This inspection took place on the 30 August 2017 and was announced.

Stapleton Drive provides care and accommodation for up to 12 people with a diagnosis of a learning disability or autistic spectrum disorder. The accommodation comprised of three adjoining houses with accommodation for four people in each house. At the time of our visit there were three people living in each house.

At our last inspection in May 2015 the service was rated Good. At this inspection we found the service remained Good, but some improvements were required in the leadership of the home.

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 was a registered manager in place, but they had been on extended leave for six months at the time of our inspection visit. The deputy manager had assumed day to day responsibility for the home with the support of two home managers.

There were enough skilled and experienced staff on duty to support people safely. Staff understood people’s needs and knew how to protect them from the risk of abuse. Plans to manage identified risks were detailed and provided staff with information to enable them to provide care in the safest possible way. People indicated by their body language and facial expressions they felt safe living at Stapleton Drive.

People were cared for and supported by staff who had the skills and training to meet their needs. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were involved in making every day decisions and choices about how they wanted to live their lives.

Care plans were detailed and personalised and contained specific guidance for staff to follow so they were able to support each person in the way they preferred. People were involved in choosing menus and any needs or risks related to their nutrition or eating and drinking was included in their care plans. People accessed healthcare services as required and received on-going healthcare support and reviews. Medicines were administered and managed safely.

People enjoyed talking with staff and engaging in activities with them. Staff treated people with dignity and respect by promoting them to be as independent as possible. Relationships and friendships outside the home were encouraged. People were encouraged to maintain their interests and take part in social activities.

There had been a period of change and uncertainty within the service. The changes had impacted on staff morale because staff felt information had not always been shared in a timely way. Despite the uncertainty, staff were confident people had continued to receive safe, effective and responsive support that met their individual needs.

This inspection took place on the 21 May 2015 and was unannounced.

Stapleton Drive provides care and accommodation for up to 12 people with a diagnosis of a learning disability or autistic spectrum disorder. The accommodation comprised of three adjoining houses with accommodation for four people in each house. At the time of our visit there were three people living in each house.

We last inspected the home in May 2014. After that inspection we asked the provider to take action to make improvements in the safety of the premises and their quality assurance systems. At this inspection we found improvements had been made in these areas, but further work was needed to ensure records of safety checks were consistently maintained in all three houses.

There was a registered manager at the time of our inspection. 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.

Some people who lived at Stapleton Drive had complex needs and required high levels of support to maintain their mental and physical wellbeing. There were enough staff on duty to meet people’s needs, but a large number of staff vacancies meant the service was using a high percentage of bank and agency staff.

Staff had received training in keeping people safe and understood their obligation to report any concerns to the management team. Some people could occasionally display behaviour that could compromise their own health and safety, or that of other people. The service had worked with healthcare professionals in psychology to produce guidelines to manage those risks. Medicines were managed safely and where people were prescribed medicines for agitation or distress, there were detailed guidelines in place to ensure they were given them safely and consistently.

Staff completed an induction and received on-going training so they could meet the needs of people effectively. The registered manager had introduced a system of monitoring staff work practice which was used to inform discussions about their personal development.

The provider and registered manager understood their obligations under the Mental Capacity Act and the Deprivation of Liberty safeguards (DoLS). The provider had made appropriate applications to the local authority in accordance with the DoLS.

Staff were caring and supportive of people and encouraged people to participate in activities and interests that provided them with fulfilling lives. People were encouraged to develop and maintain relationships with others who were important to them.

People were involved in making every day decisions and choices about how they wanted to live their lives. Where people had limited or no verbal communication, a range of tools was used to support them in making those decisions.

Staff supported people to attend appointments with external healthcare professionals to maintain their physical and mental health. People had varied diets that met their nutritional needs.

The registered manager had been in post for eight months at the time of our visit and provided clear and supportive leadership within the home. Managers and staff were given opportunities through meetings and supervision to share good practice and discuss issues within the home.

We visited this service and talked with people to gain a balanced overview of what people experienced, what they thought and how they were cared for and supported. There were ten people living in the home at the time of our visit. We saw nine of the people during our visit.

We spoke with six members of staff, four of the people who lived in the home and the manager. Some of the people had limited verbal communication skills. We observed how people were cared for and how staff interacted with them to get a view of the care they experienced.

We considered all of the evidence we had gathered under the outcomes that we inspected. We used that information to answer five key questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We observed the interactions between the people who lived in the home and staff. People looked at ease in their surroundings. Staff spoke with them in a calm and friendly manner. There were enough staff on duty to meet the needs of the people who lived at the home.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLS) which applies to care homes and hospitals. No applications had been made. The manager understood how this legislation applied to people and protected their rights.

We found that equipment was serviced at regular intervals to ensure it was safe to use. However records indicated that the required in house checks on fire equipment had not been undertaken. This could put people at risk of harm.

