The inspection took place on 2 October 2018 and was unannounced. The last comprehensive inspection took place in April 2016 when the registered provider was rated good. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Larch Avenue’ on our website at www.cqc.org.uk. At this inspection we found the service had remained good.

Larch Avenue 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.

Larch Avenue is a care home situated in Auckley, Doncaster. It provides care for to up to 6 people living with a learning disability. The accommodation and housing support is provided by South Yorkshire Housing Association and the care staff are employed by Rotherham Doncaster and South Humber NHS Foundation Trust.

At the time of our inspection the service had a 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.

The registered provider was working within 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.

People were safeguarded from the risk of abuse. Risks associated with people’s care had been identified and were managed appropriately. People were supported by sufficient staff to keep them safe. The service managed people’s medicine in a safe way. The service had a safe recruitment procedure.

People had their assessed needs and choices met by staff with the right skills, knowledge and experience. Processes were in place to ensure there were no discrimination, including the protected characteristics under the Equality Act. People were supported to maintain a healthy, balanced diet. People had access to healthcare professionals. Consent to care was sought in line with legislation. 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.

We observed staff interacting with people and found they were kind, caring and compassionate. We saw staff respected people’s privacy and dignity.

People received personalised care which met their needs and took into consideration their preferences. People accessed the community and took part in activities of their choosing. Complaints were listened to and used to improve the quality of care.

There were systems in place to monitor the service. People had a voice and had opportunities to contribute to the service. Staff found the management team approachable. Lessons were learned and improvements made when things went wrong.

Further information is in the detailed findings below.

The inspection took place on 29 January 2016 and was unannounced. Our last inspection of this service took place in December 2013 when no breaches of legal requirements were identified.

Larch Avenue is a care home for people with learning disabilities, it can accommodate up to six people. The service is situated in Auckley, close to Doncaster. The accommodation and housing support is provided by South Yorkshire Housing Association, and the care staff are employed by Rotherham Doncaster and South Humber NHS Foundation Trust.

The service did not have a registered manager in post at the time of our inspection. 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 previous manager had recently retired, and we were told that recruitment interviews for the post of manager were taking place in the week of the inspection. In the meantime, the service was managed by the deputy manager, with support from other, senior managers.

There were five people living at Larch Avenue at the time of the inspection, one of whom was out, attending a day service when we arrived. We met all of the people who used the service during the course of the day and they all indicated that they were very happy living in the home and that everyone got on well with each other.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

Overall, the service was meeting the requirements of the Mental Capacity Act 2005 (MCA). The Deprivation of Liberty Safeguards (DoLS) are part of MCA legislation and ensure that where someone may be deprived of their liberty, the least restrictive option is taken.

The staff were good at communicating with and engaging people. They were respectful of people’s wishes and feelings.

The staff we spoke with were aware of their role in safeguarding people from abuse and neglect. They told us they had received training in safeguarding both adults and children.

We saw risk assessments had been devised to help minimise and monitor risk, while encouraging people to be as independent as possible. Staff were aware of the particular risks associated with each person’s individual needs and behaviour.

There were enough staff to keep people safe and to meet their needs. There was very positive interaction between people who used the service and the staff supporting them.

The staff we spoke with knew each person’s needs and preferences in detail, and used this knowledge to provide tailored support to people.

People’s needs had been identified in their assessments and care plans, and from our observations, people’s needs were met by staff. There was a lot of emphasis on observations, especially for signs of any discomfort, as not everyone could communicate their needs verbally.

People were supported to eat and drink sufficient to maintain a balanced diet. People were supported to maintain good health and have access to healthcare services. We looked at people’s records and found they had received support from healthcare professionals when required. There were appropriate arrangements in place to manage people’s medicines.

People were supported to keep in touch with those who were important to them, such as their family and friends, and we saw that people took part in activities in the home and in the community.

The service had a complaints procedure, which was available in an ‘easy read’ version to help people to understand how to raise any concerns they might have.

There was evidence that people were consulted about the service provided. We saw that service user h

There were six people living at Larch Avenue at the time of the inspection. One person was not well and was in hospital. Four of the five people who were at home were able to tell us what they thought about the service. One person told us they were very happy living at Larch Avenue and said that everyone got on well with each other. Three more people indicated that they agreed with this.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

People experienced care, treatment and support that met their needs and protected their rights. During the inspection we spent time observing how staff members interacted with people who used the service. The staff were good at communicating with and engaging people. They were respectful of people’s wishes and feelings.

People were protected from the risks of inadequate nutrition and dehydration.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There was an effective complaints system available.

We spoke with four people living at Larch Avenue. They told us the staff were very good, they supported them to make decisions and choices. They also told us they liked living at Larch Avenue and did lots of activities. Interactions we observed between people and staff were appropriate, inclusive and positive.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work. We also found there were enough qualified, skilled and experienced staff to meet people’s needs.

We observed that there was an effective system to regularly assess and monitor the quality of service that people received. There was a complaints policy that took account of complaints and comments to improve the service.

There were six people who used the service. We met them all briefly at the start of our visit and they appeared happy and at ease in their surroundings.

Five people were planning to go out ten pin bowling on the day of our visit and left soon after we arrived. One person remained in the home. We chatted to them at lunch time but they spent a lot of time in their room through personal choice.

People who used the service told us that they had a good choice of social activities to take part in. Staff took them out into the community on a regular basis and supported them to take part in local events and celebrations.

People said the care was good and they knew to speak to the manager or staff if they had any concerns.