This inspection took place on the 1 February 2019. We announced the inspection as Meade Close is a small home and we wanted to ensure the registered manager was available.

This was the first inspection since Meade Close was bought by Ambito Care (which is part of the Salutem Group) in April 2018. The staff team at Meade Close, including the registered manager and team leaders, remained the same. The area managers also transferred to the new company. The home, under its previous ownership (Scope), was inspected in June 2016 and was rated as Good in all domains.

Staff members and the registered manager said there had been no change in the support provided for the people living at Meade Close following the change in ownership.

Meade Close is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Meade Close comprises two separate fully adapted bungalows. Each bungalow could accommodate up to four people with a severe learning disability, some of whom also had physical needs. The staff team work across both bungalows.

The care service 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.

Meade Close had a registered manager in post. They were supported by two team leaders. 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.

Clear person-centred risk assessments and care plans were in place providing guidance for staff so they could meet people’s assessed needs.

People had little (one word) or no verbal communication. Information was available for staff to interpret what people’s facial expressions or body language was trying to communicate. From our observations it was clear staff knew the people and their needs well. People seemed relaxed and comfortable with the members of staff. We observed people being treated with dignity and respect during our inspection.

Staff enjoyed working at the service and had the training and support to meet people’s needs. Staff had completed specific training, such as Percutaneous endoscopic gastrostomy (PEG) feeding, the use of suction machines, moving and handling and epilepsy where required.

People received their medication as prescribed. The registered manager said they would introduce records of when thickeners were added to drinks to reduce the risk of choking and have clear protocols for when medicines should be administered that were not routinely given.

There were sufficient staff on duty to meet people’s needs. A recruitment system was in place to ensure staff were suitable for working with vulnerable people.

The service was working within the principles of the Mental Capacity Act. Capacity assessments, best interest decisions and deprivation of liberty safeguard applications were all completed as required.

Staff gave people choices where possible and involved them in the day to day tasks of the home. This ensured people were engaged by staff throughout the day. Each person had an activity planner in place with what they were doing each day. These were personalised for each person. Two relatives said that they thought more activities should be arranged for people living at the service. The registered manager was working with the staff team to plan and record activities, both within the house and when they went out.

People’s health, nutritional and dietary ne