This inspection was completed on 28 January 2019 and was unannounced.

Rebe is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Rebe provides accommodation for up to three men or women over the age of 18. People may have a learning disability and/or a mental health diagnosis. There were three people living at Rebe at the time of the 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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post at the 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The previous comprehensive inspection was completed in July 2016 and the service was rated ‘Good’ overall. At this inspection, the service was rated ‘Good’.

The service was safe. People’s medicines were managed safely. People were protected from the risk of abuse. Staff had a good awareness of safeguarding policies and procedures and felt confident to raise any issues of concerns with the management team. Risk assessments were in place and accurately reflected the current level of risk to people. There were sufficient staffing levels to meet people’s needs. Robust recruitment processes to ensure the suitability of staff were in place however could be further improved. A recommendation was made to consider current legislation around staff recruitment.

People were receiving effective care and support. Staff received the training they needed to support the people living at Rebe. Staff felt supported and received regular supervisions and appraisals. Where required, the service was adhering to the principles of the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS).

The service was caring. People and their relatives spoke very positively about the staff. The people appeared happy and relaxed. Staff demonstrated a good understanding of respect and dignity and knew people well.

The service was responsive. Care plans were person centred and reviewed regularly. People were involved in the planning of their care. People took part in a range of activities of their choosing. There was evidence of ongoing improvements in people’s ability to be as independent as possible. There was a robust complaints procedure in place.

The service was well-led. There was a strong leadership presence. Staff lived the values of the home. Quality assurance checks and audits were occurring regularly. Staff, people and their relatives spoke positively about management.

The inspection took place on 19 July 2016. This was an unannounced inspection. The service was last inspected in January 2014. There were no breaches of regulations at that time.

Rebe provides accommodation for up to three men or women over the age of 18. People may have a learning disability and/or a mental health diagnosis. There were three people living at Rebe at the time of the inspection.

There was a registered manager at the service at the time of our inspection. 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 service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment to support people. Staff had a good awareness of safeguarding policies and procedures and felt confident to raise any issues of concerns with the management team.

People were receiving effective care and support. Staff received appropriate training which was relevant to their role. Staff received regular supervisions and appraisals. Where required, the service was adhering to the principles of the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS).

The service was caring. People and their relatives spoke positively about the staff at the home. Staff demonstrated a good understanding of respect and dignity and were observed providing care which maintained peoples dignity.

The service was responsive. Care plans were detailed; person centred and provided sufficient detail to provide safe, high quality care to people. Care plans were reviewed regularly and people were involved in the planning of their care. Staff had made considerable effort to get to know people and support them to engage in the activities they liked. Staff were knowledgeable and supportive in assisting people to communicate with them. People were confident in the presence of staff and staff were able to communicate well with people. Staff evidently knew people well and had built positive relationships. There was a robust complaints procedure in place and where complaints had been made, there was evidence these had been dealt with appropriately.

The service was well-led. Quality assurance checks and audits were occurring regularly and identified actions required to improve the service. Staff, people and their relatives spoke positively about management.

We spoke with three people who lived in the home and four members of staff. People told us they were fine and were supported to do lots of activities they enjoyed such as riding their bike or visiting garden centres for coffee. We observed people being offered a range of activities such as going to the shops, to college or for a drive.

People's likes, dislikes, routines and wishes were noted in their care records. These were person centred and produced in a format using plain English, symbols and pictures.

People were supported to access a wide range of social and health care professionals. Information was passed between the provider and other services to ensure a consistent and co-ordinated approach to their care.

Medicines were administered safely and appropriately. People had their medicines at times to suit them. Staff were trained to administer medicines and their practice was monitored.

People said they had chosen fixtures and fittings for their rooms and chosen the colour schemes. Plans for the upgrade of shared areas would ensure that the environment was adequately maintained.

We spoke with two people and observed the care being provided to them during our visit. One person told us they liked living in the home and enjoyed going out for drives, going to the rugby and to have a meal out with their relative. We observed them being supported to be independent around their home.

We heard a person making choices and decisions about their day to day life and staff respecting those decisions. A person told us staff were fine. We observed positive and respectful interactions between people and staff. There was a light hearted atmosphere in the home.

People told us they were happy with the care they were receiving. We saw a person taking their activity schedule from their room to talk to staff about what they were doing that afternoon. They then went out to take a dog for a walk. They told us they had been to a local shop in the morning.

Another person said they used public transport to go into Gloucester or to travel to Cheltenham. They said they liked to go to local pubs and cafes.

People said they were supported and helped by staff. They said they had visited the home before they had moved in and staff had shown them around the local area. They said they were settling in well and liked living at the home.

People told us they would talk to staff or an advocate if they had any concerns.