The unannounced inspection took place on 30 January and 5 February 2018. At our last inspection in December 2015 there were no regulatory breaches. However, we rated "Effective" as "Requires Improvement" and made a recommendation about the premises needing to be refurbished and made more adaptable for people. During this inspection we found that improvements had been made, including redecorating and a new carpet.

Seymour Gardens accommodates up to five people with a learning disability in one adapted building. At the time of our inspection there were five people living at the service.

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.

On the day of our visit, a registered manager was in place and gave us access to all the records we needed. 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.

People told us they felt safe and trusted the staff that supported them. They knew staff by name and told us staff were kind and caring and treated them with dignity and respect.

Staff were aware of the steps to take to safeguard people from harm. They had attended relevant training and were able to explain how they would recognise and report abuse.

Medicines were managed safely by staff that had undergone the necessary training. However we made a recommendation to follow best practice guidelines for all as required medicines.

Accidents and incidents were managed safely. Any identified trends were discussed with staff and steps taken to reduce avoidable harm.

Risk assessments were in place for the environment and for people and these were known by staff in order to enable them to take appropriate steps to minimise harm.

People were protected from the risk of infection. Staff had attended food hygiene and infection control training and wore personal protective clothing when required.

People told us there were enough staff to meet their needs. There were robust recruitment systems in place to ensure only staff that had undergone the necessary checks and were suitable to work in a care setting were employed.

People were assisted to be as independent as possible at times with the aid of assistive technology. They were enabled to eat a balanced diet that met their individual and cultural specific needs. Where required they were supported to see healthcare professionals in order to maintain their health.

Staff had attended relevant training and were supported by means of regular supervision and annual appraisal. They were aware of the Mental Capacity Act 2015 and how they applied it in practice.

People told us their consent was sought before support was delivered. Where restrictions were in place these had been done following capacity assessments and best interests decisions.

Assessments took place before people started to use the service. These were followed up by holistic personalised support plans which were reviewed regularly to ensure they accurately represented people's social, religious and physical support.

People were able to express their concerns and told us these were listened to. There was a complaints policy which was known and followed by people and staff. The registered manager monitored and investigated complaints to ensure they were resolved in a timely manner.

There were effective quality assurance systems in place to ensure the quality of care delivered was monitored. We made a recommendation about ensuring policies are kept up to date in a timely mann

This unannounced inspection took place on 15 December 2015. At our last inspection in June 2014 the service met the regulations we inspected.

Seymour Gardens is registered to provide accommodation and personal care to five people with learning disability. The inspection was carried out by one inspector. At the time of our inspection five people were using the service who were all of Jewish faith.

People lived in a large terraced house in a residential area, close to public transport and other services. The house did not have any special adaptations but the ground floor was accessible for people with mobility difficulties.

At the time of the inspection there wasn’t a registered manager at the service. An interim manager has been in charge of the home since June 2015. They have made an application to the Care Quality Commission to become the 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 were protected from abuse or the risk of abuse. There were clear safeguarding and whistleblowing policies and procedures in place to protect people. Staff were aware of what action to take if they suspected abuse.

People were encouraged to meet their friends, family and relatives. We saw that people went out to various activities. People identified as ‘at risk’ when going out in the community, had risk assessments in place and we saw that, if required, they were supported by staff when they went out.

People were cared for by staff that were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Staff spoke positively about their experiences of working at the home.

We saw that staff treated people with kindness and that people were relaxed and at ease at the home.

Care plans were person centred and were regularly reviewed and updated when people’s needs changed.

The staff encouraged people’s independence and care plans provided prompts for staff to enable people to do the tasks they were able to do by themselves.

People were consulted and activities reflected people’s individual interests, likes, dislikes. Their religious and cultural needs were well accommodated.

People were supported to maintain links with the wider community. They were also supported and encouraged to maintain relationships with family members and were able to visit them when they wished.

The home had a clear management structure in place. Relatives told us that they felt able to approach the interim manager and could raise any concerns with them and knew that they would be listened to.

The home had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service.

We observed that all areas of the home were in need of refurbishment and updating. In discussion with the business manager they told us that they had identified these issues and were in discussion with the landlord to attend to these matters. We recommend that this issue is dealt with in a timely manner by the organisation in order to provide well-maintained accommodation and to ensure that people are cared for in a safe environment.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:-

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we found.

Is the service safe?

People told us they felt safe and were happy with the service provided. We spoke with four of the five people who used the service. They told us that they liked living at Seymour Gardens. We saw that staff treated people with respect and dignity and they told us that they were very happy with the service provided. Safeguarding procedures were in place and staff understood how to safeguard people they supported. They had received training to ensure that they knew how to support people safely.This included safeguarding vulnerable adults. The Organisation had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff had received Mental Capacity Act 2005 and Deprivation of Liberty Safeguards training.

