About the service: Windsor House is a care home that provides accommodation and personal care for a maximum of 10 people with a learning impairment or associated conditions. The service accommodated eight people at the time of the inspection. The service operates from one purpose built building.

People’s experience of using this service: Some of the people who used the service had complex needs and they did not express their views about the service. During the time we spent with people we saw they appeared comfortable with staff.

Systems were in place to protect people from abuse. However, we have made a recommendation about the financial arrangements that are in place for a person, as they are not independent of the organisation and could pose a conflict of interest.

There were enough staff available to provide individual care and support to each person. Staff upheld people's human rights and treated everyone with respect and dignity.

Communication was effective and staff and people were listened to. Staff said they felt well-supported and were aware of their rights and their responsibility to share any concerns about the care provided.

The atmosphere was bright and welcoming and the building was well-maintained with a good standard of hygiene.

Information was accessible to involve people in decision making about their lives. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice

Staff knew the people they were supporting well. Care plans were in place detailing how people wished to be supported. Staff had developed good relationships with people, were caring in their approach and treated people with respect.

Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks. Staff knew the needs of the people they supported to provide individual care and records reflected the care provided. Arrangements for managing people’s medicines were safe.

There were opportunities for people to follow their interests and hobbies. They were supported to be part of the local community and to go on holiday. People enjoyed their meals and their dietary needs had been catered for.

Staff were well-supported due to regular supervision, annual appraisals and an induction programme, which developed their understanding of people and their routines. Staff received training to ensure they could support people safely and carry out their roles effectively.

There was regular consultation with people. All people were kept involved and encouraged to make decisions, whatever the level of need. They were involved in regular meetings about their care and the running of the home. Menus and activities were planned with input from people, based on their personal preferences and choices.

The registered manager monitored the quality of the service through audits and feedback received from people, their relatives, staff and external agencies.

Rating at last inspection: At the last inspection the service was rated good (11 May 2016.)

Why we inspected: This was a planned inspection to check that this service remained good.

Follow up: We did not identify any concerns at this inspection. We will therefore re-inspect this service within the published timeframe for services rated good. We will continue to monitor the service through the information we receive.

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

Windsor Road is registered to provide accommodation with personal care for up to a maximum of ten people who have a learning disability or autistic spectrum. There were ten people living at the home on the day of our inspection which included one person who was temporarily living at the home.

There was a registered manager in post who was present during 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 felt safe and happy living at the home. Relatives were confident that people were safe and well looked after. Staff ensured measures put in place to protect people did not restrict their independence or freedom to do things they enjoyed.

People were protected from risk of harm or abuse because staff knew how to recognise different types of abuse and knew how to report concerns. Staff did not start working at the home until all the necessary checks had been completed to ensure they were suitable to work there.

There were sufficient staff to meet people’s needs. Staffing levels were adapted in line with changes in people’s need and things they enjoyed doing.

People received support to take their medicines when they needed them. The provider had systems in place to ensure that medicines were administered and stored safely.

People were supported by staff who had received training and had the skills and knowledge to care for people. Staff received support and guidance to enable them to meet the individual needs of people living at the home.

Staff communicated with people in the way they preferred to enable them to make decisions about their care and treatment. People were given choices and staff sought their consent before supporting them. The provider was aware of their responsibilities under the Mental Capacity Act and was working with the local authority to ensure people’s rights were protected

People and their relatives told us they thought the food was good. People were supported to choose and prepare what they wanted to eat and drink.

People and their relatives felt staff were caring and kind. Staff had built positive working relationships with people and their families. People were supported to maintain contact with relatives and friends who were important to them. Relatives we spoke with told us they were always made to feel welcome when they visited the home.

People were treated with dignity and respect. Staff promoted people’s independence and supported them to develop new skills. People were actively encouraged to follow their interests and hobbies. Care plans were tailored to people’s individual needs and preferences.

