The inspection took place on 10 and 11 January 2017 and was unannounced. We previously inspected Tanglewood Mews on 14 January and 9 February 2015. We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010: consent to care and treatment, and; supporting staff.

At this inspection we found that the registered manager, who had been in post for 6 months, had ensured improvements were made regarding the understanding and application of consent as well as staff support. We found the service was no longer in breach of the Regulations.

Tanglewood Mews is a residential home in Stanley, County Durham, providing accommodation and personal care for up to seven people with learning disabilities. There were four people using the service at the time of our inspection. The service also provides personal care to people living in their own apartments. There were 16 people receiving personal care at the time of our inspection.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like directors, 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 were sufficient numbers of staff on duty in order to safely meet the needs of people using the service and to maintain the premises, whilst the rota system for the on-call rota system had been improved.

All areas of the building including people’s rooms, bathrooms and communal areas were clean.

The storage, administration and disposal of medicines was safe and in line with guidance issued by the National Institute for Health and Clinical Excellence (NICE). Specific plans were in place for people with ‘when required’ medicines and controlled drugs were safely stored.

Pre-employment checks such as Disclosure and Barring Service (DBS) checks, ID checks and references were in place to reduce the risk of employing unsuitable people.

People who used the service acted in a trusting, calm manner with staff and relatives we spoke with expressed confidence in the ability of staff to protect people who from harm.

Staff we spoke with demonstrated a good understanding of safeguarding procedures and what was expected of them, whilst risk assessments in place were suitably person-centred and detailed. Person-centred means a focus on the individual's needs, wants, desires and goals so that these become central to their support.

There was regular involvement by GPs, nurses and specialists such as physiotherapists to ensure people received the treatment they needed. External professionals we spoke with confirmed staff knowledge of people’s needs was good.

Staff were trained in areas specific to meeting people’s needs, for example Autism awareness and Non-Abusive Psychological and Physical Intervention NAPPI) training, and were also trained in areas the registered provider considered mandatory, such as safeguarding, fire safety, food safety, manual handling, medication administration and infection control.

The manager had ensured staff were supported by regular supervision meetings and staff confirmed they received a range of formal and ad hoc support to perform their roles.

Staff were aware of people’s dietary needs and preferences and we observed people being supported to choose a range of meal options.

Group activities included outings to a local social club, themed nights and walks, as well as day-to-day activities such as shopping and swimming. The registered manager had made improvements to activities provision planning and was committed to ensuring these improvements continued. The registered manager had also ensured people were able to access the local community through attendance at local clubs.

A complaints process was in place and we saw this had been followed were a