About the service: Anvil House provides accommodation and care for up to seven people with a learning disability and physical disabilities within a large detached property. The service does not provide nursing care. At the time of our inspection there were seven people using the service.

Anvil House has been developed and designed in line with 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’s experience of using this service:

¿ People living at this service were well supported by a team of care staff who knew them well.

¿ People were supported by staff who had a good understanding of how to recognise and report potential harm or abuse and were confident in local safeguarding procedures.

¿ Staff had appropriate skills and knowledge to deliver care and support people in a person-centred way.

¿ People received their medication as prescribed and there were sufficient staff on duty to keep people safe and ensure their needs were met.

¿ People were supported by staff who were kind and caring and who encouraged people to be as independent as possible within their home.

¿ 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.

Rating at last inspection: The service was rated ‘Good’ at our last inspection on 24 February 2016. The report following that inspection was published on 18 May 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection took place on 24 February 2016 and was unannounced.

Anvil House provides accommodation and care for up to seven people with a learning disability and physical disabilities within a large detached property. The service does not provide nursing care. At the time of our inspection there were seven people using 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. 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.

Staff had a good understanding in how to keep people safe. The service had appropriate systems in place to keep people safe, and staff followed these guidelines when they supported people. People received flexible and responsive care because they were supported by sufficient numbers of staff. There were systems in place to manage medicines and people were supported to take their prescribed medicines safely. The provider had a robust recruitment process in place to protect people from the risk of avoidable harm.

Staff were supported to develop skills and knowledge to meet people’s needs. Decisions were made in people’s best interests. People were supported to make choices about the care and support their received.

Staff supported people to have food and drink that met their individual needs and preferences. People’s health needs were monitored and managed by staff with input from relevant health care professionals.

People were treated with kindness, dignity and respect by staff who knew them well. Staff had developed creative ways to supporting people to communicate their preferences.

Staff supported people to maximise their independence. Support was tailored around people’s needs and outlined in person centred care plans. Staff ensured that people had meaningful lives and took part in the daily running of their home.

People’s feedback was actively sought. They were involved in residents meetings and were able to influence how the service was run. Complaints were dealt with and responded to positively.

There was an open culture and the manager demonstrated good leadership skills. Staff were enthusiastic about their roles and were able to express their views. The provider had systems in place to check the quality of the service and to make improvements where necessary.

During our inspection of Anvil House on 5 December 2013, we were unable to speak with the people who used the service because they had complex needs and did not communicate freely. To help us understand their experiences we spent time with them and observed the interaction between them and the staff. The staff were able to communicate with them on our behalf. We saw that they were relaxed and happy.

When we arrived to start the inspection, all but one of the seven people who used the service were out accessing the community with staff or attending a day centre. As people returned to Anvil House we saw they were supported to become engaged in activities they liked and enjoyed within the home.

We saw that a sufficient number of suitably trained and qualified staff were available to meet the needs of the people who used the service at all times. During the inspection we spoke with seven members of staff who were all familiar with the services policies and procedures. They explained their responsibility to keep the people who used the service safe.

We saw the premises were clean, suitably designed, well maintained and set in a well tendered garden. There were handrails in the garden to allow everyone to access all areas of the grounds. There was ample space at the front of the home for vehicles, including the home's transport.

We used a number of different methods to help us understand the experiences of people using the service. This was because the people living at the home had complex needs which meant that they were not able to tell us their experiences. We spoke to a relative of one person living at the home and were able to observe staff supporting people.

We saw that the people living at the home were supported and encouraged to exercise choice in their day to day lives. Independence was also promoted and staff worked with people to achieve this. People received the care, support and treatment they needed and this was provided in an individual way. One relative told us "My relative is well cared for here, including their health and the staff pick up on things very quickly."

We found that the staff at the home were well trained and supported to undertake their role and responsibilities. We spoke to one relative who said "The staff are well trained, they have a lot of training."

We found that the provider had systems in please to assess and monitor the quality of the service provided. One relative told us "I would give the home 10/10, my relative could not be anywhere better."