This inspection took place on 04 October 2018 and was unannounced. At our last inspection completed in March 2016 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.

Pinetrees is a ‘care home’. People in care homes receive accommodation and 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. The care home accommodates up to four people in one adapted building. At the time of the inspection there were four people living at the service.

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.

A registered manager was 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.

The registered manager and staff team strived to ensure people were able to play an active role in the community and to lead full and active lives. A range of work, volunteer and leisure opportunities were arranged in partnership with people taking into account their strengths and personal interests. People were fully involved in the design and review of their care.

People were supported by a staff team who understood how to protect them from abuse. Care staff managed risks to people in a positive way. People were protected from harm while their independence was maximised. People were supported by sufficient numbers of staff who had been recruited safely.

People received their medicines safely and as prescribed. People were protected by effective infection control procedures.

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.

People were supported effectively to eat and drink sufficient amounts in a way that supported their health. People were encouraged to be involved in monitoring and maintaining their day to day health.

Staff supported people in a way that was kind and caring. People’s privacy was respected and their dignity was promoted and upheld. People were encouraged to be as independent as possible and were supported to maintain important relationships.

People were able to raise complaints and concerns were listened to and responded to appropriately. The registered manager had developed an open and transparent culture within the service where people were respected and everyone was free to share their views. People were fully involved in the development of the service.

A range of quality assurance and governance systems were in place and these were being developed to make further improvements. Care staff had been equipped with the skills they required to support people effectively. Further improvements to training and development were planned.

The provider engaged with the wider community and other organisations in order to drive improvements to the lives of those being supported.

We inspected this home on the 12 January 2016. This was an unannounced inspection. Pinetrees provides accommodation for four people living with Asperger’s syndrome and who require personal care.

The home does not currently have a registered manager as the past manager recently retired. 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. There was an operations manager at the home who was in the process of applying for registration at the time of the inspection. There was also a team leader based at the home who was responsible for the day to day running of the home.

People we spoke with felt safe. Staff had a good knowledge of the people living at the home and used this knowledge to identify when people may be at risk of harm. Systems had been put in place to minimise these risks whilst still allowing for independence. We saw there were sufficient staff available to meet people’s requests for support and staffing levels were increased depending on people’s requests for certain activities.

The Mental Capacity Act 2005 (MCA) sets out what must be done to protect the rights of people using services who may lack capacity to make decisions for themselves. We found that the service was working within the principles of the MCA and staff had a good knowledge of what this meant for people living at the home.

Medicines were managed safely and only staff who had received training were allowed to administer medication. People had been encouraged to be independent, where possible, with administering their medication.

People were encouraged to be independent in all aspects of their lives. This included menu planning, meal preparation, house work and in deciding activities they wished to participate in. Care was planned with the person and people were able to state what they wanted to achieve each week with staff.

People felt cared for and staff we spoke with talked passionately about the people they supported. People told us that staff had a good understanding of their needs and we saw that staff had been provided with regular training to enable them to support people effectively.

Staff were responsive to people’s needs and we saw examples of people’s requests for support been actioned. People and their relatives were aware of, and had opportunity, to raise any concerns or complaints they may have about the service. We saw that where concerns had been raised by people, staff responded appropriately.

Staff felt valued and supported in their role and had opportunity to make suggestions for improvements to the service.

We saw that there were systems in place to monitor the quality of the service. These included seeking feedback from people and staff at regular intervals. The operations manager had ideas of how she wanted to improve the service further for both the people living at the home and the staff supporting people.

All the feedback we received about the home was positive and comments included:"Everything here is very good," "A nice home for all of us" and "I have no issues at all, I could only praise the place."

We found people at Pinetrees had lived together for many years. Some of the staff who were supporting them had also worked there for a long time. We found people had been able to write their own care plans and record how they wished to be supported. During our visit we saw the support being delivered in this way. One relative told us: "I am very happy with the support he receives to stay clean and healthy."

We found that systems were in place to recognise and prevent abuse from occurring. Staff were knowledgeable about their responsibilities and people told us they could approach staff. We asked, "If you were worried about something what would you do? "They replied: "I could go to any member of staff."

We found systems were in place to ensure people received their medicines at the correct times.

People, relatives and professionals praised the knowledge and approach of staff. We asked one person: "How do you find the staff?" They replied: "Of course, they are very kind and supportive."

We found the home was well run and people praised the manager. Comments included: "She is a great manager-so supportive. She works really hard for the guys." We found that the home had effective systems in place to ensure it was a safe place to live and work.

During our inspection we spoke with three people who used the service, two care staff and the registered manager. Following our visit we also spoke with the relatives of two people who used the service by telephone.

When we visited the home, people who used the service appeared relaxed and at ease in their surroundings. They told us about the things that they were interested in. We saw that the home had supported them to pursue these areas of interests. People actively participated in the development of their care plans and in the running of the home. One person told us, “It’s okay living here” another person said “I wipe up the work surface, I make myself useful.”

The relatives of people we spoke with were satisfied with the care and support provided at the home. One relative said, “I am confident (my relative) is happy and well looked after and particularly happy with the way they manage their health.”

We saw that staffing levels continued to be a cause of concern. This relied on the manager having to undertake care responsibilities at the expense of their managerial duties.

The home was clean, tidy and well maintained.

We met with all of the people who lived at the home. We observed the way care workers supported people throughout the time of our visit. We heard people being spoken with in a friendly and kind way and the atmosphere in the home was pleasant and lively. One person who lived at the home told us ‘’It’s a good place to live.’’

People told us they felt safe living there. One person told us ‘’If I was worried about something I would talk to my key worker.’’

People had individual activity planners which showed what activity they would be undertaking each day. One person who lived at the home told us ‘’I go to tea rooms, art galleries and the library. I do lots of things.’’

We asked people who lived at the home if there were enough care workers. One person told us ‘’We are okay for staff, not brilliant but satisfactory.’’ Another person told us there were enough care workers.