This inspection took place on 26, 28 and 29 March 2018 and was announced. The provider was given 48 hours notice because the location was a small service for people who are often out during the day; we needed to be sure that someone would be in.

The Court 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. The Court is registered to provide residential care and support for up to three adults with a learning disability or autistic spectrum disorder. At the time of our inspection three people were living at the home.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 has been 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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last inspection, the service was rated good. At this inspection we found the service had deteriorated to requires improvement.

During this inspection we found the service did not have robust systems and processes in place for the monitoring of DoLS applications and to safeguard people from abuse. Some people did not receive their medicines as prescribed. We also found the service did not have effective quality assurance processes to monitor the quality and safety of the service provided.

Staff had completed safeguarding training and spoke confidently about the actions they would take if they thought a person was at risk of harm. Sufficient appropriately trained staff were available to support people’s needs.

An effective recruitment and selection process was in place. The provider carried out monthly health and safety checks to ensure people lived in a safe environment. A business continuity plan was in place to ensure people would continue to receive care following an emergency.

Where risks were identified they were assessed and managed to minimise the risk to people who used the service and others.

Care plans were comprehensive and included clear information for staff to follow to make sure people's needs were met.

People were supported to maintain good health and had access to healthcare professionals.

The service was responsive to people’s individual needs and preferences, enabling people to live as full a life as possible. People were supported to maintain relationships, access the local community and go on holidays.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Accessible information was used throughout the service including an easy to read complaints and compliments procedure and within people’s care records.

Staff told us they felt supported by the registered manager and enjoyed working at the service.

The registered manager ensured statutory notifications had been completed and sent to the CQC in accordance with legal requirements.

Relatives felt the organisation was well run and that the registered manager was approachable.

You can see what action we told the provider to take at the back of the full version of the report.

This inspection took place on 28 January 2016. The last inspection of this home was carried out on 18 March 2014. The service met the regulations we inspected against at that time.

The Court is registered to provide care and support for three people who have autism spectrum condition. There were three people living there at the time of this inspection. The care home is a semi-detached family house in a residential area near the city centre. The service is situated next to two similar small care homes and all three services are managed by the same 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.

The people who lived at The Court had complex needs associated with their autism spectrum condition. For some people this affected their communication and comprehension of the world around them. Two people were unable to give their opinions of the service they received but one person was able to tell us they felt “safe” at the home and “enjoyed” living there. Relatives and social care professionals also felt the service was managed in a safe way.

All members of staff were trained in safeguarding adults so were aware of their responsibility to report any concerns. The members of staff we spoke with all said they knew how and when to report any concerns and would have no hesitation in doing so. One staff member told us, “We get lots of safeguarding training and are always prompted to read the policy. I would be able to report anything but certainly haven’t had to.”

There were enough staff to assist people in the house or to go out to activities in the community. The recruitment of staff included the right checks and clearances so only suitable staff were employed. Potential risks to people’s safety were assessed and managed. People’s medicines were managed in a safe way.

Relatives and care professionals said the service provided specialist support for people with autism spectrum condition. Staff were well trained in autism to help them understand the individual challenges faced by the people who lived there. They said they felt “very supported” by the registered manager and other senior staff.

Staff had training in the Mental Capacity Act 2005 for people who lacked capacity to make a decision and deprivation of liberty safeguards to make sure they were not restricted unnecessarily. People’s capacity to consent to care was clearly outlined in their care records. People were supported to maintain a balanced and healthy diet, and to attend any health services when required.

One person told us they were “happy” living at the home and they said they had a good relationship with the staff including the registered manager. People chose to spend time with staff members and were comfortable in their presence. Staff were encouraging and patient with people and made sure people had time to respond to any questions or choices.

A relative commented, “This home is a home, and I feel very lucky that [my family member] is in such a lovely place.” A social care professional told us, “My client’s parents are happy with the placement, their [family member] has been supported by this service for many years now and they see it as their [family member’s] home in every sense of the word.”

The service provided personalised care. Staff understood each person and supported them in a way that met their specific needs. Relatives told us they felt people were well cared for in the home. Each person had a range of social and vocational activities they could take part in.

Staff were familiar with how people might show if they were unhappy with a situation. Relatives had up to date information about how to make a complaint or comment. There had been n

During our previous visit we identified that staff were not properly supported to provide care and treatment to people using the service because they did not receive regular supervisions or appraisals. During this visit we saw that regular supervisions had been carried out and all staff had now received an annual appraisal.

Some of the people using the service had complex needs which meant they were unable to tell us their views. Because of this we used a number of different methods to help us understand their experiences.

The service planned and delivered care and support so that people’s needs were met. One relative told us “I can tell my daughter likes it there, she never gets upset when we take her back.”

The home was suitably designed and adequately maintained and systems were in place to manage risks to the health, safety and welfare of people using the service. One relative told us “We are really happy with The Court.”

Staff were trained to carry out their role however staff had not been fully supported in meeting people's needs because they did not receive regular supervision sessions or appraisals.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We observed that staff interacted appropriately with people within the service and promoted their independence.

We found that each person had their own bedroom and that they had chosen how to decorate it. The people living within the service had also been involved in deciding how to decorate the communal areas of the house.

One person using the service told us that “there’s a lot of choice for food”, and “I like the staff here”. Other people using the service were unable to communicate with us during our visit.