This inspection took place on 7 November 2016 and was unannounced. At our last inspection in August 2014 we found that the service met the legal requirements and provided an overall good service.

Poplars provides residential support and accommodation for up to six people who have a learning disability and or a mental health diagnosis. At the time of this inspection six people used the service.

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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Systems were in place to ensure that people who used the service were protected from the risk of abuse.

People’s individual levels of risks were assessed, monitored and reviewed; remedial action was taken quickly to protect people from the risk of harm.

There were enough suitably qualified staff available to maintain people’s safety and meet their individual needs. Staff had been recruited using safe recruitment procedures.

People’s medicines were managed safely; staff were well trained and supported people with their medication as required. People were supported to access external healthcare professionals and other agencies in order to ensure their healthcare needs were fully met.

People consented to their care and the provider followed the requirements of the Mental Capacity Act 2005 (MCA) where people lacked the capacity to make certain decisions about their care.

People were supported with their nutritional requirements and preferences.

People were supported by staff who were caring and compassionate. People were involved in the planning and review of their care.

The provider had a complaints policy available and people knew how to complain and who they needed to complain to. People were given the opportunity to feedback on the quality of their care and actions were in place to make improvements.

People and staff told us the registered manager was approachable and staff felt supported in their role.

The provider had systems in place to monitor the quality and safety of the service.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

Our inspection was unannounced which meant the service and staff did not know we were visiting.

At our last inspection on 5 November 2013 we identified that the provider was not meeting all the Regulations we inspected them against. People were not adequately protected against the risks associated with medicines and effective systems were not in place to regularly assess, monitor and improve the quality of care. Following the inspection the provider submitted an action plan that showed how they would make the required improvements and they also regularly contacted us to update us on their progress towards making the improvements.

The Poplars provide residential support and accommodation for up to six people who have a learning disability and/or a mental health diagnosis. On the day of our inspection six people were using the service.

One week prior to our inspection the provider notified us that they no longer had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. During our inspection we saw information to confirm that a new manager had been recruited and suitable management cover had been put into place whilst they were waiting for the new manager to start. This showed the provider had taken prompt action that ensured a suitable management structure was in place at the service.

During this inspection we saw that the required improvements had been made. People were now consistently protected from the risks associated with medicines and effective systems were in place that meant the quality of care was regularly assessed, monitored and improved.

People told us they were happy with the care. We saw that people were treated with dignity and respect and their privacy and independence was promoted. People were involved in the planning and review of their care which meant their care preferences and choices were identified so they could be met by the staff.

People were safe because systems were in place to help manage the risks posed to people. This included risks relating to the environment, infection and specific risks relating to each individual. There were sufficient numbers of staff to keep people safe and the staff reported safety concerns to managers, who took appropriate action to make improvements to safety.

The staff were suitably trained to provide the care people required. People’s health and wellbeing were monitored so they could receive the right care at the right time and the staff worked closely with other professionals and services so that people received consistent care. People were supported to eat a balanced diet and the staff understood the action they needed to take if a person’s eating deteriorated.

The legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were being followed. The Mental Capacity Act 2005 and the DoLS set out the requirements that ensure where appropriate, decisions are made in people’s best interests when they are unable to do this for themselves.

People were encouraged to share their concerns and suggestions about the care and the staff listened to and acted upon people’s feedback to improve the care. Managers also used national and best practice guidance to make improvements to the care.

Staff told us they were supported by the managers and we saw that managers were always available to offer support.

When we inspected ‘Poplars’ on 2 July 2013, we identified that improvements needed to be made. This was because effective systems were not in place to protect people from the risks associated with medicines. Effective systems were also not in place to enable the provider to consistently assess, monitor and improve the quality of care.

We completed this inspection to see if the required improvements had been made. The registered manager named in our report was absent at the time of our inspection. We had been informed of the registered manager’s absence and the provider had told us about the temporary changes to how the home was being managed.

During this inspection we spoke with two members of staff and the person in charge.

We found that some improvements had been made to how medicines were managed. However, further improvements were needed to ensure people were suitably protected from the risks associated with medicines.

We found that effective systems were not in place to assess, monitor and improve quality at the home. This meant that the provider could not show that they were appropriately assessing and monitoring people’s risks and managing changes to people’s needs.

We have asked the provider to submit an action plan to outline how they will make the required improvements. We will then visit the service again to see if improvements have been made.

During our inspection we spoke with four people who used the service, two members of staff, the registered manager and the deputy manager.

People told us they were given choices about how they received their care and support and we saw that staff were responsive to people’s individual choices and requests.

People told us they felt safe and we saw that people were supported in a caring and professional manner. This was because there was an effective system in place to train and support staff.

We saw that improvements needed to be made in how people’s medicines were administered and recorded. The systems in place at the time of our inspection were not effective and meant we could not be assured that people were receiving their medicines in a safe and effective way.

We saw that there were systems in place to assess and monitor the quality of the care provided, but these systems were not always effective. This meant that some areas of care and support which required improvement had not been identified by the provider.

People we spoke with told us that they liked living at Poplars. They told us that they were supported to be independent and knew about the care records held on their behalf. One person said, "The staff do talk to me about the things in my file". We saw that people's capacity to consent to care and treatment had been assessed and people using the service had access to the health services they needed.

People confirmed that they knew how to complain and felt confident to do so. A relative confirmed that they had been made aware of the procedure for making a complaint. They stated, "I don't have any concerns about the support my relative receives".

Staff we spoke with were fully aware of how to protect people from abuse and how to recognise signs of abuse. People we spoke with told us they felt safe living in the home.

We saw that suitably trained staff were employed at the home.

People living at Poplars told us and we confirmed from the records available during this visit, that they met regularly to discuss the home, the things they wanted to do and their food choices .