5 St Margaret’s Gardens is one of a number of care homes owned and managed by The Ordinary Life Project Association (OLPA). The care home provides accommodation for up to four people with a learning disability. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. At the time of our inspection there were three people living in the home.

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.

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.

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.

Risk assessments were in place. Staff had received safeguarding training and knew what to do if they suspected abuse and how to report any concerns. Medicines were managed safely.

A staff training plan was in place. Staff had regular supervisions and appraisals. People had enough to eat and drink and external advice and guidance was sought when needed. Mental capacity assessments had been carried out and best interest decisions made when people lacked capacity.

People living at the service said the staff were kind. There was a relaxed and calm atmosphere. Staff spoke positively about their roles.

Care plans were person centred and had been regularly reviewed. People had been involved in the reviews. A complaints procedure was available. No complaints had been received.

There were quality assurance processes in place. Action plans were in place to ensure improvements when issues were noted.

The registered manager was a visible presence. Staff and people living at the service spoke highly of the registered manager.

This inspection took place on the 23 August 2016 and 05 September 2016 was unannounced. At the previous inspection visit which occurred in February 2014 we found all standards inspected were met.

This service is registered to provide accommodation and personal care for up to four people with learning disabilities. At the time of the inspections there were four people living at the service.

There was a registered manager 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.’

The people we asked said they felt safe with the staff. The staff on duty were able to describe the procedure for safeguarding vulnerable adults from abuse and were able to list the types of abuse.

Risk assessments were developed on how to minimise the risk to people. For example, moving and handling and staying home alone. People at the service were able to take risks safely. Where there were potential risks to people’s health and welfare staff were aware of the actions needed to minimise the risk.

Staffing levels were maintained by permanent and relief staff. The registered manager told us new staff were recruited to cover a vacancy. The duty rota showed there were two staff on duty throughout the day and at one member of staff was on duty sleeping in the premises.

People were enabled to make day to day decisions. The people we asked told us the decisions they were able to make. Staff were knowledgeable about the decisions people made for themselves. Mental Capacity Act (MCA) assessments were undertaken to determine people’s capacity to make specific decisions. Best interest decisions were taken where people lacked capacity to make specific decisions.

People told us the staff were kind. They were supported to maintain contact with family and friends. We saw good interaction between staff and people. Their interaction was meaningful and not task led. People participated in day care centres, joined clubs and went on shopping trips. One person was employed to deliver weekly papers.

Statements, guidelines and care plans were developed on how staff were to assist people with their care and treatment needs. However, we saw documents were duplicated. The registered manager said where there were changes and additional information, another care plan was developed. This may create confusion as staff may assume they have read the relevant care plan.

We recommend that the service finds out more about care planning, based on current best practice.

We spoke with three people using the service and three members of staff during our visit (a support worker and two people from the maintenance team).

One person using the service said “I like it here” and commented that “It’s clean”. Another person described how they were able to choose their meals and said that staff supported them. Records showed that people were invited to share their views about the home and their suggestions were listened to and acted upon.

People using the service said that they were able to see a doctor if they wanted to, and staff said “at the sign of anything, we are on the ‘phone.” Records showed that peoples’ healthcare needs were identified and appropriate professionals were involved in their care.

People using the service said how much they liked their rooms and that they had been involved in the decoration. All areas of the home that we saw were ‘homely’ and well-maintained. Risk assessments were used to identify hazards and promote peoples' safety.

Staff described how staffing levels were adjusted to ensure that people using the service could take part in recreational opportunities of their choice. They described “a very good team” and said “our manager has always been there and supports you.”

Records were safely stored and clearly identified peoples’ wishes and preferences. Easy -read formats were used for some records to assist people using the service to share their views.

People told us they were happy living at St. Margaret’s close. One person said “I am happy with everything.”

People were involved in the planning of their care and consented, where appropriate, to staff interventions for their health needs. A person we met with described how a medical procedure had been explained to them, prior to undergoing an operation.

People told us staff supported them with their personal care needs, if required. Two people we spoke with explained they only needed minimal staff support. They said “we don’t need help from staff, we can do it ourselves.” One of the people said “I just need help with washing my hair.”

We saw people were encouraged to live as independently as possible. Risk assessments were in place and monitored to minimise any potential risks to people.

People told us about their employment in the local community. A person said “people at work are nice to me.” We saw one person carrying out their paper round.

We talked to people about their medicines. They told us they knew why some medicines were prescribed, but not recently prescribed medicines. They were able to tell us the colours of the tablets.

People we spoke with knew who they would talk to if they were worried or concerned about something.

We spent time with two of the people who lived at the home. They told us they were happy and staff treated them well.

We observed people were clean, well presented and appropriately dressed, and were happy and relaxed in the company of staff they knew.

We saw people’s independence was promoted and their privacy respected. People made decisions on how they spent their time and had the opportunity to undertake employment opportunities. One person told us they enjoyed working at a local McDonalds. Another person told us about their paper round.

People confirmed they felt safe living at the home. They described how staff ensured the property was secure.

People told us they liked their rooms and we saw how they were personalised to reflect people’s interests.