This inspection took place on 9 May 2017 and was unannounced. The inspection continued on 10 May 2017.

The service is registered to provide personal care with accommodation for up to eight adults. The service had one ensuite bedroom on the ground floor. There was a large open plan living area which led round into a dining area which led into a large kitchen. Just off the hallway was a staff toilet and shower room. On the first floor there were seven bedrooms six of which were en-suite. There was one bathroom and a laundry room. Outside there was a large driveway with electric gates and an enclosed rear garden and patio area. The service had just renovated the Avatar. This was an area which people used for activities which also had a home cinema system.

The service has a Registered Manager in place. 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.

Staff were aware of the Mental Capacity Act and training records showed that they had received training in this. However, people’s records did not always contain an assessment of their capacity. Where decisions had been made in people’s best interests around their care and treatment these were not always being recorded fully. This meant we were unable to tell, if decisions were specific, made in consultation with appropriate people such as relatives or were being reviewed. We did not find that people had been disadvantaged or that decisions taken were not in people's best interest.

People, relatives and staff told us that the service was safe. Staff were able to tell us how they would report and recognise signs of abuse and had received safeguarding training.

Care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about how they chose to live their lives. Each person had a care file which also included outcomes and guidelines to make sure staff supported people in a way they preferred. Risk assessments were completed, regularly reviewed and up to date.

Medicines were managed safely, securely stored in people’s homes, correctly recorded and only administered by staff that were trained to give medicines. Medicine Administration Records reviewed showed no gaps. This told us that people were receiving their medicines.

Staff had a good knowledge of people’s support needs and received regular mandatory training as well as training specific to their roles for example, autism, epilepsy, diabetes and learning disability.

Staff told us they received regular supervisions which were carried out by management. We reviewed records which confirmed this.

People were supported with shopping, cooking and preparation of meals in their home. The training record showed that staff had received food hygiene training.

People were supported to access healthcare appointments as and when required and staff followed health professional’s advice when supporting people with ongoing care needs.

People told us that staff were caring. During the inspection we observed positive interactions between staff and people. This showed us that people felt comfortable with the staff supporting them.

Staff treated people in a dignified manner. Staff had a good understanding of people’s likes, dislikes, interests and communication needs. Information was available in various easy read and pictorial formats. This meant that people were supported by staff who knew them well.

People, staff and relatives were encouraged to feedback. We reviewed the findings from quality feedback questionnaires which had been sent to people and stakeholders. Relatives confirmed that they had received and completed these. We noted that they contained mostly positive feedba

This inspection took place on 16 February 2016 and was unannounced. The inspection continued on 18 February and 19 February 2016. The service is registered to provide personal care with accommodation for up to eight adults. The service had one ensuite bedroom on the ground floor. There was a large open plan living area which led round into a dining area which led into a large kitchen. To the rear of the dining room there was an activities/craft room and then three offices. Just off the hallway was a staff toilet and shower room. On the first floor there were seven bedrooms six of which were en-suite. There was one bathroom, a staff sleep-in room and a laundry room. Outside there was a large driveway with electric gates and an enclosed rear garden and patio area.

The service has a Registered Manager in place. 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 had risk assessments in their care files which identified the risk and had control measures in place to minimise them however people’s risks in relation to holidays were not appropriately assessed. The provider had a system to assess peoples risk and needs when being supported away from the home, however these were not followed. One person using the service was supported on holiday the week prior to our inspection.

Staff and relatives told us that there were not always enough staff to support people who had one to one hours which meant that sometimes these people were unable to access the community or do activities outside of the home. The proprietor told us there was no arrangement in place for deploying staff at different times during the day. They said they had recently recruited a new staff member and are currently advertising for more new staff.

Staff and relatives told us that some people lacked capacity to make decisions in areas such as medication, support planning and personal care. Staff were not able to show us any capacity assessments or best interest meetings which had taken place on behalf of people. The registered manager told us capacity assessments and best interest decisions are not completed but should be. Four people had a standard DOLs authorisation in place and two were in process with the local authority.

Staff and relatives told us that they did not feel the service was well led or managed. Staff told us that the manager didn’t support or listen to them. A relative said, “I don’t feel the registered manager has any idea what’s happening”. We discussed these concerns with the proprietor in the absence of the registered manager who told us they are in the process of taking action to address this.

People said they felt safe living at the service and that staff supported them. Staff and relatives told us they thought the service was safe. One relative told us, “My relative comes home every Sunday and they aren’t sad to go back which is good”.

Staff were able to tell us how they would recognise signs of abuse and what they would do if they had concerns that someone was at risk. One staff member said, “Signs of abuse may include changes in behaviour, unexplained bruising or money not adding up”. Training records we reviewed showed that staff had received training in safeguarding adults.

Medicines were stored and recorded safely by staff. Only trained staff administered medicines.

Staff were knowledgeable of people’s needs and told us that they had received regular training which related to their roles and responsibilities. We reviewed the training matrix and saw that refresher training was required in a number of areas. The proprietor showed us a list of confirmed training days which were coming up for all staff. Staff had not received training specific