This inspection took place on 13 October 2016 and was announced. During our last inspection in September 2014 we found the provider was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations, Safe care and Treatment. We found that the registered provider had not made suitable arrangements for the administration and recording of medicines.

During this inspection we found that the provider had provided medicines administration training to staff and procedures for the administration of medicines had been updated and improved.

Matthew Residential Care Limited – 59 Woodgrange Avenue is a care home providing accommodation and personal care for the maximum of three people who have learning disabilities and mental health needs. The home has currently one vacancy.

The inspection was carried out by one inspector.

59 Woodgrange Avenue has a manager who is registered with the Care Quality Commission (CQC). 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 safe in the home. Staff understood the safeguarding processes and knew what constituted abuse. Staff knew how to keep people safe and reported any issues of concern appropriately. Risk assessments were clear and detailed and reviewed regularly. Staff followed guidance and protocols that were in place to help reduce the risks for people. People received their medication on time and in the manner the prescriber intended.

There were enough staff to meet people's needs properly and the staff on duty had the skills and knowledge to support people effectively and meet their needs in a timely manner. Appropriate and safe recruitment practices were followed, to help make sure staff were suitable to work with people in a care environment.

Staff received good support from each other and the registered manager. Staff were regularly supervised and the management team was hands on and approachable. The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The registered manager ensured the service operated in accordance with the MCA and DoLS procedures and staff demonstrated a clear understanding of the MCA, DoLS, capacity and consent.

People were supported to make their own decisions and choices as much as possible. People received enough food and drink to meet their individual needs and staff had a good understanding and knowledge of people's dietary needs. Referrals to healthcare professionals were made promptly as needed and any advice or guidance given was followed appropriately by staff.

People were fully involved, where possible, in planning and reviewing their own care and staff appropriately supported people, when necessary, to make informed choices for themselves. Staff were kind, caring and compassionate. People were treated with dignity and respect and their privacy was upheld. People were also supported and encouraged to do as much for themselves as possible, in order to enhance and maintain their independence.

People took part in activities of their choosing and followed their own hobbies and interests, inside and outside of the home. Visitors were always welcomed without unnecessary restrictions and people's personal relationships were valued and respected. People were listened to and comments or complaints were welcome. Any complaints were fully investigated and actions taken to improve the quality of care provided.

There were effective systems in place to monitor the quality of the service and these were used to develop the service further. Staff and people living in the home were regularly involved in making decisions on how the home was run. Record keepin

An inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, is the service effective, is the service caring, is the service responsive, is the service well led?

We spoke with the registered manager, a manager from another home within the same organisation, and one staff member. We reviewed the care plans of two people.

This is a summary of what we found:

Is the service safe?

Systems were in place to ensure that staff learnt from events such as accidents and incidents. This reduced the likelihood of people being at risk. We saw systems were not in place to protect people against the risks associated with medicines. We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to the administration and recording of medicines.

During our inspection we assessed how the Mental Capacity Act (MCA) 2005 was being implemented. This is a law which provides a system of assessment and decision making to protect people who do not have the capacity to give consent. We also looked at Deprivation of Liberty Safeguards (DoLS). DoLS aim to make sure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom. We saw one person was unable to leave the home without the assistance of staff. This may mean a deprivation of liberty authorisation was required.

Is the service effective?

We found from speaking with staff and watching how they communicated with people, they had an understanding of people's care and support needs and knew them well.

Staff assessed people's health and care needs with the person. Staff told us care plans assisted them to meet people's needs through the provision of information on people’s care needs.

Staff received supervision and appraisals and were provided with feedback on their performance. This meant staff were given support to deliver the care and support to people.

Is the service caring?

Both people told us they felt safe in the care of staff. One person said, “Staff are nice,” the other person said, “Staff are O.K, I get on with them.”

People told us they could speak with staff if they had concerns or were unhappy about their care. One person said, “I would like to stay here for life, it’s my favourite home.”

Is the service responsive?

People's preferences, interests and diverse needs were recorded, and care and support was provided in accordance with the wishes of people using the service. For example, care plans recorded activities people enjoyed.

People we spoke with knew how to make a complaint. We saw there was a process in place to respond to any issues of concern.

Is the service well-led?

This small service was introducing quality assurance systems to identify and address issues.

We found that the provider obtained consent from people before providing care and support. The manager told us that people at the home refused support on offer and this was recorded in their care plan.

One person who used the service told us "I like it here." Another said "The staff are nice."

Records showed that people's needs were assessed and a care plan was developed detailing how a person's needs would be met.

Records showed that the provider worked along with other agencies to deliver the care and support to people who used the service

We found that the provider had systems in place to monitor the cleanliness of the service. Staff we spoke with were able to detail the protective equipment they used when supporting people.

Records showed that the provider completed the necessary checks when recruiting staff.

People using the service told us that they had been involved in their treatment or care. People told us that they chose their employment or day service. Comments made included, "that is what I like doing" or "I enjoy my job.”

People told us that they were involved in their care plans, comments included "I have a care plan and I meet with my key worker to discuss it regularly.” They said, that they felt ”safe” at the home. Staff received adult protection training and demonstrated that they were able to transfer learned skills. Staff told us that they would contact the provider or the appropriate authorities if witnessed or were told of any adult protection issue.

People using the service lived in an environment suitable to their needs. We observed people clean the communal areas and a person told us that they "tidy my room.” People appeared very comfortable within the presence of staff and told us "I like the carers, they are nice." People were aware of the complaints procedure and told us "I would talk to my key worker or the manager if I have a problem.”

We were able to talk to some of the people who use the service and discuss their care. We also observed how staff interacted and responded to them. We noted that people who use the service appeared relaxed and were able to approach staff and move freely in the home. One person who use the service had gone out to join in community activities. We were informed by people who use the service that there were meetings in the home where they could express their views and this included one to one sessions with staff.

People who use the service said they were well cared for. There was evidence that their needs had been carefully assessed, discussed with them and professionals involved in their care. Suggestions we made for improving care and care documentation during our visit were promptly responded to after the visit.

The home had arrangements in place to safeguard people who use the service and they informed us that they felt safe and staff had treated them with respect. We however, noted that the safeguarding policy and procedure had not been update to fully reflect current guidance. This was promptly responded to and revised copies were sent to us.

Staff were caring and knowledgeable regarding the individual needs of people who use the service. People who use the service and staff were of the opinion that the home had adequate staff to respond to the needs.

There are arrangements in place to ensure that the quality of care provided is monitored and people who use the service received a good quality of care and are able to influence the service provided for them. The feedback received from a recent customer survey indicated that people who use the service were on the whole satisfied with the care provided.