Raymond Avenue is a ‘care home’ for eight people with learning disabilities and/or autism. There were eight people living in the home when we visited. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.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.

At our last inspection in December 2015 we rated the service as ‘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.

At this inspection we found the service remained Good.

People told us and we observed that they were happy about living in the home. Relatives and healthcare professionals were equally positive. One relative told us, “They [the staff] know [person’s name] as well as I do.” One healthcare professional told us, “The staff are experienced in managing complex service users based on their care needs. The team always act upon any issues I raise.”

Staff had a shared understanding of people’s needs and were motivated by their work. One member of staff told us, “The staff work well as a team here; they are motivated. Caring is done for the support you give and not for the financial reward. I would place a family member here.”

Staff had a good understanding of how to protect people from abuse and risks and worked well as a team to help people with behaviours that can be challenging to others. People’s medicines were managed so that they receive them safely and on time.

There was sufficient staff to ensure people were safe and the staff team were recruited safely and trained to ensure they were suitable and had the right skills to meet people’s needs. People were treated with respect and were encouraged to become as independent as possible, as well as accessing the local community on a daily basis.

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 encouraged to take part in making decisions about how the house was run.

The registered manager and senior managers knew people’s needs and this enabled them to offer the right support, guidance and resources to the staff team. Managers reflected on lessons learnt when things went wrong and took prompt action to implement new plans and support for people.

Further information is in the detailed findings below.

The inspection took place on 04 December 2015 and was unannounced. At our last inspection on 06 January 2014 the service was meeting all of the regulations that we assessed.

Raymond Avenue is registered to provide accommodation and care for up to eight adults who have a learning disability or autistic spectrum disorders. At the time of our inspection there were eight people living at Raymond Avenue.

There was a registered manager 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.

There was a positive and inclusive atmosphere within the home and people were at the heart of the service.

People felt safe using the service and they were protected from the risk of abuse because the provider had systems in place to minimise the risk of abuse.

People were supported to receive their medicines as prescribed.

People were supported by staff who were trained to carry out their role. There were enough staff to provide care to people when they needed it.

People were treated with kindness and compassion. We saw that care was inclusive and people benefitted from positive interactions with staff.

People were able to consent to the care they received and systems were in place to protect people’s rights if they did not have the ability to make decisions for themselves.

People were supported to stay healthy and opportunities were provided so people saw a range of health professionals. People were supported to have food that they enjoyed and meal times were flexible to meet people’s needs.

Effective and robust systems were in place for the monitoring of the quality of the service provided to people.

There were eight people living there on the day of our inspection. Some people were unable to verbally communicate to us their experiences of living at the home so we spent time observing how staff interacted with them. We spoke with four members of staff and the registered manager. We spoke with one relative by telephone during our inspection and a health professional by telephone following our inspection.

People were involved in their care planning and were asked how they wanted to be supported to meet their needs. A relative told us, “I asked to be involved in my relative’s care when my relative moved into the home and I am.”

Staff had the information they needed to know how to support people to meet their individual needs. We saw that people's needs had been assessed by a range of professionals and people’s needs had been monitored and met.

Systems were in place to safely manage people's medicines to help meet their health needs.

Appropriate staffing levels were maintained to ensure people's needs were met. Staff had the skills and knowledge to know how to safely support people who lived there to meet their needs. One person told us, "I like all the staff, they help me."

People and their relatives were asked for their views about the home and these were listened to. We saw that audits were completed and action was taken to make improvements where needed.

There were eight people living there on the day we visited. We met with all the people living there and spoke with one relative, the manager, three members of staff and the provider. We looked at the records for two people living there.

People were asked for their consent before any care was given. Where people did not have the capacity to consent, care and treatment was only provided if it was in the person's best interests.

We saw that people could choose what they did and how they spent their time. One person said, “We can choose what we do, we go to bed and get up when we want to.”

We saw that people were supported to have regular health checks to ensure their well being.

People were given opportunities to try out different activities and experience new things to develop their skills and interests.

Systems were in place to ensure that people were safeguarded from harm. We saw that people were comfortable in the company of staff. One person said, “I’m happy here, the staff are very nice.”

Appropriate checks were completed before staff started working there to ensure they were 'suitable' to work with the people living there. Staff told us they were well supported in their role.

The people living there and their relatives were asked for their views about the home and these were listened to. Audits were completed and action taken where needed to make improvements.

Seven men were living in the home when we visited. Some of them were not able to talk with us. We talked with one of the men about his experience of living there and with the relatives of two other people.

People and their relatives told us that they were happy with the quality of the care provided. One person said “I enjoy living here.” Both relatives said the people had “settled in” to the home and that staff had got to know them.

People and their relatives told us that they were happy with how staff supported them and the activities they did. One person said “I get on fine with the staff” and “I enjoy going swimming and horse riding.” The relative of another man said they had “no worries” about how staff interacted with him.

Relatives told us they thought staff had the skills they needed to support the men living in the home. One relative said “The staff know (the person) well.” The other told us they thought the staff were “very good, caring, intuitive” and that they had some good ways of dealing with issues.

People and their relatives told us they were asked to give their opinions and feedback on the care provided. Both relatives told us they had received a questionnaire asking about the home. They said they were confident that they could raise any concerns they had with the registered manager, who would listen to their opinions and would deal with any problems.