The inspection took place on 24 and 25 April 2017. The inspection was announced. The provider and registered manager oversee two registered services on the same site. Fairway House is registered for personal care and Link House for residential care. We inspected both services together as they had some shared staffing, and policies. We also wanted to ensure we could meet people using the service so we gave 48 hours’ notice. We have not inspected either service since a change in their registration, (ownership) in March 2015.

Link House provides residential care to up to six adults with a learning disability.

There was a registered manager in post at the time of our inspection. They were registered for both services. 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 service was extremely well managed and clearly run in the interest of people using the service. The service was generously staffed and all staff were familiar with people’s needs and provided continuity of support. There was minimal turnover of staff and no agency usage. This meant people using the service had built up relationships with staff and had a degree of predictability and established routines. Staff said this was important in terms of reducing people’s anxieties.

There were safe systems in place to ensure people were protected from unnecessary risks and staff knew what actions to take to mitigate risk. The environment was well maintained and equipment checked regularly to ensure it was safe to use.

People received their medicines as intended and checks were carried out by staff to ensure they received their medicines safely.

Staff understood different types of abuse and knew what actions to take should abuse occur or they suspected someone to be at risk of harm or actual abuse.

Staff recruitment procedures were sufficiently stringent to help ensure only suitable staff were employed. Staff were supported in their role and had the necessary competencies. There was a thorough induction, ongoing training and support for staff including regular supervision, observation of practice and appraisal.

Staff were highly motivated and had developed good relationships with the people they were supporting and extended this support to family and friends. Staff supported people to have relationships of their choosing and to make their own decisions about this.

Staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The MCA ensures that people’s capacity to consent to care and treatment is assessed. If people do not have the capacity to consent for themselves the appropriate professionals, relatives or legal representatives should be involved to ensure that decisions are taken in people’s best interests according to a structured process. DoLS ensure that people are not unlawfully deprived of their liberty and where restrictions are required to protect people and keep them safe, this is done in line with legislation. Practice related to MCA and DoLS was very good and in line with legal requirements.

People were supported to make appropriate choices about their diet and staff provided opportunities for people to follow a healthy lifestyle and take regular exercise. People were fully involved in menu planning; shopping and preparing meals for themselves and others they lived with.

People were encouraged to live independent, fulfilling lives and had opportunities to participate in a range of different social activities, work placements and day centres. There was opportunity for evening and weekend activities and annual holidays. This helped ensure people were fully engaged and participating within their local commu