4 Nimrod Drive is registered to provide accommodation and personal care for up to six adults with learning disabilities and autism. At the time of our inspection there were six people using the service.

The home is built over three floors and is in a residential area.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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At this inspection we found the service remained Good.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns. People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff with the correct skill mix on duty to support people with their required needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Effective infection control measures were in place to protect people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people. 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.

Staff received an induction and on-going training. They had attended a variety of training to ensure that they were able to provide care based on current practice when supporting people. They were also supported with supervisions and observed practice.

People were able to make choices about the food and drink they had, and staff gave support if and when required to enable people to access a balanced diet.

People were supported to access a variety of health professionals when required, including opticians and doctors to make sure that people received additional healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times. Care plans were written in a person-centred way and were responsive to people’s needs. People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place and accessible to all. Complaints had been responded to appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

Further information is in the detailed findings below

The inspection took place on 30 and 31 March 2016 and was unannounced. Nimrod Drive is a care home without nursing that provides accommodation for up to five younger adults who live with learning disabilities. At the time of our inspection five people were living at the home. We simultaneously inspected a sister service located at 10 Nimrod Drive, a service which has the same registered manager.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

Most people who were present at the home during our inspection were unable to communicate with us verbally. People who were able to communicate told us they felt safe and secure. Staff had received training in how to safeguard people against the risks of abuse and knew how to report concerns both internally and externally.

Safe and effective recruitment practices were followed. Flexible arrangements were in place to ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.

Plans and guidance had been put in place to help staff deal with unforeseen events and emergencies. The environment and equipment used were regularly checked and well maintained to keep people safe. People were supported to take their medicines by trained staff. Potential risks to people’s health and well-being were identified, reviewed and managed effectively.

People were positive about the skills, experience and abilities of the staff who supported them. Staff received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to maintain good health and access health and social care professionals and specialist services when necessary. They were provided with appropriate levels of support to help them eat a healthy balanced diet that met their individual needs.

Staff obtained people’s consent and permission before providing support which they did in a kind and compassionate way. However, this was not always accurately or consistently reflected in people’s individual plans of care. People were supported to access local advocacy services if they needed independent advice or guidance.

Staff developed positive and caring relationships with the people they supported. People and their relatives were fully involved in the planning, delivery and reviews of the support provided. The confidentiality of information held about people’s medical and personal histories had been securely maintained.

Support was provided in a way that promoted people’s dignity and respected their privacy. They received personalised support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines, goals and personal circumstances.

People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community. Relatives told us that staff listened to them and responded to any concerns they had in a positive way. Complaints were recorded properly and investigated promptly.

Relatives, staff and professional stakeholders were very complimentary about the registered and assistant manager and how the service operated. Measures were in place to monitor the quality of services provided and reduce potential risks.

We consider all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we ask;

•Is the service safe?

•Is the service effective?

•Is the service caring?

•Is the service responsive?

•Is the service well led?

This is a summary of what we found.

Is the service safe?

We spoke to three carers and two people who used the service on the day of inspection and we spoke with two family members over the phone the following day. One person said, "He was fine, staff are good. I go out regular for a walk on my own; sometimes I go to the town." Another person said, "He was ok, happy living here." A staff member said, "I like working here it is a good home." One family member we spoke with said, "I have been involved in the care plans and have no issues with the home. The staff are lovely and always helpful."

We spoke with three members of staff about safeguarding people from abuse. They all understood their responsibilities and how to report any concerns or allegations of abuse. One member of staff said, "We protect people from abuse, if there was an incident for example: one person impacting against another. I would report this to my manager." Staff members were able to identify types of abuse and were also aware of the whistleblowing policy.

There were regular audits undertaken of all medicines held within the home.. There was a list of signatures for staff that were trained to administer medicines. At the time of our inspection there were no controlled drugs being used in the home.

The lounge was spacious with enough seating for people who used the service. The home was suitably designed and had a good layout.

We looked at the staff training matrix. We found that staff members were up to date with their training in areas such as: first aid, managing challenging behaviour, how to assist people to move safely and the safeguarding of vulnerable adults. We spoke with three staff, one said, "I have completed a level three diploma.” Another member of staff said, “I am up to date with all my training.” The manager confirmed that staff members were supported to undertake additional training.

Is the service effective?

We saw that the provider had a system in place, ‘The Purple Folder’. This was used for medical appointments or emergencies. The separate folder contained all relevant information about the person. For example, contact details, medical history, medication and allergies the person might have. This meant that there was a procedure in place to help with the sharing of information in an emergency.

Is the service responsive?

We looked at one care plan and found that this was detailed and centred on the person’s needs including information about their lifestyles, communication, behaviour support plan and their likes and dislikes. The care plans included risk assessments for areas such as, behaviour management. All staff had signed to say they had read and understood the risk assessments contained in people’s care plans. There was clear guidance for staff to follow in the care plans for example: one person’s risk assessment around epilepsy. There were clear guidelines in place for staff to follow in the event of a seizure to keep the person safe.

Is the service well led?

Not assessed during this inspection.

We visited Nimrod Drive on 24 June 2013. On our arrival we were greeted by people who used the service and staff. We saw that people were happy and that their personal care needs had been met. When we visited the service we were unable to speak with people who used the service but observed them to be content in their surroundings and they were willing to approach us and show us around their home. We spoke with staff and the families of people using the service, we were told by one person who had a relative at the service that they could not 'find the words to express how wonderful they are'. We were told that they never thought their relative could 'do so good' and that the staff were 'brilliant'. We were told that the home helped people to 'live their lives' and that even staff who had been with the service for a short time and worked only short hours knew 'so much about' the people using the service.