The home was generally clean and tidy. However improvements were needed to ensure that all areas were kept to an acceptable standard of cleanliness and infection control guidelines were followed.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to following the appropriate infection control guidelines.

Is the service effective?

It was clear from our observations and from speaking with staff they had a good understanding of people's care and support needs and they knew them well. We saw people's support plans and risk assessments were reviewed on a regular basis to ensure their changing needs were planned for.

People were asked to consent to what was happening in their lives and encouraged to make decisions. Where people were not able to communicate verbally staff had developed a range of methods to help them. This ensured people were enabled to make their own choices and decisions on an everyday basis.

Staff training was sufficient to meet all the needs of people using the service. People living in the home were supported to meet goals and improve their skills.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people.

People appeared settled and happy. Three people told us they liked living at the home. One person said, “I like living here, the staff are nice.” We saw that people were supported to take part in a range of activities of their choice. This ensured people led fulfilling lives. People were supported to maintain relationships that were important to them.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People's needs had been assessed before they moved into the home. People told us about their weekly planning meetings with staff to ensure they remained satisfied with their support. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

People regularly completed a range of activities in and outside the service. The home had its own transport which helped keep people who were unable to use public transport involved with their local community.

Records showed that staff responded quickly to changes in people's health. We saw that people had access to a variety of health care providers to ensure their needs could be met.

Is the service well led?

The manager was experienced and caring and provided good leadership based on how best to meet the individual needs of people.

The service worked well with other agencies and services to make sure people received their care in a joined up way.

There were systems in place so people who lived in the home could share their views about how the home was run. The manager was able to give us examples of actions taken and changes that had been made as a result of listening to the people living in the home.

Staff were supported to meet the needs of people through the provision of regular training, supervision and staff meetings that enabled good practice to be developed.

The systems in place to ensure the quality of the service was regularly assessed and monitored were not robust. Records indicated there were only two ongoing internal audits, others had lapsed. This meant that the shortfalls in the service had not been identified and addressed to ensure ongoing improvement for the people living there.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to quality assurance.

When we visited 25 - 29 Stapleton Drive there were ten people living in the three adjacent houses. During our visit we spent time chatting to people and observing the care and support they received. We spoke to most of the staff on duty and the registered manager. People who lived at the home interacted positively with staff and appeared comfortable and relaxed. People told us they enjoyed living at the home. One person described it as "very nice". Another said, "I like it here. It's really quiet."

We saw that where possible people were encouraged to develop and maintain their independent living skills. People’s right to privacy was respected.

We saw care files provided staff with details about people’s mental health needs as well as their physical care needs. Staff we spoke with were able to tell us about the individual needs and abilities of people and how they supported them.

People were supported to participate in a range of activities of their choice and that promoted their health and wellbeing. Everyone participated in an activity outside the home on the day of our visit.

The service had a procedure for supporting staff through formal induction, supervision and annual appraisals. Some staff training required updating.

We looked at how the service managed medication. We saw there were systems in place to ensure medicines were administered safely to people.

Records were accurate, fit for purpose and held securely.

When we visited 25 - 29 Stapleton Drive on 1 November 2012 there were eight people living in the three adjacent houses. All the people living there had complex needs. Some of the people were able to talk to us. They told us what it was like living at Stapleton Drive. Others had limited communication so we watched the care being provided to those people. We also spoke to three staff and the manager of the service.

We saw that those who were able were supported to maintain their independent living skills. Staff were knowledgeable about what people were able to do for themselves and what they required assistance with.

Support plans were person centred and reflected people's individual needs. We saw that people and their families were involved in regular reviews of support plans. This enabled them to raise issues and maintain an involvement in their relative's care.

Staff were clear as to their responsibilities for reporting any potential abuse and understood the importance of keeping people safe. People spoke positively about the support they received from staff. One person told us, "The staff are quite good to us they help us out."

People enjoyed telling us about holidays they had recently been on. One person said, "I chose who I wanted to go with." We saw that people were being taken out regularly which provided them with interests and helped maintain their links with the community.

When we visited the service on 6 January 2011 we were told by the registered manager that eight people were living in the home at that time.

The home was three separate houses adjacent to each other. The manager told us that there were vacancies in two houses at that time. We saw that everyone had somewhere to go that morning supported by workers.

We followed the care of two people who were sharing a house. We met each of them and they looked well groomed and relaxed in their home. They each had their own bedroom and shared a bathroom. Support workers and managers treated them with kindness and interacted with them constantly. They were helped to do as much for themselves as they were able.

Each person had well organised and up to date care and health records. They had a support plan that was individual to them. It included directions for workers about how risks to the person posed by their condition should be managed and their rights protected.

They were supported by sufficient numbers of workers. Their keyworkers had qualifications and up dated training in social care.

The provider organisation had policies and procedures in place for safeguarding people from abuse including systems for protecting their money.

We asked one person whose care we followed if they were happy and they said 'yes'.