The inspection took place on 17 March 2017 and was unannounced. We last inspected the service in June 2016 and found it required improvement. We found there was a breach of regulation as the systems to monitor and improve the service were not robust. This was partly because the registered manager had insufficient time to carry out all of their responsibilities to ensure that people received the support and care they needed. At this inspection we found that improvements had taken place and the service was no longer in breach of regulation.

The service is registered to provide care for up to six people who have a learning disability or autistic spectrum disorder. There were six people living there at the time of our inspection. There was a registered manager 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.

Relatives and staff told us they felt people were safe in the home. Staff were aware of the need to keep people safe and they knew how to report allegations or suspicions of poor practice. We saw that people were happy around staff and with the support they were receiving. There were sufficient appropriately trained, skilled and supervised staff and they received opportunities to further develop their skills. The registered manager checked staff’s suitability to deliver care and support during the recruitment process. People’s medicines were managed, stored and administered safely.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The registered manager had applied to the Supervisory Body for the authority to restrict people’s rights, choices or liberty in their best interests.

People told us, or indicated by gestures and their body language, that they were happy at this home and this was confirmed by people's relatives. We observed some caring staff practice, and staff we spoke with demonstrated a positive regard for the people they were supporting.

People were supported to maintain good health and to access appropriate support from health professionals where needed. People were supported to eat meals which they enjoyed and which met their needs in terms of nutrition and consistency. People participated in activities they enjoyed.

The relatives of people living at the home told us they were confident to raise any concerns or complaints directly with the registered manager. There were systems in place to continuously monitor the quality and safety of the service provided to people living at the home.

The inspection took place on 30 June 2016 and was unannounced. We last inspected the service in March 2015 and found it required improvement. We found there was a breach of regulation as the provider had failed to ensure people received person centred care as they did not have access to things they enjoyed doing. At this inspection we found that improvement had taken place and this was no longer a breach. Further improvement was needed to make sure people had additional opportunities to participate in activities in the community.

The service is registered to provide care for up to six people who have a learning disability or autistic spectrum disorder. There were six people living there at the time of our inspection. There was a registered manager 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 was responsible for the management of two other services and this had contributed to them having insufficient time to carry out all of their responsibilities to ensure that people received the support and care they needed.

We had not been notified about some incidents that we should have been, in order for the provider to comply with regulations however we had been notified of a recent incident as required. It was not evident that arrangements for checking the safety and quality of the service by the registered provider were effective in driving forward continuous improvement and making sure identified areas for improvement were actioned. The registered manager advised of plans in place to reduce the number of services they managed from three down to two.

Systems in place to monitor. assess and drive up improvements had not been effective. You can see what action we have told the provider to take at the back of the full version of the report.

Relatives and staff told us they felt people were safe in the home. Staff were aware of the need to keep people safe and they knew how to report allegations or suspicions of poor practice. We saw that people were happy around staff and with the support they were receiving. There were sufficient appropriately trained, skilled and supervised staff and they received opportunities to further develop their skills.

All medication was administered by staff who were trained to do so but some aspects of medicines management needed improvement.

People could not be certain their rights in line with the Mental Capacity Act 2005 would be identified and upheld.

People were supported to maintain good health and to access appropriate support from health professionals where needed. People were supported to eat meals which they enjoyed and which met their needs in terms of nutrition and consistency.

People told us or indicated by gestures and their body language that they were happy at this home and this was confirmed by people's relatives. We observed some caring staff practice, and staff we spoke with demonstrated a positive regard for the people they were supporting.

We spoke to staff and families, viewed records, policies and observed daily routines to gain further insight of the care provided.

On the day of inspection everyone was preparing for a birthday party which was arranged around a musical activity. We saw that people enjoyed both the activity and the preparation immensely. People we spoke to at the home told us the staff were very good and they were happy. Families we spoke to had nothing but praise for the care provided. One said the home was “everything you could hope for”, another that their relative was very well cared for. We saw that people were able to personalise their own rooms and that the home was clean and comfortable. People were encouraged to be as independent as possible and there were a variety of activities available. However, there were suggestions that more activities and holidays away from the home would be very welcome.

Processes were in place to recruit staff and support training. However all staff appraisals and some training was overdue. There were plans to address this. Staff had a good knowledge of the people they cared for and care was provided in a considerate manner. Staff we spoke to said they had worked there a long time and would not want to work elsewhere.

Systems were in place to audit the quality of care. There was a complaints process and families knew how to complain if needed. Regular meetings were used to discuss new information and matters important to people using the service.

This inspection took place on 12 and 26 March 2014 and was unannounced.

At the previous inspection, in January 2014, the home was found to be compliant in the areas we inspected.

Real Life Options – Bevis provides accommodation for up to six people with a learning disability. The accommodation is a detached bungalow with a garden. On the day of our visit there were five people living in this home.

There should be a registered manager at this home. 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. When we carried out this inspection there was no registered manager at this home, but we had received an application from a prospective manager who was managing this and three other locations at the time.

Most of the people living in this home were not able to discuss their feelings about the home with us. People seemed to be calm and relaxed when we visited. We saw staff treating people with respect and communicating well with people who did not use verbal communication. We found enough staff to cover people’s basic needs. The staffing levels did not provide many opportunities for people to go out of the home, other than for short walks, or to participate in activities in the neighbouring community. People had limited access to the things they enjoyed, such as going out in the car and visiting leisure facilities. We judged this to be a breach of the regulation which says that care should meet people’s needs and reflect their preferences.

People received the correct medication at the correct times. All medication was administered by staff who were trained to do so and there were systems to make sure that the medication was stored, administered and recorded in a safe way.

People were supported to maintain good health and to access appropriate support from health professionals where needed. However, relatives told us, and we saw in records that, due to low staffing numbers, people’s opportunities to take exercise outside the home and go out and about were less than in the past.

People were supported to eat meals which they enjoyed and which met their needs in terms of nutrition and consistency.

There were systems for quality monitoring and assurance but these had failed to reveal shortfalls in record keeping and staff training which had been found by the service commissioners. The new manager was now addressing the shortfalls and undertaking improved monitoring of the performance of the home.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care. This includes decisions about depriving people of their liberty so that they get the care and treatment they need where there is no less restrictive way of achieving this.

The MCA Deprivation of Liberty Safeguards (DoLS) requires providers to submit applications to a ‘Supervisory Body’ for authority to deprive someone of their liberty. We spoke to staff and looked at records to see if the home was complying with this legislation. We found that the manager had received training in relation to recent interpretations of this legislation and he demonstrated an understanding of the impact on people at the home. He had made relevant applications as required. However, staff had not yet been trained in this area.

You can see what action we told the provider to take at the back of the full version of the report.