The inspection was unannounced and took place on 26 September 2018.

Tudor Gardens provides accommodation and personal care for up to 15 people who require specialist support relating to their learning and physical disabilities. The home consists of three bungalows, each purpose built to accommodate five people. At the time of our inspection, there were 15 people living at Tudor Gardens. At the last inspection on 08 March 2016, the service was rated as Good. At this inspection we found the service remained Good.

A registered manager was in place. A 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.

Staff understood how to protect people from abuse and received regular training around how to keep people safe. Staff had been recruited following appropriate checks.

People received their medicines as prescribed to support their healthcare needs and there were enough staff to support them. People were supported to access other healthcare professionals when required and to maintain a healthy diet which reflected their choices and preferences.

Staff said on-going training was in place to ensure they had the skills to meet the needs of the people they supported. People’s choices were listened to and staff understood they could only care for and support people who consented to their care.

People had positive relationships with staff, who they were comfortable around and we saw staff treated people with dignity and respect. Staff spoke warmly of the people they cared for and said they enjoyed their role.

Staff respected people's individuality and diversity and care files contained information about people's personal histories and people’s preferences, so staff could consider people's individual needs when delivering their care.

The staff and the management team were approachable and people and relatives told us if they had any concerns they would be listened to and dealt with appropriately.

People told us they enjoyed living in the scheme and relatives spoke positively about the management team.

The provider ensured regular checks were completed to monitor the quality of the care that people received. Areas identified for improvement were acted on.

Staff were supported by management team to provide a good service. The registered manager had a clear vision for the further development of the service and worked with other agencies to support the well-being of the people living at scheme.

This inspection took place on 8 March 2016. This was an unannounced inspection.

At the time of our last inspection in December 2013, Tudor Gardens was found to be meeting all of the essential standards relating to the quality and safety of care.

Tudor Gardens provides accommodation and personal care for up to 15 people who require specialist support relating to their learning and physical disabilities. At the time of our inspection, there were 15 people living at Tudor Gardens.

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.

The service was safe because people were protected from the risk of abuse and avoidable harm and staff were aware of the processes they needed to follow.

People were supported by enough members of staff to meet their needs.

People received their prescribed medicines as required.

The service was effective because people received care from staff who had received adequate training and had the knowledge and skills they required to do their job effectively.

People received care and support with their consent, where possible and people’s rights were protected because key processes had been fully followed to ensure people were not unlawfully restricted.

People’s nutritional needs were assessed and monitored to identify any risks associated with nutrition and hydration and they had food they enjoyed.

People were supported to maintain good health because staff worked closely with other health and social care professionals when necessary.

The service was very caring because people were supported by staff that were very kind and caring.

People received the care they wanted based on their personal preferences and likes and dislikes because staff were dedicated and committed to getting to know people well.

People were cared for by staff who protected their privacy and dignity.

People were encouraged to be as independent as possible and were supported to express their views in all aspects of their lives including the care and support that was provided to them, as far as reasonably possible.

The service was very responsive because people and their relatives felt involved in the planning and review of their care because staff communicated with them in ways they could understand.

People had an enhanced sense of well-being and quality of life because staff actively encouraged and supported them to engage in group and individual activities that were meaningful to them.

People were supported to maintain positive relationships with their friends and relatives and shared celebrations within the local community.

People were encouraged to offer feedback on the quality of the service and knew how to complain.

The service was very well led because the provider had clear visions and values that promoted a positive, person-centred culture within Tudor Gardens.

Relatives and staff reported the registered manager to be a positive role model who was dedicated to providing a high quality service.

Staff felt supported and appreciated in their work and reported Tudor Gardens to have an open and honest leadership culture.

The management team endeavoured to improve and develop the service and therefore had systems in place to assess and constantly monitor the quality of the service.

No one knew we would be visiting that day as our inspection was unannounced.

At the time of our inspection 14 people lived at 27-29 Tudor Gardens. During our inspection we spoke with or spent some time with all of the people who lived there, staff on duty and the registered manager. We later spoke with three relatives of people that used the service.

As some people had complex needs and were not all able to tell us about the service they received we used different methods to help us understand their experiences, including observation. We observed good interactions between staff and the people that lived there. We observed that people smiled when staff engaged with them. We asked one person who lived there some questions about their experience of the service. They smiled and said, “Yes”, to both questions when we asked if they were happy and if they felt safe living at the home.

We found that people who lived there were treated with respect and dignity. We also saw that people’s independence was promoted whenever possible. One staff member told us, “Choices can be made by people pointing to what they want to eat.”

We saw that people's needs had been assessed by a range of health care professionals including specialist doctors and the dietician. This meant that staff had enabled people to have their health care and safety needs monitored and met.

We found that processes were in place to protect people from the risk of harm or abuse. One relative told us, “I have no concerns. My relative is well looked after there.”

We found that the premises were suitable for the people that lived there. Overall we found that rooms were warm, homely and adequately maintained.

We saw that systems were in place to monitor the quality of the services provided so that actions, when needed, could be taken to make improvements.

There were fifteen people with learning disability living at the home on the day of our visit; no one knew we would be visiting. We spoke to two people who lived at the home, three relatives, three staff and the manager. One person told us, ‘’It’s really nice I like living here.’’ We looked at records relating to people’s care and observed staff caring for them.

We saw that choices were offered and that people's views were sought and acted upon. Staff spoken with were able to tell us about people's needs and how they ensured that people received care in a way that they preferred. One staff told us, ‘’I show X a bowl of water and they will splash if they want a bath, they push it away if they don’t.’’ All the relatives we spoke to told us they were consulted about their relative's care and were kept informed about their relative's health needs so they felt involved in their care.

We saw that people were relaxed in their environment and that systems were in place to keep people safe from harm. One person said, ‘’Staff are really nice to me.’’ A range of training was provided to staff so that they had up to date knowledge and skills in order to support the people who lived in the home. There were systems in place to monitor how the home was run, to ensure people received a quality service. A relative said '' After a short time they know X’s needs; If I was a jealous person I would be jealous of staff because X loves and trust them.''

We visited the three bungalows and met staff and people who lived there. The people who lived in the bungalows had limited verbal communication and relied on staff to interpret their gestures and expressions. They indicated that they were happy. The people who lived in the home looked relaxed and comfortable with the staff.

We spoke to relatives of people who lived in the bungalows. They told us that they were pleased with the care and had no concerns about the safety or welfare of their relatives. One said, “the staff and people at the home are like our extended family”.

Relatives told us that there were enough staff, who knew the people well and made sure that people have enough stimulation and activity.

Staff told us that they enjoyed working in the bungalows. They said that they had good access to relevant training so that they knew how to care for the people who lived there.