and managed in a safe manner. There were sufficient numbers of staff deployed to support people, and the home was calm and relaxed throughout our inspection. There were suitable arrangements for the safe storage and administration of people’s medicines, including controlled drugs and people’s medicines were regularly reviewed.

People were asked for their permission before staff assisted them with care or support. Staff had the skills and knowledge necessary to provide people with safe and effective care and demonstrated this throughout the inspection. Staff received regular support from management which helped them feel supported and valued. People received appropriate support and encouragement to eat and drink sufficient quantities and people’s nutritional needs were assessed and monitored effectively. People had access to a range of healthcare professionals when they needed them and feedback from health care professionals was positive and supportive of the care provided at Lammasmead.

People’s privacy and dignity was promoted. People told us they were treated with kindness and compassion by staff that listened to them.

People and staff told us the culture in the home was open and supportive. The manager had identified a number of key areas for improvement in areas such as updating people’s care records, and submitting notifications as required. Arrangements were in place to obtain feedback from people who used the service, their relatives, and staff members about the quality of care services provided.

Care was planned and delivered in a way that ensured people’s safety and welfare. During our inspection we spoke with three members of staff and observed support being provided to the three people who lived at the home. Throughout our inspection staff demonstrated that they were very knowledgeable about each person’s needs. The people who lived at the home made very positive comments about the service they received and clearly had a good relationship with the staff.

People living at the home told us they liked the food and had plenty to eat and drink. They said they were involved in deciding each week’s menu, shopping for the food and the preparation of the meals.

We found that appropriate arrangements were in place in relation to obtaining, recording, storage, administration and disposal of medicines.

Staff were provided with appropriate training and support which enabled them to meet the needs of the people living at the home.

The people living at the home said they felt they could raise any complaints they had with the manager and were confident they would be listened to.

We spoke with two of the three people who lived at the home. Both told us they were happy living there and liked the staff who supported them. We saw that people were involved in decisions about their lives, both informally on a day to day basis, and more formally through surveys and meetings. People told us that they felt able to raise any concerns they had with the staff and the Registered Manager.

During our inspection we spoke with three members of staff and observed them supporting the people who lived at the home. Throughout our inspection staff demonstrated that they were very knowledgeable about each person’s needs. People told us there were always staff available when they needed help.

We found that care plans and associated documentation provided staff with the relevant information on how to safely meet people’s needs and preferences. From discussion with the people who lived at the home, and the staff who support them, it was clear these plans were being followed and people's needs were being met.

The Registered Manager had ensured the people who lived at the home were safeguarded and had referred a concern to the correct authority for investigation. However, they did not notify the Care Quality Commission of the event. This meant that information had not been provided to us to assess whether regulatory action was required.