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Inspection carried out on 11 December 2018

During a routine inspection

42 Beeston Drive 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.

The care service has been developed and designed 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.

At our last inspection we rated the service Good. At this inspection we found 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. However, we did find some areas that needed improving which have impacted on the rating of the Well Led Domain. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service overall remained Good.

Systems were in place to monitor and assess the quality and safety of the care provided. However, we found that these were not always robust enough to identify issues and action was not always taken. We made a recommendation that the registered provider review its quality monitoring and oversight of the service.

People were supported with diet and hydration. However, we made a recommendation that the registered provider undertake a full review of its menus as they were not healthy or nutritionally balanced.

Checks were undertaken as required with the safety and suitability of the premises in regards to cleanliness, gas, electricity and water. Fire Safety checks had been carried out but we made a recommendation for a further review of the safety and suitability of the evacuation plans.

People continued to receive safe care as they were supported by staff who knew how to protect them from harm. Staff were aware of people's individual risks and plans were in place to minimise these while maintaining the person's independence. Where areas for improvement were identified, systems were in place to ensure lessons were learnt and used to improve the service delivery. Staffing was arranged based on people's individual needs and what activities were happening . Staffing remained flexible to suit the people living at the service.

The registered manager supported staff by arranging training so staff developed the skills to provide care and support to people, which was in-line with best practice.Staff were supported to carry out their roles and responsibilities effectively, so that people received care and support in-line with their needs and wishes.

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. People receive care and support that was in line with their consent.

People were supported by staff who knew their individual requirements and how to support them in the right way. People had access to healthcare professionals when they required them. 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 were treated well which had a positive impact on their well-being. We observed that all staff spoke kindly to them and they presented as being happy and comfortable. Staff helped people to make choices about their care and the views and decisions they had made about their care were listened

and acted upon. Information was provided to people should they wish to raise a complaint.There were opportunities for people and relatives to feedback their views about their care and this was used to imp

Inspection carried out on 19 and 22 January 2016

During a routine inspection

The inspection took place on 17 and 22 January 2016 and the first day was unannounced.

The service provides accommodation and support to four adults with autism. It is based within a detached property in a residential area of Winsford, close to local amenities. At the time of the visit, there were three people living at the service.

The service did not have a registered manager. 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.’ This service had a manager who was the registered manager at another iMap location but she had applied to have this service added to her registration.

People lived in a detached house that had been adapted in part to meet their needs. Improvements were needed to ensure that the building was kept clean in order to minimise the risk of infection. We were informed that remedial repairs and refurbishment were planned to improve the communal areas and to give the service a more ‘homely” feel. The registered provider ensured that it was safe and that all required checks were carried out on a regular basis.

Observations indicated that people were happy at the service and there were positive interactions with staff. People were supported by staff that knew them well and could anticipate their needs. The requirements of the Mental Capacity Act 2005 were met and staff used a range of strategies to communicate with people to help them express themselves and to indicate consent. Applications had been made under the Deprivation of Liberty Safeguards where it was felt a person’s liberty was being restricted or deprived.

Staff were aware what was required in order to keep people safe and there was evidence that they were confident to report matters of concern. People received care and support from staff that had been through robust recruitment procedures to ensure that they were of suitable character to work in this setting. Staff also underwent an induction programme to equip them with the knowledge and skills to support people.

Care records were personalised and gave an accurate picture of a person’s needs, wishes, preferences and personality traits. There were also risk assessments in place to direct staff in managing certain aspects of a person’s care. This meant that staff not familiar with people at the service would be able to know about them and how their support needed to be delivered.

The registered provider ensured that audits (checks) were carried out on a regular basis in order to monitor the quality and effectiveness of the service. They responded in a timely manner to any complaints that were raised in line with their complaints policy.