The inspection took place on 20 September 2016. The inspection was announced. This was because the service was a domiciliary care service and we needed to be sure that someone would be available so we could carry out our inspection.

Riverside Close is registered to provide accommodation for three people who require personal care. The service is provided by Autism Initiatives and the registered Landlord for the property is Riverside Housing Association. At the time of our inspection one person was using the service.

There was no 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 manager at the service was in the process of applying to become the registered manager and had issued their application form into the Care Quality Commission.

At the time of inspection the person who used the service self-medicated their own medicines. The person had a locked facility in their room to store the medicines. One medicine was stored in the managers office due to it not being able to be removed from its original packaging and placed in a compliance aid. We made a recommendation about this medicine.

Staff understood safeguarding issues, and felt confident to raise any concerns they had in order to keep people safe.

Risks to people arising from their health and support needs or the premises were assessed, and plans were in place to minimise them. Risk assessments were regularly reviewed to ensure they met people’s current needs. A number of checks were carried out around the service to ensure that the premises and equipment were safe to use.

Accidents and incidents were monitored each month to see if any trends were identified. The last incident had taken place in January 2016. The manager used reflective practice to learn from incidents that this had reduced them dramatically.

The registered provider followed safe recruitment practices. A number of recruitment checks were carried out before staff were employed to ensure they were suitable. The service had employed a new staff member who was due to start, once the person who used the service was settled with the new member of staff another member of staff was to be recruited.

Staff received training to ensure that they could appropriately support people, and the service used the Care Certificate as the framework for its training.

Staff received support through regular supervisions and appraisals. Staff felt confident to raise any issues or support needs they had at these.

Staff had completed a range of training that enabled them to meet people’s assessed needs effectively. Staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) training and clearly understood the requirements of the Act which meant they were working within the law to support people who may lack capacity to make their own decisions. The manager and staff understood their responsibilities in relation to DoLS.

People were supported to maintain a healthy diet, and people’s dietary needs and preferences were catered for. People told us they had a choice of food at the service, and that they enjoyed it.

The service worked with external professionals to support and maintain people’s health. Staff knew how to make referrals to external professionals where additional support was needed. Care plans contained evidence of the involvement of GPs and other professionals.

From observations we saw staff knew the person really well and showed extreme patience.

Procedures were in place to support people to access advocacy services should the need arise.

Care was planned and delivered in way that responded to people’s assessed needs. Plans contained detailed information on

We found that people who used the service were able to make day to day choices and decisions in relation to their daily lives, and that staff encouraged this. Staff were knowledgeable about the processes they needed to follow if they felt a person was no longer able to make decisions.

People's individual needs were recorded and understood by staff. People were encouraged to live independent and safe lifestyles.

People were given a choice of nutritious food and drink. People who used the service had a nutritional support plan which included goals they had set and agreed to.

We found there were the right numbers of suitably qualified and experienced staff to support people who used the service.

People had access to a complaints procedure in a format they could understand. People's complaints had been listened to and acted upon.

On the first day of our unannounced inspection we found that the service user was attending an outdoor activity, which was provided by Autism Initiatives. We were unable to gain access to the property so we contacted the main office of the organisation and arranged to visit and attend their management meeting that was taking place. This was considered as part of the inspection and the following day we revisited 8 Riverside Close to continue with our inspection.

We looked at the care file of the person living at the home. We looked at staff files, training and supervision records.

We spoke with the registered manager and one of the support workers employed at the home.

We were unable to have any conversation with the person living in the home. We contacted the service user’s relative by phone the following evening to obtain information and gain their opinion.

The feedback received from the members of staff and the relative of the service user were all positive.

Some of the comments from the person's relative were, “Gets on really well with the staff," "(Person named) is very content and happy," "The people who work with (Name) have the right temperament and there is something rather special about the attitude of the people who work with (Name) and relates to them really well" and "They (staff) have motivated and encouraged (Name) and brought the best out in (Name)."