We carried out an announced inspection on 31 January 2017. Our previous inspection took place in December 2015 where we found breaches of the regulations in relation to medicines management and good governance.

Support for Living – 1 St Quintin Avenue provides care and support for up to seven people living with learning and physical disabilities. At the time of this inspection the service was providing support to five adults.

The service had 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.

People’s written risk assessments covered a range of issues including road safety, exploitation and abuse from others, self-neglect and financial management. Risk assessments had been reviewed in line with the provider’s policies and procedures.

Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs. Medicines were managed and administered safely.

Where appropriate, people were involved in decisions about their care and how their needs would be met. People were supported to eat and drink according to their individual preferences.

People were protected from the risk of potential abuse because the provider operated systems for recording these matters and notified the CQC about serious incidents and/or potential safeguarding matters.

Staff developed caring relationships with people using the service and people were being supported to maintain their hobbies and interests and treated people with kindness, compassion, patience and respect.

Staff recruitment procedures were in place and were being followed to ensure suitable staff were employed by the service. Staff received the appropriate training to equip them with the skills, knowledge and experience to carry out their duties effectively and with confidence and demonstrated a good understanding of people’s individual needs and wishes and how to meet them.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report upon our findings. DoLS are in place to protect people where they do not have capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others. The registered manager understood when a DoLS application should be made and how to submit one.

Monthly and weekly audits were carried out across various aspects of the service; these included the administration of medicines, care records and health and safety checks.

We saw that people using the service appeared happy and relaxed and staff interactions with people were friendly and helpful and demonstrated that staff knew people well.

People's needs were assessed and care and treatment was planned and delivered in line with their individual support plan.

Policies and procedures were in place for to guide staff in ensuring people's safety and well-being.

Staff received training which equipped them with the skills and knowledge to care for people. Staff told us they were well supported by the provider for training and advice relevant to their roles.

Systems were in place for the provider to assess and monitor the safety of the premises and the standard of the service. For example, health and safety checks were carried out. Staff held a quarterly customer forum where people and their families could discuss the service and contribute ideas.

We carried out an unannounced inspection on 1 and 3 December 2015. Our previous inspection took place in September 2013 where we found the provider was meeting the regulations inspected.

Support for Living – 1 St Quintin Avenue provides care and support for up to seven people living with learning and physical disabilities. At the time of this inspection the service was providing support to six adults.

The service did not have 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. A service manager was responsible for the overall management of this service.

People’s written risk assessments covered a range of issues including road safety, exploitation and abuse from others, self-neglect and financial management. Not all risk assessments had been reviewed in line with the provider’s policies and procedures.

Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs. Medicines were not always managed safely.

Where appropriate, people were involved in decisions about their care and how their needs would be met. People were supported to eat and drink according to their individual preferences. Staff treated people with kindness, compassion, dignity and respect.

People were protected from the risk of potential abuse because the provider operated systems for recording these matters and notified the CQC about serious incidents and/or potential safeguarding matters.

There were enough staff deployed to the service and most staff had received the appropriate training to equip them with the skills, knowledge and experience to carry out their duties effectively and with confidence.

Staff developed caring relationships with people using the service and people were being supported to maintain their hobbies and interests.

Staff underwent criminal records checks before working with people using the service. We were able to review people’s application forms, proof of identity and references.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report upon our findings. DoLS are in place to protect people where they do not have capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others. Senior staff understood when a DoLS application should be made and how to submit one.

Monthly and weekly audits were carried out across various aspects of the service; these included the administration of medicines and health and safety checks. However, we noted inconsistencies and inaccuracies in some of this information.

We identified two breaches of Regulations in relation to medicines management and good governance. You can see what action we told the provider to take at the back of the full version of the report.