Our inspection took place on 30 November 2016 and was unannounced. We last inspected the service on 30 April 2014 and we found the provider was compliant with the standards we inspected. This was the service’s first ratings inspection.

The Octagon provides accommodation for people requiring personal care who may have a learning disability. At the time of the inspection there were 6 people living at the service.

There was 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 supported by a staff team who knew how to keep people safe from the risk of harm and abuse. People were kept safe as potential risks had been assessed and staff were working in ways to reduce these risks. People were supported by sufficient numbers of staff who had been recruited safely. People received their medicines as prescribed from suitably trained staff.

People received care and support from an appropriately trained staff team. People were asked for their consent to care and support and the principles of the Mental Capacity Act 2005 were followed. People’s capacity was being assessed where appropriate, and where required, decisions were being made in the best interests of people.

People were provided with the appropriate support to eat and drink and were offered choices. People were supported by staff who understood and catered for their specific dietary needs.

People were supported to maintain their health and staff appropriately sought healthcare professional’s advice where there were concerns about people’s health and wellbeing.

People were treated with kindness and respect. People’s privacy, dignity and independence was promoted and people were supported to maintain relationships that were important to them.

People’s individual care needs and preferences were understood and met. Staff knew people’s care needs well and supported them appropriately. People and their relatives were involved in the planning and review of their care. The provider had a complaints process in place to ensure complaints were appropriately investigated.

The management of the service had been inconsistent and as such staff did not always feel supported or well communicated with, and there was low staff morale.

People and their relatives were provided with opportunities to give feedback on the service. The registered manager had systems and processes in place to monitor and analyse the quality of the service, and they used information from quality checks to drive improvement.

This is the first inspection completed for this service. As part of this inspection we spoke with the manager, care staff, one person who received a service and relatives.

We considered our inspection findings to answer the questions we always ask;

Is the service safe?

Safeguarding procedures were in place. Staff and managers were aware of how to safeguard people and the actions they should take if they had any concerns.

Some people could not make complex decisions about their care. Multi-disciplinary meetings were held to make decisions about people's care. This made sure that actions were taken in a person's best interest and their rights were upheld.

The service had a risk management system in place. This made sure that people still had choices about their lifestyle but were not placed at unnecessary risk.

The provider had a recruitment process that made sure staff were appropriate to work with people and that they received induction training to provide care in a safe way.

Is the service effective?

Plans of care were in place that identified people's needs. Some elements of the plans of care were not up to date due to people's rapidly changing needs. This had not impacted on people's care as staff knew people well and liaised closely together to ensure that care remained appropriate and met people's needs.

Staff took account of people's wishes and their previous lifestyle to ensure that care was provided in the way people preferred.

Is the service caring?

When we spoke with staff it was very clear that they genuinely cared for the people they supported. Some staff had worked with people for many years and were very keen to provide care in the way they wanted and to improve their quality of life.

People’s preferences and lifestyle wishes were recorded and acted upon. If people had spiritual needs the staff ensured these were responded to.

Comments from relatives included: “The staff are very good with my relative. They are wonderful” and “[The staff] do a marvellous job”.

Relatives had the opportunity to complete an annual satisfaction survey. People who received the service could take part in regular meetings. Where improvements or omissions to the service were identified these were acted upon.

Is the service responsive?

People who received a service were given an easy read complaints procedure. This was not provided to relatives and the manager told us they would ensure a copy was provided. Complaints and concerns made to the manager were acted upon promptly. A complaint made directly to the provider had not been dealt with promptly although action was taken locally by the service.

Is the service well led?

Relatives and professionals had seen good improvements in the service since the current managers had worked at the service.

The service had a number of quality assurance processes to monitor and check the service. Action was taken when shortfalls were found although these were not always fully recorded. The checks and audits in place had led to an improvement in the quality of care people received.