This announced inspection took place on 3 and 4 September 2018. We gave the provider short notice of this inspection because we wanted to ensure the registered manager, staff and people who used the service would be available to speak with us.

The Old Vicarage is a care home for up to 7 people. At the time of this inspection there were 3 people living at the home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Old Vicarage consists of one building with self-contained flats, communal areas and garden tailored to support adults and young adults with complex needs including autism spectrum conditions and learning disabilities.

This was the first time we inspected this service since it was registered in September 2017.

On the day of our inspection a registered manager was 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.

The provider considered people’s mental capacity when making decisions about their health and care, however, some mental capacity assessments were not decisions specific and some best interest decisions did not evidence how family had been involved in making relevant decisions. We made a recommendation to the registered manager to make improvements in how they were recording this information.

People told us they felt safe using the service and relatives corroborated this. Safeguarding procedures were in place and staff knew what to do if safeguarding concerns were identified.

People’s medicines were managed safely.

There were assessments in place that identified relevant risks to people and management plans to reduce these risks were in place to ensure people's safety. There were sufficient staff to meet people’s needs and provide a flexible service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People’s needs in relation to the protected characteristics under the Equalities Act 2010, were considered in the planning of their care. People's communication needs were assessed and staff adapted their communication methods to better meet people’s needs, for example, using simple questions or pictures.

People were supported to prepare and eat a balanced diet that met their individual dietary needs. They were supported to access healthcare services to maintain their health.

Staff were supported through a comprehensive induction, regular supervision and annual appraisals. People were supported by staff who had attended regular and relevant training.

Staff had a good understanding of infection control procedures and used personal protective clothing when required to prevent the spread of infection.

People and their relatives told us staff were kind and caring and their privacy and dignity was respected by staff.

Staff told us they felt supported by the management team and the team communicated regularly and effectively. The provider had monitoring systems that enable them to identify good practice and areas for improvement.

People lived in a service which had been designed and adapted to meet their needs and there were governance systems in place to maintain the quality and safety of the service.