This inspection took place on 13 and 19 November 2018 and was unannounced.

Swanrise 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.

Swanrise accommodates six people in one adapted building and is in close proximity to two other services owned by the same provider, staff work between the three services and people living in the services all interact with each other. One the day of our inspection five people were living in Swanrise.

At the time of the inspection the registered manager had not worked at the service since September 2018. There was no manager in place and no one had been asked to act up while a new manager was being appointed. 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.

The care service supports people living with a learning disability and should be developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. Meaning, people with learning disabilities and autism using the service should be able to live as ordinary a life as any citizen. However, it was not always evident that the provider understood these principals, there was not always enough staff on duty to promote independence and choice.

On the first day of this inspection, we found that there were not sufficient staff on duty to keep people safe. When we arrived, all the people who lived in the service had 1-1 support and there was no member of staff free to facilitate the inspection. People were still getting up and having their breakfast and they were not safe to be left. This meant that we started our inspection in the office examining care files and other records until a staff member was able to speak with us.

Later in the morning the general manager arrived, meaning the staff member could get back to supporting people. On the second day of the inspection, a decision had been taken to permanently add a floating staff member to the rota, however this person was to move between the three services within the same grounds and was not effective.

People were not always protected from risk. Risks in people’s environment were assessed and steps have been put in place to safeguard people from harm without restricting their independence unnecessary. Risks to individual people had been identified and action had been taken to protect people from harm. However, not all the risk assessments had been kept under review or had been updated.

People’s needs were assessed and they received care in line with current legislation. However, not everyone’s care records had been reviewed or updated. People’s daily activities were sometimes restricted because of staff not being available to support them. Staff did not always have the knowledge and skills they needed to carry out their roles. Training and supervisions had fallen behind.

The service had not been well led; failings in place prior to the registered manager leaving had not been identified by either the provider or the previous general manager, who had also recently left. However, we acknowledge that these have now been identified and the provider was taking action to make improvements. An acting manager had not been put in place while a new manager was being recruited, which meant that those shortfalls were not being properly addressed in a timely manner.

The staff had been safely recruited. People where protected from bullying, harassment, avoidable harm and abuse by staff that were trai

Swanrise provides care and support for up to six people with learning disabilities. On the day of our inspection six people were living in the home. Accommodation consisted of a large house on two floors with a large outdoor area.

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.

People were supported by staff who understood safeguarding procedures and were able to recognise the signs of potential abuse.

Risks to people had been thoroughly assessed and plans put in place to manage these risks while enabling people to live their lives without unnecessary restriction.

Robust recruitment procedures had been employed to ensure that staff were suitable to work with people who used the service. There were sufficient numbers of staff deployed to meet people’s needs. Staff received comprehensive training to enable them to meet people’s needs.

People were given support to take their medicines as prescribed. People’s nutritional needs were met and they were supported to access healthcare if they needed it.

People were supported by staff who showed respect and cared for them as individuals whilst maintaining their dignity. People were encouraged to make their own decisions where possible and their consent was sought appropriately.

Staff understood the principles of the Mental Capacity Act (MCA) and worked to keep people safe while not unnecessarily restricting their freedom. Deprivation of Liberty Safeguards had been sought appropriately for some of the people living in the home.

People and those important to them were involved in planning their care, how it was delivered and their independence was promoted. People’s care was delivered in the way they wished by staff who were knowledgeable about their needs.

People who used the service and staff who supported them were able to express their views on the service. People were supported to make complaints and were confident that these would be heard and acted upon. The service maintained good communication with people who used the service and their families.

The management maintained a good overview of the service and had systems in place to monitor the safety and quality of the service. Staff were supported by the management and felt valued by the organisation.