This inspection took place on 25 October 2018, and was unannounced.

At the last inspection in April 2016 the services was rated as Good. At this inspection we found the service remained Good. The evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going 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.

Three Roses Home is a ‘care 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. Three Roses Home provides short and long-term accommodation and care for up to 14 people with learning disabilities or autistic spectrum disorders. There were 14 people living at the home at the time of our visit.

There had been a change of registered manager since our last 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.

Improvements had been made in the way people were supported, and how this was recorded, if people were not always able to make their own decisions. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People's safety needs were considered when their care was planned and given. We found staff knew people’s safety needs well, and understood how to raise any concerns they may have for people’s well-being. Learning had been taken from previous incidents and changes introduced to the way people’s medicines were administered and recorded, so the chance of errors was further reduced. There was enough staff to care for people and to provide reassurance to them when needed. Systems were in place to reduce the chance of people acquiring infections.

People’s needs were considered and planned for before they came to live at the home. As part of this process staff talked with other professionals so they could gain their views on the care people needed. People showed us they were confident staff knew how to care for them, and they would be listened to. Staff were supported to provide good care to people and to develop the skill and knowledge they needed to assist people living at the home.

Staff supported people to have enough to eat and drink so they would remain well. People told us they enjoyed their meal time experiences, which reflected their choices. People were complimentary about the support they received to enjoy good health.

We saw people liked the staff who cared for them, and people were also happy to express their affection for other people living at Three Roses Home. Staff spoke respectfully and warmly about the people they cared for, and people were encouraged to make their own decisions about the care they wanted. People’s right to dignity and privacy was promoted by staff.

Care was offered to people which reflected their individual needs, goals and preferences. Staff adapted how they communicated with people, so they were offered care in the ways they preferred. The care service was working within the values in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. The views of people’s relatives and other health and social care professionals were considered when people’s care was p

This inspection took place on 21 March 2016 and was unannounced.

The provider of Three Roses Home is registered to provide accommodation for up to 14 people with learning disabilities. At the time of this inspection 14 people lived at the home.

There was a registered manager at the time of this 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’s consent was sought by staff before they helped them with anything. Staff made sure people understood what was being said to them by using gestures, short phrases, words or items of reference. However, a consistent approach was not taken when people did not have the mental capacity to make their own specific decisions about some aspects of their care so the principles of the Mental Capacity Act 2005 had been followed and recorded. This was because we saw specific equipment was in use ,however no documentation was in place to reflect an individual people’s mental capacity had been assessed or to state whether a best interest decision had been made on their behalf.

People were supported by staff who knew how to recognise and report any concerns so people were kept safe from harm. There were sufficient staff on duty to respond to people’s individual needs at the times they needed support. People were helped to take their medicines by staff who knew how to manage these in line with safe principles of practice.

Staff had been supported to assist people in the right way which included helping people to eat and drink enough to stay healthy and well. People had been assessed for any risks associated with eating and drinking and care plans had been created for those people who were identified as being at risk. People were supported to access health and social care services to maintain and promote their health and well-being.

People were treated with kindness, compassion and respect. There were many examples of staff showing they cared for people and the warmth of touch was used, such as, hugs. Staff promoted what people could do and supported people with dignity when they needed a little help. People’s right to private space and time to be alone and with their relatives was accepted and respected.

People indicated to us with their facial expressions, verbal communication and body language they were happy with the support they received from staff. People received care and support to meet their diverse needs including people’s individual communication methods and people with dementia. Staff offered people the opportunity to pursue their interests and try different things for fun. There were arrangements in place for receiving and resolving complaints which took into account people’s individual needs.

The views of people who lived at the home and their relatives were sought to develop the service and quality checks had also been done to make improvements. The registered manager had strong values about encouraging inclusive opportunities for all and enhancing the lives of people with learning disabilities through good practice initiatives.

On the day of our inspection there were 13 people living at the Three Roses and one person attending day care. We spoke with five members of staff and the registered manager, five people who used the service and two relatives. We looked at policies and processes, four care records and four staff records to gain insight into the care provided.

We saw that people were consulted about their care. People we spoke with told us they felt included in their care and that changes were discussed with them.

Care plans and risk assessments were updated regularly to ensure people received the care they needed. There were a variety of activities designed to meet people's needs and maintain their independence. People told us they liked living at the Three Roses. One person told us, “It’s good here.”

We saw that the home was clean and tidy. There were rotas for cleaning and appropriate infection control processes in place. Staff received relevant training and showed a good knowledge of how they would prevent infection spreading if people became unwell.

There were suitable selection and recruitment systems in place and staff were supported with appropriate training by the provider. Staff we spoke with said they liked working there. People we spoke with said, “Staff are great.”

People experienced good quality care and effective systems for monitoring were in place. There was evidence that people and their relatives knew how to complain if things were not right.

During our inspection we spent time with people who used the service while they were in the dining room and in the lounge. We were able to spend some time with everyone who was using the service. We also spoke to staff on duty and one of the directors. The manager was on annual leave on the day we carried out this inspection.

We saw people who used the service engaging in a range of activities during the day and they told us about other things they do outside of the home. People told us that they go on holidays and days out.

We found that staff on duty had a good understanding of the needs of people and that they supporting them in meeting their needs.

People who used the service indicated that they were happy and felt safe. Some people were able to tell us what they who do if they were worried about something. Staff had some knowledge about safeguarding procedures in the home.

Staff had been trained in areas relevant to the specific needs of people who used the service.

Suitable systems were in place to assess and monitor the quality of care provided and as a means to identify any improvements needed.