87 Pinkeys Road is a three-bed care home without nursing situated in a residential part of Maidenhead, Berkshire. It is part of a group of locations collectively called Voyage Care, classified by us as a 'corporate provider'. The service can accommodate three people with complex learning disabilities or autism spectrum disorder. At the time of our inspection, three people lived at the service. There are three bedrooms and communal living spaces on the ground floor.

At the last inspection, the service was rated good.

At this inspection we found the service remained good.

Why the service is rated good:

People were protected against abuse or neglect. Staff understood what constituted poor care practice and ensured they supported people in the best possible way. Staff attended regular training that ensured their knowledge of safeguarding people was up-to-date. People had personalised assessments tailored to their specific living risks. The premises had appropriate maintenance to ensure that people do not sustain any harm. We saw sufficient staff were deployed to provide people’s care. We found medicines were safely managed.

Staff received appropriate support from the management and provider to ensure their knowledge, skills and experience were appropriate for their roles. The service was compliant with the provision of the Mental Capacity Act 2005. 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 received a varied, balanced diet and any risks of malnutrition were overseen in conjunction with a GP and dietitian. We saw people were supported to maintain good health.

Staff at 87 Pinkneys Road were caring. We found staff had detailed knowledge of people they supported. Staff were able to describe people’s traits and personalities because they had supported them for long periods of time. People could not participate in care planning themselves, but staff worked with other healthcare professionals to ensure that support was suitable. People’s privacy and dignity was respected.

People had detailed care plans which were regularly reviewed. We saw care plans contained detailed information relevant to each person. The service had an appropriate complaints system in place.

The service was well-led. There was a positive workplace culture and staff treated the service as people’s home. Staff expressed they liked to work together, they worked well with the management, and enjoyed supporting people who used the service. We saw there were a range of checks by the management and provider to measure the safety and quality of care.

Further information is in the detailed findings below.

We carried out an unannounced comprehensive inspection of this service on 11 and 12 March 2015 at which a breach of legal requirements under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 was found. We made a compliance action in relation to required checks for agency staff working at the service.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach and submitted an action plan. We undertook a focused inspection on the 29 June 2015 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ’87 Pinkneys Road’ on our website at www.cqc.org.uk.

Pinkneys Road provides accommodation for up to three people with learning disabilities who require support with their personal care. There were three people living at the home at the time of our inspection.

Pinkneys Road has a registered manager in place. 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 focused inspection on the 29 June 2015, we found that the provider had made improvements and had followed their plan which they had told us would be completed by June 2015. We found all legal requirements had been met.

Recruitment checks were now in place to ensure people were safeguarded by staff who had their suitability to work within the service assessed.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. The three people living at the location were not able to communicate with us during the visit. We also tried to speak with a relative of a person who uses the service, but were unable to talk with them.

In this report the name of a registered manager appears who was not in post and not managing the regulated activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time of this inspection. We have advised the provider of what they need to do to remove the individual's name from our register. We spoke to the acting home manager during our visit.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. Since our last visit, refurbishment of the premises had occurred to increase the safety of people who use the service. There was evidence of regular maintenance of the premises, for example, maintenance associated with electrical works and fire safety.

There were enough qualified, skilled and experienced staff to meet people’s needs. The staffing levels were set by the provider in consultation with the management and care workers based on people's dependency levels.

We used a number of different methods to help us understand the experiences of people who use the service because people had complex needs and they were unable to tell us their experiences.

The registered manager was not present during the inspection. We spoke with care workers during the visit and the operations manager by telephone.

People who lived in the home had been accommodated since the home had opened. Some of the care workers had been employed for the same period, and knew how to care for people who use the service because of the long professional relationship they had developed.

The menus we viewed contained a variety of nutritious and healthy foods and were checked by a community dietician.

The provider had not taken steps to provide care in an environment that was adequately maintained. We saw problems with the carpets, some windows and the heating was not working properly.

People who use the service were unable to communicate verbally, so we used observation wherever we could, to help us understand their experiences.

We saw that the routines of the service were unrushed and that staff respected people's wishes to be in their rooms.

We saw that any personal care was carried out in private areas of the building and that staff communicated with people when helping them.

We had some concern when we observed that people had not been offered drinks and how this was responded to. Lunch was freshly prepared and served well. We saw staff administering medication properly to make sure people receive their medicines safely.

This inspection took place on 11 and 12 March and was unannounced. We last inspected the service on 25 April 2014. At that inspection we found the service was meeting all the essential standards that we assessed.

Voyage 1 Limited – 87 Pinkneys Road is a care home without nursing that provides a service to up to three people with learning disabilities or autistic spectrum disorder. At the time of our inspection there were three people living at 87 Pinkneys Road. They had all lived there for almost 20 years. All people had complex needs and were not able to communicate with us verbally or tell us their views. We used feedback from relatives and health and social care professionals, and our own observations, to determine their experiences living at the service.

The home 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run. On the days of our inspection the registered manager was on leave. The company's operations manager was present for the inspection in place of the registered manager.

Recruitment practices for employing the provider’s own staff were robust and all required checks were carried out. People were protected from abuse and their human rights were protected. Risks to individuals were managed well so that people were protected from avoidable harm. A relative and care managers we spoke with felt people were safe at the service.

Staff were well trained and available in enough numbers to meet the needs and wishes of the people they supported. People's health and well-being was assessed and measures put in place to ensure people's needs were met in an individualised way. Medicines were managed well and staff administering medicines were only allowed to do so after passing their training and being assessed as competent. A relative told us they thought staff had the skills they needed when providing support to their family member.

People were treated with respect and their privacy and dignity was promoted. Staff were caring and put the needs of people they supported at the centre of their work. Staff sought people's consent before working with them and where people were not able to make their own decisions, they were made in their best interests.

People were supported with eating and drinking and staff ensured diets were nutritious and took account of individual people's likes and dislikes. People were able to participate in activities of their choice and were supported to be involved in local community activities.

Staff were happy working at the service and told us they were a close team that worked well together. The registered manager oversaw and managed practice at the service and encouraged an open and inclusive culture. Health professionals felt the staff at the service worked well with them and one told us staff were always quick to make referrals and seek advice when needed. A relative told us: "Everything is great. They are always very caring and have always been very good."

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The provider had not made sure that recruitment checks had been carried out on agency workers to ensure they were suitable to work with the people living at the service. You can see what action we told the provider to take at the back of the full version of this report.