This inspection took place on 12 November 2018. It was unannounced.

The Meadows is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Meadows provides accommodation for a maximum of 10 people living with a learning disability or autism. The service comprises of two semi-detached buildings made into a larger home. All bedrooms are single rooms. At the time of our visit, seven people lived at the service.

The service was registered with the CQC prior to the CQC’s publication of ‘Registering the Right Support’ guidance for homes which accommodate people with learning disabilities and autism. Our guidance now says people with learning disabilities should not live in homes of more than six people. Although the service does not meet our new criteria, people have lived with each other for many years and describe the home as being a ‘family’.

At our last inspection we rated the service as ‘good’. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service continued to be safe. People received their medicines as prescribed. Staff understood the risks to people’s health and wellbeing and acted to lessen each risk. Checks had been made on staff before they started working for the service to make sure they were safe to work with people. There were enough staff on duty during each 24 hour period to meet people’s needs. The home was clean and tidy and staff understood infection control practice. Premises were well-maintained, with regular checks made on water, gas and fire facilities to ensure safety.

The service continued to be effective. People enjoyed the meals prepared at the home. Staff received training to support them to work effectively with people who lived at the home. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People had access to different health and social care professionals when required, and good relationships had been formed between the service and those professionals.

The service continued to be caring. People were treated with dignity and staff respected their privacy. Staff were kind to people, and had developed positive relationships with the people they supported. They understood people’s needs and preferences, and what was important to them. The service supported people to maintain and develop relationships with their family.

The service continued to be responsive. People’s needs were assessed and planned for with the involvement of the person. People lived purposeful lives having opportunities to work and train in the community, as well as being involved in pursuing their interests and hobbies. There was a complaints procedure, although no complaints had been made to the service since our last inspection. Procedures were in place for planned end of life care.

The service continued to be well-led. The registered manager worked hard to ensure a good quality of service was maintained. The registered manager provided good support to the staff group, and to people who lived at the home. Checks were made to ensure the service met its obligations to provide safe accommodation to people and to deliver care and support which met people’s individual needs.

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This inspection took place on 25 July 2016 and was unannounced. We returned on the 26 July 2016 announced.

The Meadows is registered to provide residential care and support for 10 people with a learning disability or autistic spectrum disorder. At the time of our inspection there were 10 people using the service. The service is an extended residential property which provides accommodation over two floors. Communal areas are located on the ground floor; bedrooms are all single and two had en-suite facilities. There was an accessible garden to the rear of the service. The service was located within a residential area with nearby shops and other community facilities.

The Meadows 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.

People were protected from abuse by care staff who were well trained and understood their responsibilities. There were risk assessments in place that supported people to be as independent as possible.

There were enough sufficiently skilled and experienced staff to meet people’s needs. The provider had robust recruitment procedures that ensured as far as possible that only people suited to work at The Meadows were employed.

People received their medicines at the time they needed them and in a way they preferred to receive them. The provider had systems in place to ensure the safe storage and disposal of medicines.

People were supported by staff with the necessary skills, experience and training. Staff were supported through effective supervision, appraisal and training. However supervision was not always recorded.

The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People had their nutritional needs supported. They had a choice of healthy meals, care staff understood people's food preferences and these were respected. People’s health needs were met through heath action plans. People were supported to access health services when they needed them.

People were supported to take part in a wide range of activities to maintain their independence.

People using the service, their relatives and staff had opportunities to develop the service. The registered manager and staff shared a vision for the service. The provider had effective arrangements for monitoring and assessing the quality of the service.

Our inspection team was made up of one inspector. There were nine people using the service on the day of our visit. We spoke with four people who used the service and four members of staff. They helped answer our five questions which are set out below.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. There were sufficient staff to meet people's needs. Staff had regular supervision and annual appraisals were being completed. Staff had received mandatory training. This meant that staff had the right knowledge to meet people's individual needs.

The premises were fit for purpose. Bedrooms were personalised to reflect the needs and wants of the person concerned. The home was clean, warm and well lit. Regular maintenance audits were completed of the property and outdoor areas.

Is the service effective?

People who used the service told us the care and support provided at the home was good and they got on well with staff. They said staff were caring and listened to them. One person told us, “I like it here, just the way it is”. Another said, “It is good here, I have a nice bedroom and have made friends”.

Improvements had been made in ensuring the provider had a system in place to gain consent from people who used the service.

Is the service caring?

We talked with four people who used the service who told us they got on well with staff. One person told us, “All the staff here help us and support us”.

Is the service responsive?

People’s needs were assessed and care and support was planned and delivered in line with their individual care plans. Care plans considered all aspects of the person's circumstances and were centred on them as an individual. Information was given on how best to provide different aspects of a person’s care. This helped staff provide care and support according to the person’s needs and choices.

Information on how to make a complaint was given to people who used the service and their representatives. There had been no recent complaints.

Is the service well-led?

The service had a quality assurance system in place. We found that a range of internal audits were carried out to assess and monitor the quality of service that people received. Any action needed to improve the service was identified and followed up.

People who used the service were asked for their views about the quality of care and support being provided. This meant that the care and service provided was informed by the comments made by people who used the service.

There were nine people using the service at the time of our inspection. We spoke with one person living at the home as part of our inspection as the other eight people were out of the home during our visit. We also spoke with four members of staff working at the service and the relatives of two people who used the service.

The person who lived at the home described being very happy there. They had lived by themselves before moving to the home and told us: "It's a lot better here. I'm not so isolated. The people are very nice. We get on quite well." They told us they enjoyed the food at the home and that their diet had been much better since they had lived there.

The relatives we spoke with spoke positively about the accommodation provided by the service and about the staff who delivered the care at the home. None of the relatives had any concerns about the care being delivered.

Staff we spoke with described supporting people to remain independent and knew the care needs of people living at the home well. One staff member told us that they had not had much training over the past year. We looked at training records and saw that some of the training was due to be refreshed. The manager informed us that this was being arranged.

We found people were offered a choice of nutritional food each day and that their care needs were being met. We found that consent to care was not always obtained and that people were not always involved in the planning of their care.

We inspected this service and spoke with several people to assist us in making judgements about the providers compliance against the essential standards we inspected. We spoke with two people who used the service, two members of staff working at the service, and the relatives of three people using the service.

The people who used the service told us they were happy living at the home. One person commented, "It's pretty good here." They went on to say, "It's nice here because there are other people. The staff are very good." We looked at people's bedrooms and the home environment the service offered. This was clean and decorated to the tastes of the people using the service.

The staff we spoke with described being very happy working at the home. They described a supportive management style and knew about the people using the service in-depth. One staff member told us, "I do love my job and I love working here."

We spoke with three relatives, none of whom had any concerns with the service. They all told us that they had never had issues with the service. One relative said, "By and large it's extremely good. There's no question about that. The staff are extremely good. One of them said she adored her job." Another commented that, "We have a lot of faith in them."

We found that people were involved in their care and that the service was monitoring the quality of care it was delivering to people.

We spoke to nine of the ten people who used the service. They told us that they liked living at the home and enjoyed the activities that they had taken part in. One person told us that the activities made them happy; another said that they liked the food. One person told us that they had been helped to become more independent and that they enjoyed going by themselves to different places often by public transport. Staff told us that they felt well supported.