There was a warm and friendly atmosphere at the home. Staff felt well supported by the management team who encouraged an open and inclusive culture. The staff and management team worked in partnership to enable people to achieve their aspirations. Staff felt valued and were motivated to provide good quality care

The provider sought people’s, relatives and staff views about the quality of the service. People and their relatives felt able to raise concerns with staff and were confident that their views and suggestions would listened to and acted upon. The provider completed checks to monitor the quality and safety of the service. They used the information to make improvements to the service

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People who were able to share their experiences told us they liked living at the home. Comments included, “I like it here, the staff are nice”. We saw that staff had professional and positive relationships with people. There was good rapport between staff and the people using the service. All the staff we spoke with told us they enjoyed their work.

We saw people being offered choice with regard to where and how they wanted to spend their time. We saw people were encouraged to maintain their independence. Records showed that people helped with food shopping and general household tasks.

We found people's care was appropriately planned and staff were clear about people's individual needs and associated risks. Support plans were detailed and gave staff the information they required to meet people’s assessed needs.

We saw people were protected against the risks associated with unsafe use and management of medicines. We found the provider had an effective system for supporting people with the management of their medication.

People were supported by a team of consistent and long-standing staff. The majority of staff had worked at the home for a number of years providing people with continuity of care and support. Staff said they tried to meet people's needs with the resources available although some felt more resources were required to keep one person safe in the community.

We found the provider had effective systems in place to gain people’s views and assess and monitor the quality of service that people received.

We spoke with four of the eight people who lived at the home, two staff and the deputy manager. People told us they liked living at the home and said they were happy. One person said, “I like living here, it’s very nice”.

People’s likes, dislikes, preferences and goals were considered in relation to the care and support they received. People were treated with dignity and respect and were supported to develop and maintain their independence.

People told us they were happy with the care and support they received. Staff met people’s care and support needs in ways that they preferred. Staff were very knowledgeable about the individual needs of the people they supported. People told us they were supported to attend health appointments to maintain their health and welfare.

People were protected because staff were confident to recognise and report abuse. Staff told us they had received training on protecting vulnerable adults and were confident to speak out about poor or abusive practice.

Staff told us that they felt well trained. They told us about the courses they had undertaken to keep people safe and meet their needs. Some staff required refresher training to ensure their practice was in line with current good practice guidelines.

People said if they were not happy they would tell the staff. Staff told us they were confident in raising concerns on behalf of the people they supported.

We spoke with three people who lived at the home, three representatives and seven staff. People who used the service shared positive experiences of living at the home. They said they liked living at the home and got on well with the staff and the people they lived with.

People told us about the activities they were involved in. One person told us they enjoyed going into town to do their shopping. Another person said they enjoyed having a bet on the horses every Saturday and going to work in the week to do their job. One person told us they had been on holiday to London and really enjoyed it and regularly had their hair and nails done.

People told us they attended their reviews and talked about things important to them. They said they were supported to go shopping, planned and prepared their meals and helped with keeping their home clean and tidy. They told us they were supported to keep in touch with their family and friends. People told us they liked the staff and said if they were unhappy they would speak to their key workers or the staff.

We spoke with seven staff during our visit and through telephone discussions following our visit. Staff told us they attended team meetings and received formal supervision to discuss their work practice, performance and identify any training needs. Overall staff were positive and reported morale was improving. They said staffing levels had recently increased providing positive outcomes for people using the service. They demonstrated a sound understanding of people’s needs and were confident they met the individual needs of the people living at Windsor House. Staff told us they had received training to keep people safe and that additional training was being sourced to meet the specific needs of the people in their care. Comments included, “I like coming to work. My aim is to make this home the best”. “We provide good support for independent living”.

We spoke with three representatives to gain their views about the service provided. The feedback gained overall was positive although people said the continuous changes in management and staffing had impacted on the people who used the service. Comments included, “It’s better than it’s been for a long time, there are some very very good staff that do their best but the high use of agency staff is a problem”. “The home has some good quality staff and I’m very pleased”.

We did identify an issue during our review of the service that we passed onto senior managers to address. We will monitor the outcome.