This inspection visit took place on 17 November 2016.

We last inspected the service in 2013 and found that the service was meeting the requirements of the regulations.

Simmins Crescent/Whitteney Drive provides accommodation for up to 15 adults who need personal care and support. The service provides care for people who have a learning disability and sensory impairment across three bungalows. At the time of our inspection there were 15 people using the service.

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.

There were systems in place to keep people safe. There were good systems for making sure that staff reported any allegation or suspicion of poor practice and staff were aware of the possible signs and symptoms of abuse. Staff were confident to report through safeguarding or whistleblowing procedures.

Potential risks to people had been assessed, such as risks associated with people's health conditions and the environment. Risk assessments were reviewed and updated to reflect changes in people's needs and abilities.

The provider had ensured that effective systems were in place to ensure medicines were stored, administered and managed in a consistent and safe manner.

Staff received training and support that provided them with the knowledge and skills required to provide people with effective care. We observed staff were confident and skilful in their interactions with people and demonstrated that they fully understood their roles and responsibilities.

People were supported to meet their healthcare and well-being needs and encouraged to maintain a healthy lifestyle. Staff made appropriate use of a range of health professionals and followed their advice when provided.

We found the requirements to protect people under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards had been followed. Staff sought people's consent before supporting them and respected their right to decline care.

Throughout our inspection we saw examples of good care that helped to ensure people felt included and consulted in their care. People and, where appropriate, relatives were involved in the planning of the care. People were treated with dignity and respect and encouraged to maintain and develop their independence.

Staff working in the service understood the needs of the people who lived there. We saw that staff and people communicated well with each other and that people were enabled to make choices about how they lived their lives.

Staff were knowledgeable about the people they supported and demonstrated that they knew their likes, dislikes and interests. Care plans had been developed to focus on people as individuals and described their preferences, choices and how they wanted their care to be provided. People were provided with a range of activities to pursue their individual interests and hobbies.

The registered manager assessed and monitored the quality of care and provided clear leadership to the staff team. All areas of the service were quality assured through a series of internal audits. People, their relatives and staff were supported to share their views about the service and these were used to develop and bring about improvements within the service.

In summary the expert by experience commented: ‘I really enjoyed this visit and was heartened by the level of choice and control residents had and the obvious commitment of the staff.”

We spoke with five people who use the service and spoke with six members of staff. We found staff use a range of techniques to aid choice making including; giving clear information, checking understanding, allowing sufficient time for a response and helping people to identify how a particular choice might affect them.

We noted that people have free access to the gardens. Garden paving and surfaces have been chosen so that texture can aid navigation and help people orientate themselves as well as adding interest. In places raised beds have been used to enable people to have easier access to the plants many of which have tactile and aromatic attributes. The bedrooms of people were well appointed with peoples’ choice of décor, furnishings, pictures and ornaments.

We found people are involved in the day to day decisions of their daily lives and people’s decisions to take part or not take part in activities are recorded. People are encouraged to be independent and support plans provide clear guidance for staff as to the support individual people need in all aspects of their daily lives. We found where people do not have the capacity to make decisions for themselves they are supported by relatives or in some instances an independent advocate. We found legislation in place to support people who do not have the capacity to make decisions is implemented and followed.

We found people’s individual health, cultural and religious needs, along with their personal preferences are noted and considered when compiling menus and shopping lists. We found care is taken to meet all individual needs and to give people as much choice as possible about what, when and where they eat. People are involved in the planning and purchasing of groceries and are asked at each mealtime what they wish to eat.

Throughout the visit we found staff treated residents and their belongings with respect and found staff were mindful of people’s privacy and took care not to disclose personal information about individuals when it might be overheard. We also noted that staff members clearly demonstrated an understanding of the individuals they were supporting, their individual support needs and the strategies most likely to be beneficial in enabling them to make choices and live as independent and as full a life as possible.

People’s medication is managed well and support plans include information about the medication people take and include how staff monitor people’s health and medication.

We spoke with four people who live at the service and spent time observing others and their interactions with staff. People spoke to us about their experiences of living at the home and the activities they took part in. Discussions with people and information we gathered from our observations and the reading of records showed that people with the support of staff regularly accessed a wide range of community activities,

People’s equality and diversity were recognised and supported. Staff supported people to attend religious and social events within the local community. Staff were able to communicate with people in their first or preferred language, which included English and Gujarati. People were supported by staff to be independent.

Our observations of staff interactions with people and our discussions with staff showed staff had a good understanding of people’s need.

Records including support plans were comprehensive and regularly reviewed and provided comprehensive information for staff as to the support and care each person required. Staff received ongoing support and training which enabled them to meet the needs of people.

The service had a robust quality assurance system which ensured all areas of the service were monitored and any shortfalls noted were addressed. People using the service were involved in day to day decisions about their care and support.