This inspection took place on 5 January 2017 and was unannounced. At the time of our visit there were twelve people using the service.

110 West Street is registered to provide care and accommodation to 17 people with a learning disability. It is divided into three adjoining Houses. House A provides more traditional residential accommodation for crisis minimal risk short term care. House B accommodates people who choose to remain long term and House C comprises five flats for people who may challenge. The office for the service is situated in House C.

People admitted to this service were often in crisis due to their behaviours having led to police involvement or due to placements having broken down elsewhere as services were not able to provide the level of support needed.

The service was last inspected in September 2013 when it was found to be compliant with the regulations inspected at that time. Compliance had been found on the two previous inspections.

There is a registered manager in place but they were not available on the day of our 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. The deputy manager was available to support the inspection process.

Safeguarding people was included at the interview stage for new staff and was followed through with induction and training. Staff demonstrated a thorough knowledge of, and commitment to, keeping people safe.

Staff had a positive and innovative approach to risk taking. Rather than minimising risks to people by reducing their opportunities to live a full life, people were supported to develop links with the community and seek new experiences whilst having support to manage any associated risks. Staff understood that risk assessments put the focus on what the person could achieve rather than the difficulties they faced. This positive risk taking meant people were able to lead fulfilled lives and seek new opportunities.

Accidents and incidents were monitored to look for any themes and trends for which action could be taken to minimise the risk of reoccurrence.

Systems for managing medicines were safe and staff employed imaginative ways of supporting people to be independent with their medicines. One person told us about the support they had received to manage their medicines in preparation for independent living.

Recruitment processes were followed to make sure new staff were safe and suitable to work in the care sector. People who used the service were involved in the recruitment of new staff. Staff followed a thorough and bespoke induction programme and then went on to complete the Care Certificate. Staff received training which was relevant and important to their area of work.

Staff received high levels of support from the management team. Supervision sessions were arranged on a four weekly basis and annual appraisals centred around setting personal goals and valuing staff performance. Staff told us the management team all encouraged professional and personal development. We saw this had a positive impact on morale and the care and support people received.

Systems were in place for making sure the premises were safe and infection control procedures followed. Checks were made on a daily basis to check standards of hygiene and availability of equipment to ensure effective infective control.

Staff understood their responsibilities under the Mental Capacity Act. We saw good and innovative examples of staff using communication aids to support people to voice their decisions and of how best interest meetings were used when people were unable to make an informed decision. There was a strong emphasis on supporting people in the least restrictive way possible. This allowed some peo

During our inspection we met and spoke with three staff and the registered manager. We also met all of the six people who lived at 110 West Street at the time of our inspection. Those that we asked said they were involved in their care planning and decisions regarding their lives. They told us they were happy with the care and support they received.

We saw records that showed us people had busy lives and were supported on an individual basis to choose how to spend their time. Care plans clearly reflected people's needs and the level of support they required. We observed staff supporting people to plan their evening and discussing future plans with them. There was a natural and friendly rapport between staff and people using the service. Staff were respectful and patient and clearly knew people well and understood their individual needs.

We saw that medicines were safely stored and administered and those people we asked told us they received their medicines and were satisfied with how this as handled by the home.

The home has a clear complaints procedure and people told us they would "Talk to staff" if they had any complaints. One person said "The staff will listen to me" and added "They ask me if I'm happy here, if I've got any problems".

110 West Street is divided into three houses which are referred to as house A, house B and house C. We met five people using the service at the time of our inspection, all three houses were represented. We spoke to two of people privately about their views on the service. We spent time with one person who did not communicate verbally; we observed how they were cared for by staff. We were shown around one of the houses by two of the people living there and met another person in passing.

The people that were able to tell us their views said they were happy with the care and support they received. They said they could talk to staff if they were worried about anything and felt their privacy was respected. The other people we met looked happy and relaxed. They had a good rapport with staff and moved freely around the service. Those that were able to accessed local the community independently and this was reflected in people's care plans and risk assessments.

We spoke to a relative of someone using the service and they spoke very highly of the care and support their loved one received. They said things like "Top marks to them", "They are doing everything they possibly can" and "It's done him the world of good". They also said they felt their relative was getting "The best of worlds" because if anything was wrong, for example with their health the staff were "Straight on it" but they were also being supported to do lots of activities and "Social things".

People we spoke to said they were happy in the home and were involved in planning their care. They told us that staff were kind, patient and good listeners. They said they could choose how to spend their time and received the support they needed to do the things they wanted to do.