This inspection took place on 21 June 2016 and was unannounced. The last inspection we conducted was on 13 March 2014. This was to check, that the provider had taken action to meet standards that they had not met, at the previous inspection on the 23 July 2013. At the inspection on 13 March 2014, the provider had met the essential standards of quality and safety.

Lindale Residential Care Home (Lindale) is registered as providing accommodation for a maximum of 9 persons with learning disabilities or autistic spectrum disorder who require personal care.

There was a registered manager 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.

People were protected from abuse because staff were trained in identifying and dealing with suspected abuse and safeguarding.

We saw staff were available to meet people’s needs and manage risks associated with providing care for people living at the home. We found that staff were effective in ensuring people received their medications safely.

The provider had ensured that suitably qualified staff provided care to people who used the service. People were able to consent to the care they received from the staff.

People’s health care needs were effectively met by the staff and the registered manager.

People liked living at Lindale and had positive views of the staff. Staff interactions with people were warm and friendly. The staff were knowledgeable about people’s likes and dislikes. Staff ensured that people’s privacy and dignity was maintained.

People were involved in planning their care and activities. The registered manager had received no complaints from people or their relatives recently. We could see that learning had taken place from past complaints.

The registered manager carried out audits to evaluate the quality of the service provided to people.

At our last inspection in July 2013, we found that people did not always experience care and support that met their needs and protected their rights. Safeguarding procedures in place for people to raise concerns were not effective and appropriate checks were not always undertaken before staff began work. We found there was not always enough skilled and experienced staff to keep people safe and staff had not received training relevant to the needs of the people they cared for. We identified that improvements in record keeping was also required. We set compliance actions and told the provider to improve.

Following our inspection in July 2013, we also issued a warning notice for regulation 10. This was because we found that effective systems were not in place to assess and monitor the quality of service that people received or ensure that the provider, identified monitored and managed risks. We did a follow up inspection in November 2013 to see if the provider had met the requirements of the warning notice and we found that they had. The purpose of this inspection was to see if the provider was now compliant with the remaining outcomes, we found that the necessary improvements were made.

On the day of our inspection seven people lived at the home. Due to some of the people's limited verbal communication skills we briefly spoke with three of the people who lived at the home. Other people were unable to verbally share with us their views about their care due to their individual needs. We used different ways to evidence their experience, such as observing care and looking at their care records, we also spoke with three relatives. We spoke with two members of staff, the registered manager and looked at four sets of staff records.

People experienced care and support that met their needs and protected their rights. One person told us, “I went out today and had a nice time”.

Safeguarding procedures were in place and staff were confident that they would recognise and report any allegations of abuse so that people were protected from the risk of harm. A relative told us, “I cannot fault the care, it’s very good”.

Recruitment processes were in place which gave people who used the service, some assurance that only suitable staff had been employed.

We found that there were enough staff employed to meet people's needs safely and people were cared for by staff who were supported, supervised and trained to deliver care to an appropriate standard. A relative told us, “The staff are able to meet their needs, I am more than happy”.

We saw that care records reflected people’s individual needs and were accessible to staff when needed.

We inspected Lindale Residential Care Home to check if improvements had been made. At our last inspection in July 2013 we issued a warning notice for regulation 10. This was because we found that effective systems were not in place to assess and monitor the quality of service that people received or ensure that the provider identified monitored and managed risks. We judged at the time that this had a moderate impact on people who lived at the home.

At the time of our inspection there were eight people who lived at the home, we spoke with four people and looked at two sets of care records. We also spoke with the registered manager and two members of staff.

We saw that improvements were made in the provider's quality assurance systems. This meant that the risks to people had been reduced. Areas of improvements included the implementation of an effective auditing system to ensure standards of care were regularly monitored and that people were able to give feedback on the quality of service. One person told us, “We have a meeting every Sunday to talk about things”.

On the day of our inspection there were a total of nine people living at the home. We spoke with six people and three relatives and we looked at three sets of care records. Some people were unable to verbally share with us their views about their care due to their individual needs. We used different ways to evidence their experiences such as observing care and speaking with relatives. We also spoke with three members of staff and the registered manager.

Care was not always planned and delivered in a way that was intended to ensure people's safety and welfare.One person told us that the lack of activities meant, "It's boring".

Safeguarding procedures were not robust enough to ensure that staff were alert to allegations of abuse and people were not at risk of harm.

Recruitment processes had not been as thorough as they should have been to give assurance that only suitable staff had been employed.

There was not enough staff on duty at all times to ensure that staff were able to respond to an emergency safely and effectively.

Lack of appropriate training meant that not all staff had the knowledge and skills to provide care that was safe and effective.One person said,"Staff don't want to know".

The system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others was not robust to be fully effective.

Care records did not always fully reflect people's needs.

Eight people were living in the home when we visited. We met all of them and talked with two of them. Two people had health conditions that meant they were not able to talk with us. We spent time in the common rooms, observing the care people received. We looked at the care records of two people. We also spoke with two members of staff and both the home’s manager and deputy manager. This helped us to understand what it was like to live there.

Most of the people living in the home had lived there for several years and they all seemed relaxed in the company of staff. One person told us “It’s OK living here.” They also said they generally ‘got on’ with the other people who lived there and they would tell staff if something was worrying them.

People’s privacy and dignity were respected. One person showed us their room, which had their personal belongings in it. We saw staff treat people with respect, talking with them and helping them at a pace the person was comfortable with.

People were involved in making decisions about their care and support. They met together every Sunday to talk about what they wanted to do. One person said they were “going to see their family” at the weekend. Another person told us they had started talking about where they would go on holiday later this year.

Staff had a good understanding of people’s needs and preferences and what they needed to do to meet these needs. However, people’s care records were not fully complete or accurate.