Is the service effective?

People’s care needs were assessed with them and they were involved in developing their plans of care. People’s care plans were up to date and reflected their current needs.They had access to choice and remained in control of decisions about their care and lives. We spoke with four people who used the service and asked them for their views about the care and support they received. They were positive about their experiences and described staff as "kind" and "helpful." The staff had a good understanding of how to meet people's individual needs and were aware of their preferences. Staff had current information and details about individuals, to enable them to effectively meet people’s needs.

Is the service caring?

We asked people who used the service for their opinion about the staff who supported them. One person told us “I like the staff, they are very kind. They are helpful." Another said "this home is very nice. They (staff) are very helpful. They help me with my shower to make sure I do it alright. We go out every day to the shops or for walks." They told us that staff had enough time to deliver the planned care. People's preferences and diverse needs were recorded and daily notes showed that care and support was provided in accordance with this. People's religious and social needs were identified and staff assisted them to follow these. For example, going to visit their families and celebrating Jewish festivals. People were also supported to be part of the wider community. They went out to college, clubs and outings with staff support whenever needed.

Is the service responsive?

The staff we spoke to were knowledgeable about the needs of people who used the service and how to meet them. They told us that if they identified that people's needs had changed, they reported this to the manager and the person's keyworker in order to update their care plan and risk assessments. We saw that care plans included information about people's likes, dislikes and preferences. These had been recently reviewed and updated to ensure that the staff had up to date information about people’s needs and how these should be met.

Is the service well-led?

The service had a quality assurance process in place. Sufficient systems were in place to monitor the quality of the service provided to ensure that people received safe, quality care. Annual customer satisfaction questionnaires were sent to people and their representatives to seek their views and opinions about the service in order to find out where improvements were needed. Staff told us they were clear about their roles and responsibilities. They were supported by the management team to provide good, quality care and were encouraged regularly to complete relevant training. People knew how to make a complaint if they were unhappy. A pictorial complaints procedure was in place and staff asked people if they had any complaints when they had individual meetings with them.

There were effective systems used to identify any issues within the service which were quickly escalated by the manager and resolved by the organisation. We found a number of audits were undertaken by staff, the manager and by the registered provider to ensure that people received safe, quality care.

People’s consent was sought and their views and experiences were taken into account in the way the service was delivered in relation to their care. Care was planned and delivered in line with their individual care plan because people's needs were fully assessed. Staff were caring and supportive to people. People said "I have got a care plan, we did it together." Another said "I like living here quite a lot.They look after us perfectly."

We found that medicines were safely administered by staff who were trained and competent to carry out this task. People had their own bedrooms and steps had been taken to ensure the physical environment was safe and accessible. The service had procedures in place for dealing with complaints.

We spoke to three of the adults who live in this home. They said ‘’They like living here’’, that they ‘’Go to college’’ and ‘’Go on holidays’’.

Staff spent time in ensuring the care and support delivered was what the people wanted. The feedback from meetings held with the independent advocate helped shape the service that was offered. There were regular staff meetings where staff had the opportunity to discuss the care and service they delivered.

Each person living in the home had a detailed yearly review; all significant people were invited. Risk assessments were in place and regularly reviewed. Staff spent time with each person supporting them in completing tasks in order that their independence was promoted.

We observed staff interacting with people living at the service and found them to be warm and supportive. We observed the atmosphere to be relaxes and that staff were encouraged and enabled to be involved and to express their views.

The people living here invited us to view their rooms. They told us they were involved in the decoration of their rooms. There were various activities on offer either within the home or in the wider community.

Staff received regular training and supervision which helped them to deliver person centred care to people living in this home. All staff working in the home had attended training on the ’Jewish way of life’; therefore they could support the people living in the home in respect of the Jewish practices and culture.

People said they felt supported by the staff team and that they were included in decisions about their care as far as possible.

They told us that staff were kind and respected their privacy.

They told us that staff listen to them and involve them in aspects of their care and the general activities in the home.

People told us that staff talk to them about their care needs and let them know how and why they are supporting them. One person commented, “It is nice here.”

People told us they were happy with the choice of food at the home. They told us they get enough to eat and that they can have snacks outside of meal times.

People who use the service told us they felt safe at the home and that they would talk to the manager or staff if they were concerned about anything.

They told us they were happy with the general environment of the home and their rooms. One person told us, “I like my bedroom.”

People told us they felt safe with the staff working at the home. One person commented, “the staff are nice.”

Everyone we spoke to said they knew how to make a complaint and who they would talk to if they needed to.