Church Lane Avenue is a residential home for two people who are on the autistic spectrum and have learning disabilities. People had communication needs, people communicated by using key words, gesture and/or body language.

There was 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. The registered manager and the provider was the same person.

At the last inspection on 7, 9 and 10 October 2014, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good

People were safe because staff understood risks involved in people’s care and took action to minimise these risks. There were sufficient staff on duty to ensure that people received the care they needed and to keep people safe. Staff understood their roles and responsibilities in keeping people safe and protecting them from harm and abuse. The registered manager carried out appropriate pre-employment checks before staff started work.

Medicines were managed, stored and administered safely. Accidents and incidents were recorded and reviewed with a plan in place to minimise the risk of them occurring again. The registered manager had developed plans to ensure that people’s care would not be interrupted in the event of an emergency. People were protected against the risk of infection because the home was clean and hygienic.

People’s care was provided by regular staff who knew their needs well and provided support in a consistent way. Staff had access to the induction, training and support they needed to do their jobs. People’s choices and views were respected. Care was provided in the least restrictive way to people.

People were supported to eat food they enjoyed and were encouraged to maintain a healthy diet. Staff were aware of dietary restrictions involved in people’s care. People’s health and well being were managed as they had access to the appropriate health and social care professionals. People who had on going conditions were supported to see specialist healthcare professionals regularly.

People enjoyed living at the home and had developed positive relationships with staff. Staff treated people with respect and maintained their privacy and dignity. People were supported to maintain relationships with their friends and families and were able to invite guests whenever they wished. People were encouraged to be independent and were supported by staff to learn and develop new skills.

People and their relatives were encouraged to give their views about the service they received and the registered manager responded positively to feedback. People had access to activities they enjoyed and had opportunities to enjoy an active social life. People were involved in their local community.

The registered manager provided good leadership for the service. They were experienced in their role and communicated well with people, relatives and staff. Staff felt valued and had access to support and advice from the registered manager if they needed it. Staff shared important information about people’s needs effectively. Team briefings were used to ensure staff were providing consistent care that reflected best practice.

The registered manager had quality monitoring checks that ensured people received safe and effective care and support. Staff worked co-operatively with other professionals to ensure people received the care and treatment they needed. Records were well organised and up to date.

People who used the service responded to greetings with smiles, touching of fist greetings, or said all right.

People spoke about activities they were involved in, outside the home, for example, going for a drive, going to the park, and playing football.

Although people's needs were assessed, care and treatment was not always planned in a way that ensured people's safety and welfare.

We found the provider had taken steps to provide care in a home that was suitably designed and adequately maintained.

We saw that staff received appropriate professional development and support.

We observed care and support being provided in the home.

We gathered evidence of people’s experiences of the service by reviewing written feedback comments.

People who used the service responded to greetings with smiles, thumbs up, fist to fist greetings, and one said all right.

A person who uses the service showed us their activities and music equipment, and pictures of a holiday they wanted that had been arranged.

The visitors comments book contained comments from relatives for example, a very pleasant visit, lovely location and staff friendly and accommodating to my queries, my relative looks well and happy, nice to see him happy and wonderful to see him doing so well, he is cared for and happy.

We saw people being offered choices and making choices. For example, we observed a person who used the service using a picture card to communicate they wanted to do the recycling. A staff member then supported this.

We saw that people could choose where to be around the home, and although encouraged, were still free to choose to attend events or not.

We observed that staff were attentive to people and they had a good understanding of their communication styles or body language. We observed staff offering support in a sensitive and caring manner.

This inspection took place on the 7, 9 and 10 October 2014. The first visit was unannounced. However, the provider was contacted an hour before our visit because the location was a small care home for younger adults who were often out during the day and we needed to be sure that someone would be in.

Church Lane provides residential support for two younger people with a moderate learning disability and moderate behaviours that challenge. The home is set in a detached bungalow. People have their own rooms and ensuite facilities. People receive a minimum of one to one care.

