Sycamore Drive 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. Sycamore Drive provides care for up to four people with learning or physical disabilities and any associated health needs. The service does not provide nursing care.

Sycamore Drive has been developed and designed in line with the values that underpin Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning and physical disabilities using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Staff treated people with respect and great kindness. Relatives and visiting healthcare professionals confirmed this. One relative we spoke with told us, “[Person] is as happy as Larry living here!”

Relatives told us that they thought their loved ones were safe living at Sycamore Drive. Safeguarding issues were logged and analysed with appropriate action taken. Staff were able to talk confidently regarding their understanding of safeguarding and were able to tell us the action they would take regarding any potential safeguarding issues.

The provider had a robust recruitment process which included pre-employment checks. Staff who were new to the service had a period of induction which included shadowing existing staff.

Records showed the provider carried out various health and safety checks. As such the premises were well-maintained and safe. Robust medicines processes were in place. People received their medicines from trained staff.

Pre-assessments of people’s physical and care needs were carried out prior to people coming to live at the service. This was to ensure that the service could meet the needs of that person. Staff received regular training which supported them to have the required skills and knowledge to provide appropriate care and support to people.

People were supported and encouraged to eat a healthy and balanced diet. People were involved in creating menus, going to local shops with staff to buy the ingredients and preparing meals with support from staff.

People had access to a variety of healthcare professionals, including dentists, GPs and consultants. Relatives confirmed their family members attended various healthcare appointments.

People had access to a wide range of activities within the local and extended community. These activities included involvement with a local walking club, craft classes at a local college and Zumba classes in a nearby town.

Care plans were very focussed and person-centred. They included individual personalised goals for people and these goals were reviewed and updated on a regular basis.

Staff spoke highly of the registered manager and told us they felt supported in their role. They told us the registered manager was very open and approachable. One member of staff we spoke with told us “Yes, if ever I have a problem, I go to [registered manager] and they helped me.”

The inspection took place on 5 May 2016 and was announced, which meant the provider knew we were coming. The provider was given 48 hours’ notice because the location was a small care home for adults who are often out during the day, so we needed to be sure someone would be in.

The last inspection of this service was carried out on 22 August 2014. The service met the regulations we inspected against at the time.

Sycamore Drive provides care and support for up to four adults with learning or physical disabilities and associated health needs. At the time of this visit four people were using the service. The service is a four bedroom bungalow in a residential area. People had access to two bathrooms, a communal lounge and dining room, kitchen and conservatory.

The service is managed by a registered manager who also managed another similar service nearby. They were present on the day of our visit.

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.

Medicines were managed in a safe way. People received their medicines as prescribed and in the way they needed.

People who were able to communicate their views told us they felt safe at Sycamore Drive. One person said, “I feel safe here as I’m well looked after and I know the staff.”

Staff had a clear understanding how to safeguard people, and were able to describe signs of potential abuse and the actions they would take if they had concerns about a person’s safety or treatment. Staff felt confident any concerns would be investigated thoroughly and dealt with appropriately.

There was a positive approach to risk assessment which meant people could be as involved as possible in daily activities, without being unnecessarily restricted.

There were enough staff on duty to support people in the way they needed. The service was comfortable and well maintained and had a homely atmosphere.

The provider had an effective recruitment procedure in place. Appropriate checks were conducted prior to new staff commencing work.

Staff training and supervisions happened regularly. Staff told us they had been given more responsibility and additional training where necessary.

People were supported to maintain good health because they had access to health care services. People enjoyed a healthy and balanced diet.

People who used the service told us they were happy living there and that staff looked after them well. One person told us, “I like it here as the staff are nice. I like living here very much.” There were positive relationships between staff and people who used the service.

People took an active part in the day to day running of the service, as much as capabilities allowed, and staff encouraged people to be independent. People played an active role in selecting furniture and colour schemes for the redecoration of the service.

Care plans were detailed and showed what care and support was needed to ensure individualised care was provided to people. Staff spoke positively about the impact of person-centred care.

People spoke positively about the management team which consisted of the registered manager and a senior support worker. One person said, “They’re lovely, always happy to help.”

Staff told us they felt the service was going from strength to strength and spoke enthusiastically about the impact this would have on people who used the service. A staff member told us, “The service is getting better all the time.”

We haven’t been able to speak to the people using the service because they had complex needs, which meant they were not able to tell us their experiences.

However, we undertook a short observational framework for inspection (SOFI) exercise to observe the interactions between them and the staff. SOFI is designed to be used when inspecting services for people who have some difficulty in communicating their opinions on the services they receive.

During the SOFI, we observed people being offered choices; for example, people were offered a choice of drinks and a choice of meals. Staff were seen to be attentive and gave people the information about the drink and meal options in a way that was appropriate to their needs. One person was supported to walk around the house and then sit in the conservatory. We observed another person being supported to walk to their bedroom. In addition, we observed staff trying to engage people in discussions about the activities they had planned for that day. We observed staff discreetly speaking to one person when they were showing signs of becoming anxious.

Throughout the inspection, the staff members on duty were observed speaking to people in a kind and respectful way. We also observed that the people were clean and well groomed.

We haven’t been able to speak to the people using the service because all who were using it had complex needs, which meant they were not able to tell us their experiences. However, we gathered some evidence of people’s experiences of the service by reviewing the care records, relatives’ surveys and observing care practice.

Staff members on duty were observed speaking to people in a kind and respectful way. We also observed that the people looked clean and well groomed. One relative had commented in the surveys, about their relatives’ care, “We are really happy with the care … receives, he always looks clean and tidy and is very happy”.One member of staff commented, when asked how they provided the people at the home with information about their care, they told us “We show them their care plan and read it to them”.

We were unable to find out what the people at the home thought about their care as they all had complex needs.

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

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and the staff supporting them, and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The home is safe. People’s care plans held completed assessments of risks associated with their care. They were cared for by staff who had suitable training. The manager ensured that safety checks were carried out regularly.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We saw that assessments were underway in relation to examining peoples access to the community (as most only want to go out with staff) to check to see if this needs an application being put into the local authority

Is the service effective?

The service is effective. There were processes in place to ensure that people received the medication they should when it was needed.

Each person had the risks associated with their care assessed and these were updated when needed.

Is the service caring?

The staff were caring. People had comprehensive assessments and care plans which were adhered to by staff and it was clear from observations that staff did care for people living there; they understood their needs by what was set out in the care plans.

Is the service responsive?

The service is responsive. Records showed that people’s needs were reassessed regularly

We saw records where the home responded quickly to peoples changing needs for example when one person became unwell, even though they could not communicate, the staff became aware something was wrong and sought immediate medical help.

When we spoke to the manager about torn flooring in the shower we noted that by the second visit this flooring had been replaced.

Is the service well-led?

The service is well led. The manager displayed good knowledge of the needs of people living there and was well trained. She has systems in place to monitor the service and both people living there and staff said she was kind supportive and encouraging.