We inspected this service on 20 April 2017. The inspection visit was announced.

The Four Seasons Trust Limited - 33 Abbotswood is a residential care home for three people who have a learning disability and autism. People have varied communication needs and abilities. At the time of inspection there were three people living at the service, although one was on holiday with their family.

A week before the inspection the registered manager left their 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. The provider had been proactive and appointed a new manager who had started work. Unfortunately on the day of inspection the new manager was unwell.

We last inspected the service over two days. The inspection happened on 29th March and 12th April 2016. We identified concerns with the water temperature monitoring and the quality assurance systems in place. The provider had made improvements with regards to these areas.

People felt safe at were safe at The Four Seasons Trust Limited - 33 Abbotswood. Risks of harm to people were identified at the initial assessment of care and staff understood what actions they needed to take to minimise risks. Staff understood people's needs and abilities.

People were supported by staff who understood the signs of abuse and their responsibilities to keep people safe. Recruitment practices were followed that helped ensure only suitable staff were employed at the service.

People were supported by regular members of staff who supported people in a timely manner. Staff were confident and had the knowledge to administer medicines safely. They knew how to support people to take their medicines safely and to keep accurate records.

Staff felt they received the training and support they needed to meet people's needs effectively. Staff felt supported by the management team.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had a good understanding of MCA and DoLS. When people lacked capacity the best interest process was followed.

People were supported to eat meals of their choice and staff understood the importance of people having sufficient nutrition and hydration. Staff referred people to healthcare professionals for advice and support when their health needs changed.

People praised staff for their caring nature. Staff were kind and respected people’s privacy, dignity and independence. Care staff were thoughtful and recognised and respected people's wishes and preferences.

People received person centred care and people were supported with activities which were meaningful to them and were in line with their interests and preferences.

People knew how to complain and were confident any complaints would be listened to and action taken to resolve them.

The provider audited the care and support delivered and sort feedback from people and relatives regarding the support received. All feedback from audits and questionnaires was positive so it was hard to judge if this had been used to improve the service provided to people.

The provider understood their responsibilities in terms of notifying CQC of significant events at the service. Staff support people in line with the organisational values as support was centred around increasing people’s independence.

This inspection took place on 29 March and 12 April 2016. Our first visit was unannounced. There were three people using the service at the time of this inspection. At our last inspection in December 2013 the provider met the regulations we inspected.

The home 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.

Three people told us they liked living at 33 Abbotswood and said staff were kind and caring towards them. There was an informal relaxed and friendly atmosphere when we visited.

There were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow these. Staffing numbers were sufficient to help make sure people were kept safe.

People received care and support from staff who knew them well and understood their needs and preferences. Each person had individualised support plans to make sure they received the support they required.

People were supported to have their health needs met. We saw that people’s medicines were being stored securely and administered as prescribed. The systems to safely manage and audit medicines could however be improved.

The registered manager supported staff to deliver appropriate care and support. Staff attended regular training which gave them the knowledge and skills to support people effectively. Staff had received training in the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS).

The systems in place to monitor the quality of the service required improvement. Quality assurance and management supervision processes were not fully embedded, consistent and robust. The provider organisation did not have the necessary governance in place to ensure full oversight of the service and drive improvement where required.

On the day of our visit there were four people residing in the home which meant it was at full capacity. We were met by the manager and deputy manager.

We found that people who used the service were always being asked by staff if they consented to their care, and their right to refuse care was being respected. The people we spoke with said that staff always asked their permission before offering support. We also found the provider would know how to deal with situations where decisions had to be taken in a person’s best interest.

We found that people were happy with their care and that staff engaged with people in an appropriate and sensitive manner. One person told us that they felt properly looked after in the home and that “everything’s fine.” We also found that people’s needs were being properly assessed, managed and reviewed.

We found that people were being properly protected against abuse and staff were able to identify, respond to, and report abuse. All the people we spoke with said they felt safe from harm in the home.

We found that there were enough suitably qualified staff to provide proper staffing cover at all times. One of the people we spoke with said there were “loads of staff to look after me.”

We found that the provider was regularly obtaining feedback from people and staff. We also found that the provider monitored and assessed the whole service on a regular basis.

There were four young people living at this service. Although we had tried to speak with each person separately, it became obvious they preferred to stay together. One person was more articulate than the other three and took the lead in answering questions, and the others agreed with the answers presented.

People said they were fully involved in all aspects of their care. People told us, "We are involved in setting our goals and in the review of our care with the help of the registered manager or our support worker". People said their treatment included their total involvement in their care. People said, "We like the support we receive from our support worker, neurologist and the registered manager".

We found that the service sought people’s consent prior to providing them with care and support. We saw systems in place that ensured medicines were administered safely.

People told us they were able to eat and drink adequate amounts of food and fluid to meet their needs. They said, "We have what we like for breakfast, sometimes a cooked breakfast and sometimes a continental breakfast".

We saw that staff had the relevant checks carried out prior to commencement of employment.

People told us staff were respectful of their privacy and dignity. People said they and their family were involved in their care. They said they made the decisions about their care with help and support of their carer.

People told us they liked living in their own home with their own bedrooms, with the staff for company. They said it was more natural.

People told us they loved their home, they did things they wanted to do and they had to obtain special permission to do some things because the manager wanted them to be safe.

One person told us they enjoyed doing cooking and that they planned and prepared the evening meal one day per week with the help and support of their carer.

People told us they felt safe and well looked after by staff. They described their relationships with staff as good.