This inspection visit was unannounced and took place on 19 October 2017. We also spoke with some relatives of people who used the service by telephone on 1 November 2017. The service is registered to provide accommodation for up to nine people, and at the time of our inspection, eight people with learning disabilities were using the service. St Ives Close 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.

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.

Our last inspection visit took place on 17 December 2015 and the overall rating for the home was ‘good.’ However, the key question, ‘is the service caring?’ was rated as ‘requires improvement.’ This was because there were aspects of care that needed improvement to ensure people’s dignity was promoted. At this inspection, the necessary improvements have been made, and we have been able to give a rating of ‘good’ in all the key questions, including, ‘is the service caring.’

People continued to be safe living at the home. They were supported by staff who understood how to protect them from harm. Risks to individuals were managed for people, and there were enough staff to meet people’s needs and keep them safe. Recruitment processes ensured that staff were safe to work with people and medicines were managed to reduce the risks associated with them.

People received support from staff who had the knowledge to carry out their roles effectively. When people were not able to make certain decisions for themselves, the provider followed the guidance available to ensure the care given was in their best interests. Staff understood how to support people to make decisions when possible. People were supported to maintain a balanced diet and access health care services.

Staff assisted people in a kind and caring manner, and had developed positive relationships with them. Staff knew people well and understood how to communicate with people to ensure they could make choices about their care. People were encouraged to be independent, and staff respected people’s privacy and promoted their dignity. People were able to maintain relationships that were important to them.

People and their relatives were involved in the planning and reviewing of the care they received. Their support was provided in an individual manner, and care plans were personal, ensuring people received support that was responsive to their needs. People were supported to participate in activities they enjoyed and were protected from the risk of social isolation. People knew how to raise concerns and these were responded to in a timely manner.

The service continued to be well managed. There were systems in place to monitor the quality of the service. This was through feedback from people who used the service, their relatives, and a programme of audits. These were used to drive continuous improvement. There was a positive culture within the home, and staff felt supported and motivated in their roles. There was a registered manager in post who understood their responsibilities of their registration with us.

This inspection took place on 17 December 2015 and was unannounced.

The service is registered to provide accommodation and personal care for up to nine people with a learning disability. At the time of our inspection eight people were using the service. At our previous inspection in January 2014, there were no concerns identified in the areas we looked at.

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.

People had developed good relationships with staff and staff knew each person’s individual care and support needs. Staff understood each person’s way of communicating their needs and wishes, although we saw some interactions where staff did not speak with people during their support and let people know what was happening. Where there were changes in people’s behaviour, staff recognised this could mean people were unhappy and they would raise a concern on their behalf.

Staff knew how to recognise and report any concerns so that people were kept safe from harm. People were supported to take risks at home and when out and encouraged to do the things they liked to do. Staff had a positive attitude towards managing risk and keeping people safe. Risks were assessed and reviewed to keep people safe and protect them from avoidable harm.

There were enough staff available and checks had been completed before new staff were appointed to ensure they were suitable to work with people. Staffing was flexible to allow people to do the activities they enjoyed. People were involved with a range of activities including going out shopping, attending church and they enjoyed going on holiday. People were able to continue to have relationships with friends and family, who were invited to social events in their home.

People were supported to take their medicines and systems were in place to ensure that people received their medicines as prescribed and to keep well.

People chose how to spend their time and staff sought people’s consent before they provided care and support. Some people did not have capacity to make certain decisions, and they received support to ensure decisions were made in their best interests. Some people may have restrictions placed upon them as they were not able to go out alone and may not have the capacity to make a decision about their safety. Applications to ensure these restrictions were lawful had been made.

People were supported to eat and drink the food they liked. Staff knew how to support people to eat well and maintain a healthy diet and where people needed a specialist diet. Advice was sought from health care professionals to ensure people stayed well.

The provider had arrangements in place to listen to the thoughts and opinions of people living at the service, relatives and professionals. Feedback was given to people in small groups to ensure they understood this information.

We inspected St Ives Close in January 2014. We were unable to gather people’s views about their care directly because of the complexity of people's needs. However, we observed that people appeared relaxed and comfortable in their home and in their interactions with staff. We found that people’s privacy, dignity and diversity were respected and their independence was encouraged. People’s care plans were detailed to ensure that their needs were met safely and in ways that suited them.

We found there had been one safeguarding concern since our last inspection. This had been managed appropriately and people had been protected from potential harm. We spoke with a maintenance engineer working at St Ives Close that day. They confirmed that essential items like hoists and wheelchairs were regularly maintained to ensure people’s safety.

We found that Mencap had robust recruitment procedures to promote people’s safety. They had a clear complaints policy so that people and their families could make their views known to staff.

When we went to St Ives Close we saw that the people who lived there did not use speech to communicate, nor did they use communication which relied on people learning symbols. Support workers made judgements about people’s needs and wants based on their facial expressions; their body language and the sounds they made. While we there we observed that people seemed relaxed in their home. We saw some people smiling and laughing during the day and responding to the support workers in a positive way.

We spoke with one person's relative who told us, "The staff were brilliant, they’re a really good team”. They said they were very satisfied with the support provided at St Ives Close. They told us that if they had any questions at all the manager sought to make changes in line with their wishes. They were delighted that their family member had had opportunities to develop new interests since coming to St Ives Close and they confirmed our observation that the people who lived there were treated with kindness and respect.

We found that people’s needs were thoroughly assessed. There were clear guidelines for support workers to follow when providing care and support. When we visited there were enough support workers to meet people’s needs. Support workers received appropriate training including safeguarding training. There had been no safeguarding incidents at St Ives Close. We saw that at both provider level and service level there were robust quality assurance systems in place.