About the service: The Mews is a residential care home registered to accommodate up to eight people. At the time of this inspection the service was providing personal care to eight people who have a learning disability.

People’s experience of using this service:

•The provider had taken action to make improvements and comply with the breaches of regulations identified at the last inspection visit. This ensured people received the appropriate care and support.

•The provider’s governance was effective in assessing, monitoring and driving improvements so people received an effective and safe service.

•People told us they felt safe living in the home and staff were aware of their responsibility of safeguarding people from the risk of potential abuse.

•Staff had access to risk assessments that told them how to promote people’s independence and to reduce the risk of harm whilst doing so.

•Staff were recruited safely and were provided in sufficient numbers to ensure people’s needs were met.

•People were supported by trained staff to take their medicines as prescribed.

•Systems and practices reduced the risk of cross infection.

•Where things went wrong, lessons were learned and action was taken to reduce the risk of this happening again.

•People were cared for by staff who were skilled and supported in their role by the registered manager.

•People were involved in their assessment to ensure they received a service the way they liked.

•People were supported by staff to access relevant healthcare services when needed.

•The environment was suitable for the people who used the service.

•People’s consent was obtained before care and support was provided and staff had a good understanding of the Mental Capacity Act 2005.

•People were cared for by staff who were kind, caring and respected their right to privacy and dignity.

•People were encouraged and supported by staff to be involved in making decisions about their care and treatment.

•People were treated fairly and were assisted to pursue social activities of their choice.

•People could be assured their concerns would be listened to and acted on to ensure they received a safe service.

•At the time of our inspection visit the provider was not offering a service to people who required end of life care.

•The culture of the home was person-centred which supported people to achieve their goals.

•People were encouraged to be involved in the running of the home to ensure the service they received met their specific needs.

•The provider worked in partnership with other relevant agencies to ensure people’s assessed needs were met.

Rating at last inspection: The service was rated Requires Improvement at the last inspection in November 2017.

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner. More information is in Detailed Findings below.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This unannounced inspection took place on 18 October 2017. At our last inspection in November 2015 we had no concerns about the quality of care and had rated the service as good. At this inspection we found that the service was not always safe, responsive or well led. We found three breaches of the Health and Social Care Regulations (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the report.

The Mews provides accommodation and personal care to up to eight people who have a learning disability and associated needs. At the time of the inspection there were seven people using the service.

Since the last inspection two registered managers had been employed. 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.

There were insufficient numbers of suitably trained staff to keep people safe and meet their individual assessed needs. Care being delivered was not always personalised due to the lack of available staff. There were hobbies and activities available to people at home and in the community however these were not always based on people's individual preferences.

The quality systems the provider had in place had not identified the lack of commissioned staff that were available and that people's assessed needs were not always being met.

People were safeguarded from abuse as staff and the registered managers knew what to do if they suspected abuse and had reported abuse to the local safeguarding authority.

Action was taken to reduce the risks of harm were minimised following incidents that had or could have resulted in harm to people.

People's medicines were stored, managed and administered safely by trained staff.

The principles of the Mental Capacity Act 2005 (MCA 2005) were being followed as people who had been assessed as lacking the mental capacity to agree to their care were being supported to do so in their best interests.

Staff were supported and trained to be able to fulfil their roles effectively.

People's nutritional needs were met as they were supported to eat and drink sufficient amounts to remain healthy. If people became unwell or their health needs changed the appropriate health care advice was gained in a timely manner.

People were treated with dignity and respect and their right to privacy was upheld.

People were supported to maintain their relationships and were encouraged to be as independent as they were able.

People were offered choices about their care and relatives were kept informed and involved in people's care where appropriate.

There was a complaints procedure which was available in a format to aid people with communication difficulties. People's feedback on the service was regularly sought and action taken when requests were made.

People, staff and the relative liked and respected the registered managers.

This inspection took place on the 4 November 2015 and was unannounced. This was the services first inspection since registering in December 2014.

The service provided accommodation and personal care for up to eight people with a learning disability. There were eight people using the service at the time of the inspection.

The registered manager supported us throughout the inspection. 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 safeguarded from abuse and the risk of abuse as staff knew what constituted abuse and who to report it to. The manager had previously made referrals for further investigation when they had suspected abuse had taken place.

People were supported to be as independent as they were able to be through the effective use of risk assessments and the staff knowledge of them.

There were enough suitably qualified staff who had been recruited using safe recruitment procedures available to maintain people’s safety and to support people in hobbies and activities of their choice.

People medicines were stored and administered safely by trained staff.

Staff had a good knowledge of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The MCA and the DoLS set out the requirements that ensure where appropriate decisions are made in people’s best interests where they are unable to do this for themselves. People’s capacity had been assessed and staff knew how to support people in a way that was in their best interest and was the least restrictive.

People and their representatives were involved in decisions relating to their care, treatment and support. Care was planned and delivered based on people’s preferences and regularly reviewed with people.

People were supported to have a healthy diet dependent on their assessed individual needs. People were given choices and asked what they would like to eat and drink.

People had access to a range of health professionals and staff supported people to attend health appointments when necessary.

People were treated with kindness and compassion and their privacy was respected. Staff supported people to be independent and have a say in how the service was run.

People had opportunities to be involved in the community and to participate in hobbies and interests of their choice. People’s religious needs were met.

Staff felt supported to fulfil their role effectively through regular support and supervision and training applicable to their role.

The registered manager demonstrated a passion in improving the service. The provider had systems in place to monitor the quality of the service and an on going improvement plan.