The inspection took place on 8 March 2017 and was announced.

The Meadows is a ‘housing with care’ service which contained 92 flats. The flats and main building are managed by a housing provider and the care people received in their own homes was provided by Norse. The Care Quality Commission (CQC) only regulates the delivery of personal care with housing with care schemes. This report only relates to people who received support with their personal care. At the time of the inspection visit about 80 people were in receipt of personal care.

The service supports older people, some younger adults who have a learning disability, and some people who have a physical disability. The service also included an ‘extra housing with care’ area. Staff in this area of the building supported people who were living with dementia. This was the services first inspection.

There was 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. For the purposes of this report the registered manager will be referred to as the manager. There was also a deputy manager. When we refer to the management team this relates to the manager, deputy manager, and team leaders.

People had risk assessments and care plans outlining their care needs. These records did not always fully explore people’s background and personal preferences. The manager told us that people’s records are now under review to make them more holistic.

The management team and staff responded effectively to accidents and incidents and took appropriate action to try and reduce the re-occurrence of these. Timely onward referrals to specialist health and social care teams were made with people’s permission. There were robust systems in place to ensure people who experienced accidents and incidents had the outcomes they needed, to ensure they were safe.

The management team and staff knew how to keep people safe and how to protect people from potential harm and abuse. There were systems for staff to report their concerns to the management team. The management team and staff knew of external agencies they must report such concerns to.

People benefited from being supported by staff who were safely recruited. There was consistently enough staff to safely meet people’s needs, at the time of this inspection visit.

People received their medicines in a safe way. The administration of people’s medicines was audited and checked. We did identify an issue with the supply of some people’s medicines but the management team were aware of this and had made plans to resolve this issue.

Staff were proactive in responding to a change in people’s health needs. With people’s permission staff supported people to access health care services.

Staff received regular and on going training. New staff had an induction to their new role. Staff spoke positively and in detail about how this induction had prepared them for their work. Staff received regular supervisions and their practice was checked on a regular basis.

People told us they received care visits at times they had chosen or they were happy with. People said they had experienced some late calls but this had improved and had not happened recently. People said they didn’t always see a group of regular members of staff. However the management team was aware of this issue and a plan had been put into action to improve the deployment of staff, to enable people to see a regular group of staff.

The Care Quality Commission (CQC) is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service was working within the principles of the MCA. Staff had a good understandin