We inspected this service on 29 September 2017. This was an announced inspection as we wanted to ensure there were people available to tell us about the service. This inspection was completed by one inspector. At our last inspection in September 2015 we found the service to be meeting the requirements of the regulations and we rated the service as ‘Good’. At this inspection the service remains ‘Good’.

The service was registered to provide accommodation and personal care for up to 16 people with learning disabilities. The home was divided into three units. One unit for those developing skills to enable them to be independent, a unit for people who required more support and a short stay unit for people to receive respite. Some people had lived at the home for long periods whilst others accessed the home for short term respite care. At the time of our inspection, there were nine people using the service on a permanent basis and seven using the service for respite.

The service had a registered manager. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt there was enough staff to support their needs and they made them feel safe. Risks relating to the environment and activities had been assessed and reviewed. If required equipment had been ordered to make the environment safe.

The provider had followed a recruitment process that ensured people were supported by staff whose suitability had been checked. Staff told us the training available to them was varied and provided them with the skills they required for their role.

People received their medicines as prescribed and there was a flexible approach when people went out or changed their daily routine. There was a varied choice of meals and people felt they could be part of the menu planning for their meals. Some people were supported to cook their own meals and other people had been engaged in making the meal for the other people using the service.

We saw some people were unable to make some decisions. In these instances people had been supported through a best interest approach. Some people were under constant supervision and for these people an application had been made to ensure this was done legally

The staff had developed positive relationships with people and embraced their activities and interests. People were respected in relation to their decisions and their environment when they received personal care. Relatives were welcome at the home and opportunities had been made to maintain relationships.

There was a complaints policy which had been followed when required. People felt able to raise any concerns and were confident they would be addressed. People’s opinions had been considered in making improvements.

The provider used a range of audits to maintain standards and consider improvements. The registered manager understood the requirements in relation to notifying us of events. We saw the rating had been displayed in the reception of the home and it was also accessible on the providers website.

We inspected this service on 28 July 2015. This was an unannounced inspection. At our inspection in September 2013 the service was meeting the requirements of the regulations we checked. The service was registered to provide accommodation and personal care for up to 16 people with learning disabilities. Some people live at the home for long periods whilst others access the home for short term respite care. At the time of our inspection, six people were living at the home.

The service had a registered manager. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe living at the home. Staff understood their responsibilities and the actions they should take to keep people safe from abuse. Risks to people’s health and safety were identified and plans were in place to minimise the risks.

There were sufficient staff to meet people’s individual needs. Staffing levels were reviewed and adjusted to ensure they met people’s needs at all times. The provider had a recruitment process that ensured people were supported by staff whose suitability had been checked. Staff were supported and trained to meet people’s individual needs.

People received their medicines as prescribed. They were supported to have sufficient to eat and drink to maintain good health and to access health care services when they needed to.

Staff acted in accordance with the requirements of the Mental Capacity Act 2005. Where people did not have capacity to make decisions themselves, we saw that mental capacity assessments were in place and records showed that decisions had been made in their best interest. Nobody was under a Deprivation of Liberty Safeguard at the time of our inspection.

Staff knew people well and supported them to follow their interests and keep in touch with people that mattered to them. People told us staff respected their privacy and dignity.

The registered manager investigated complaints and concerns. Complaints received were discussed with staff to ensure lessons were learnt and when appropriate improvements made. People and their relatives were supported and encouraged to share their opinions on the running of the home. Their views were taken into account in the planning of the service.

The provider’s quality monitoring systems provided information to ensure people received care and support safely. Accidents and incidents were investigated and discussed with staff to minimise the risks of a reoccurrence.

We spoke with three people at the home. They told us they were happy to be there and the service was able to meet their needs. One person told us” staff treat me well”. We saw people were out for most of the day. Some people attended day centres and others were having group or one to one activities supported by care workers. When people returned to the home we saw people taking part in activities of their choosing such as tidying their bedroom or listening to their music. We found risk assessments and care planning provided sufficient guidance for care workers to be able to ensure people’s safety and well being.

One person told us they liked the food at the home and enjoyed being included in making drinks for themselves. We saw that meal choices ensured a balanced diet was offered. Another person told us they worked voluntarily with a staff member in the kitchen and washed the dishes after the meals as one of their activities. We found people were provided with medicines that were stored safely and given as directed.

One person told us they thought the home was a nice place. Another person told us they could ask any member of staff for help and it would be given to them. We saw audits took place to monitor the quality of the service.

We spoke with four people using the service. We spoke with two relative’s who told us they were usually asked their opinions and listened to. One relative explained how staff knew and understood their relative really well.

People using the service told us they were asked their opinions and helped to make decisions when needed.

Two relatives told us the care was good. One relative explained “sometimes the week end staff do not seem to get things completely right but on the whole, I have no concerns. My relative is happy to go to Petersham Centre Care Home”.

People we spoke with and their relatives told us they were provided with comfortable accommodation at all times. One relative told us “the place has had a full refurbishment and is really nice now.” People using the service who spoke with us also told us they were satisfied with the accommodation provided. One person told us, “we get to choose the room were prefer, I like my room”.

We asked two people if they thought the staff were suitable to support them. They told us they thought the staff were safe and helpful to them. They expressed no concerns in this area.

We asked people at the service if they knew how to let someone know if they were not happy at the home. One person told us they would ask staff for help. Another person told us “I would talk to my parent if I needed help with something that staff could not help with but normally I would talk to staff first”.

People who use services told us that they felt safe living at the home and that staff treated them well.

People told us they were treated with respect and dignity.

They explained that they knew all the staff and they were always made welcome. They told us staff were friendly here.

We asked about the safe keeping of people’s money. One person told us they had access to their money and said, “I would ask for my money whenever I needed it.”

One person was having her nails painted. She told us she was looking forward to going out later that evening accompanied by staff.

One person said, “I received my medication regularly in the morning, at dinner and at night time.”

The other person told us they were happy with the arrangements for medicines. They had gained confidence in swallowing tablets, because the staff gave them support and help.

One family member we spoke with told us that they had concerns but they were resolved and improvements were made at the service.

Another family told us they thought the service overall was, “Pretty good.”