The last inspection of this home took place on 15 June 2013. During that inspection we found that the provider was in breach of the regulation that related to arrangements that were required to be in place to plan for all foreseeable emergencies. Regulation 9(2). The provider sent us an action plan stating what steps they would take to address the issues identified. At this inspection we confirmed that the provider had completed the actions in the action plan.

Because the home was owned and managed on a day to day basis by the provider, the home did not need to have a registered manager because the provider was also the 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 and associated Regulations about how the service is run.

People told us they felt safe and would tell a member of staff if anyone upset or hurt them. They told us staff were kind and the food was good. A relative said their family member received their medicines at the right time and staff kept them informed about changes to their medication, health and wellbeing. They said they had the information they needed about the home and were encouraged to contribute information about their family member to make the care more personalised. They told us that staff made them feel welcome, were patient, caring, spent time with and talked and listened to their family member.

The provider/manager had systems in place to make sure people were protected from abuse and avoidable harm. Staff were knowledgeable in recognising signs of abuse and the associated reporting procedures. Medicines were securely stored and administered. People appeared to be comfortable with each other and approached staff readily. People told us they felt safe and would tell a member of staff if someone upset or hurt them.

There were sufficient numbers of suitably qualified, skilled and experienced staff. People had a minimum of one to one care and additional staff were available for activities. Assessments were undertaken for any risks to people. Plans were in place to reduce the risks identified in assessments. Care plans were developed with people to identify how they wished to be supported. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

Care and support was tailored to meet people’s individual needs and staff knew people well. Many had worked with the people since the home opened. Staff had good relationships with the people at the home and the atmosphere was happy and relaxed.

People were provided with a choice of healthy food and drink to make sure their nutritional needs were met. People told us the food was good and they had food they liked. People’s weight had been managed well as identified in their support plan.

We observed interactions between staff and people in the home and staff were kind and respectful to people. Staff were aware of the values of the service and knew how to respect people’s privacy and dignity. A wide range of activities were provided both in-house and in the community. People were involved and consulted about all aspects of the service including what improvements they would like to see and suggestions for activities.

A health care professional told us that the manager had a very good and caring relationship with the people who used the service and always discusses the best options for the individuals. The horticultural tutor told us that people were always spoken to nicely by staff. They had never heard harsh words or frustration in the staff voices and said they were always pleasant. They told us the staff always showed respect for the people that staff always offered people a choice of what they wanted to do.

Relatives and care professional we spoke with all said they never had any complaints but they would not hesitate to speak with the provider if they felt the need to complain. They said that if they did have any concerns they felt they would be listened to and the concern would be addressed. Health care professionals told us that the manager and staff communicated well with them and would take prompt action where needed so they never had the need to make a complaint. A relative told us that because the home maintained a high level of constructive communication, any minor concerns were always sorted out before they developed into a complaint.

Staff told us the Provider/Manager was open, accessible and approachable. They said they felt comfortable raising concerns with them or to suggest ideas for improvement and found them to be responsive in dealing with any concerns raised.

There was a very low staff turnover with many staff being there since it opened 10 years ago. Some staff told us they could get other jobs nearer their home but they “Loved” working at this home. They told us this was because they were properly supported to do their job well and could see the improvements in people over time. The manager also worked on shift alongside the team, which ensured they could review the day-to-day culture in the service, including the attitudes, values and behaviour of staff.

We saw comments in the comments book that supported good governance and leadership. For example “I am happy to see them so well, I like the place here”, from a duty social worker ‘’.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes To ensure people’s rights, applications had needed to be submitted regarding some people needing supervision to be safe outside the home. Relevant staff had been trained to understand when an application should be made, and how to submit one and the proper policies and procedures were in place, to ensure applications were submitted for consideration where needed.

The last inspection of this home took place on 15 June 2013. During that inspection we found that the provider was in breach of the regulation that related to arrangements that were required to be in place to plan for all foreseeable emergencies. Regulation 9(2). The provider sent us an action plan stating what steps they would take to address the issues identified. At this inspection we confirmed that the provider had completed the actions in the action plan.