The inspection took place on 4 July 2016 and was announced. 193 St Andrews road provides care and support to three people with a range of complex health and support needs. It is situated on a main road just outside the centre of Bridport.

The service had a 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.

There were enough staff to keep people safe. The registered manager worked shifts at the service as well as their management role and staff were deployed to meet the individual needs of each person and what they had chosen to do each day.

People were protected from avoidable harm by staff who knew them well and understood the risks they faced. Risk assessments were comprehensive and focussed on supporting people to be as independent as possible whilst supporting and managing their individual risks. Staff were recruited following appropriate pre-employment checks and received appropriate training for their role.

People were supported to live in a safe environment because fire safety, building and equipment checks were carried out regularly and any issues were recorded and actioned.

People received their medicines as prescribed and we saw that they were stored safely and recording was accurate and regularly audited.

Staff had daily contact with the registered manager and were encouraged to speak with them whenever they needed to. Supervisions were regular and staff were encouraged to discuss and raise any issues and to consider further development and training.

People were supported to make decisions or to be involved in best interests decisions where they were unable to make decisions for themselves. Staff understood the relevant legislation around this and records were robust.

Staff understood how to offer people choice and we saw that people were involved in choices about all aspects of their support in ways they were able to understand.

People were supported by staff in a way which was kind and respectful. Rapport between people and staff was good and there was a relaxed atmosphere at the home. Staff ensured that they were mindful about how to maintain peoples privacy and dignity.

Relatives were regularly contacted to discuss any issues and were involved in reviews of their relatives care. Records were person centred and detailed, they gave histories of the people living at the home and focussed on what people liked and what their interests were.

There was an open culture at the service and staff were clear about their roles and responsibilities. Communication between staff and the registered manager was good, they encouraged staff to tell them about ideas and they had plans for how to further develop the service.

The registered managed encouraged best practice by linking with other organisations and ensuring they provided staff with information from research and regular updates about the service and any policy changes.

Quality assurance was robust and included checks carried out at the service and overview audits which were completed by Encompass head office.

We observed people being treated with respect and dignity. People’s independence was promoted, and their involvement in the community supported. People were able to make choices about what they ate, what they wore and how they spent their time.

People had a detailed support plan that focussed on their abilities, preferences and needs. We saw that people’s support plan, and risk assessments, were reviewed regularly and up-dated to reflect changes. People had access to the GP, district nurse, and other appropriate specialist support as required.

Staff had received safeguarding training, and up-to-date policies were in place. Staff we spoke to knew how to respond to safeguarding concerns and the provider had a clear system in place to report safeguarding alerts. We saw that action had been taken in response to medication errors. The manager told us that they felt the action taken was appropriate and adequate. They confirmed that they would stop staff from administering medication if they were not competent.

We looked at five staff files. Records showed that the provider had followed the recruitment process appropriately.

The service was undergoing extensive reconfiguration. Detailed plans, and risk assessments were in place. The provider might like to note that the quarterly health and safety audit was overdue.

The provider monitored the home's high usage of bank and agency staff. Two staff had recently been employed and further recruitment was underway.

People who lived in the home were treated with respect and dignity. People were given choices about their care and their independence was promoted in their home and community.

People's care was planned and delivered so that people were safe and their well-being was promoted. Staff demonstrated a good knowledge and understanding of people's needs and how to meet them. There were enough staff to ensure that people received the care they required and their individual preferences were met.

Improvements had been made to the home environment to ensure it provided a safe and comfortable environment for people to live in and was maintained to a good standard.

Some records about people's care were not accurate or complete. This meant that there was a potential risk that people's needs would not be identified and met.

People who lived at the home did not comment on infection control issues at the home. We spoke with staff who told us how they had improved the infection control practices at the home. We looked at the records in relation to infection control that demonstrated how the improvements were monitored, and in line with good practice guidelines.

We did not talk with the people living in the home because several people have limited ability to understand and fully communicate in words. Also the purpose of our visit was to look at the way people's care is managed by the staff at the home and to make sure people are being kept safe.