Mountain Ash provides residential care for up to 10 young people with learning and physical disabilities. There were eight people living in the home at the time of inspection. Seven people had complex communication needs and everyone required staff who knew them well to meet their needs. People’s needs were varied and included requiring support associated with cerebral palsy, epilepsy and diabetes.

The home was purpose built, all the rooms were on the ground floor and there was a large secure garden, which was easily accessible for people using wheelchairs.

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.

This comprehensive unannounced inspection took place on 4 and 9 November 2016.

There were enough staff who had been appropriately recruited, to meet the needs of people. Staff had a good understanding of the risks associated with supporting people. They knew what actions to take to mitigate these risks and provide a safe environment for people to live. Staff understood what they needed to do to protect people from the risk of abuse. Appropriate checks had taken place before staff were employed to ensure they were able to work safely with people at the home.

The manager and staff had received training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They had assessed that restrictions were required to keep people safe. This related to the need for locks on the kitchen door and to the entrance of the pool area. It also meant that those who needed bed rails or lap belts on wheelchairs had them. Appropriate referrals had been made to the local authority for authorisation.

Staff had a good understanding of people as individuals, their needs and interests. Some people attended day centres, activities were provided within and outside of the home daily, and people were supported individually to have their needs met. The sensory room had been redecorated and this offered a relaxing and calming area for people to spend time. There is a hydro pool on site. Over the past few months a number of problems had prevented its use. However, when available this presents a regular and enjoyable activity option for people.

There were safe procedures in place for the management of medicines. People had access to healthcare professionals when they needed specific support. This included GP’s, dentists and opticians. Where specialist healthcare was required, for example, from a physiotherapist or speech and language therapist, arrangements were made for this to happen and detailed guidelines were provided. This meant that if people had been prescribed particular exercises, records showed why they were needed, what would happen if they were not carried out. Along with detailed instructions, there were photographs of the equipment to be used and how it was to be used. This meant that staff had the knowledge to support people effectively.

People were asked for their permission before staff assisted them with care or support. Staff were skilled in identifying people’s various ways of communicating. They knew the various sounds and indicators people used to make their needs known and we saw that people reacted positively when staff responded to them.

Staff had the skills and knowledge necessary to provide people with safe and effective care. Training was provided which was specific to meeting people’s complex needs. Staff received regular supervision and support from management which made them feel valued. Staff spoke positively about the way the service was managed and the open style of management. Staff told us, “The manager has the service users and home’s best interests at heart. They keep

Mountain Ash provides support and accommodation for up to 10 young people with learning disabilities and physical disabilities. There were nine people living in the home during the inspection and all required some assistance with looking after themselves, including personal care and support in the community. People had a range of care needs, including epilepsy and diabetes and eight people were unable to verbally share their experience of life in the home because of their disabilities.

The home was purpose built, all the rooms were on the ground floor and there was a large secure garden, which was easily accessible for people using wheelchairs.

A registered manager was responsible for the day to day management of the home and had been in post for several years. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

This inspection took place on the 12 and 19 October 2015 and was unannounced

The quality monitoring and assessing system used by the provider to review the support provided at the home was not effective. It had not identified issues found during this inspection, including the lack of appropriate training for staff to support people with learning disabilities and that records did not reflect the support and care provided.

The staffing levels were not appropriate to the needs of people living in the home. A number of permanent staff had left, they had not yet been replaced and bank and agency staff made up the staff team.

Pre-employment checks for staff were completed, which meant only suitable staff were working in the home.

Staff had attended safeguarding training. They demonstrated an understanding of abuse and said they would talk to the management or external bodies if they had any concerns.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The management and staff had attended training and had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. The registered management had followed current guidance by seeking advice from and independent mental capacity assessor and making appropriate referrals to the local authority.

People were able to choose what they ate and where and, advice had been sought from appropriate health professionals to ensure people were offered a nutritious and varied diet safely.

Staff had a good understanding of people’s needs and treated them with respect and protected their dignity when supporting them. A range of activities were available for people to participate in if they wished.

Staff said the manager was approachable and they felt they could be involved in developing the service to ensure people had the support they needed and wanted.