185 Watling Street Road is a 'care home'. People in care homes receive accommodation and nursing or personal care as a 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 home accommodates up to nine people in one adapted building. There were six people living in the home when we inspected.

This was an unannounced inspection that took place on 10 January 2019. The service was last inspected on 26 April 2016 when there were no breaches in regulation seen and the home was rated as 'Good'. At this inspection we found the service remained 'Good' overall and 'Good' in all areas inspected.

There was no evidence or information from our inspection or on-going monitoring that demonstrated serious risks or concerns. The service met all relevant fundamental standards. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At the time of this inspection a registered manager was 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 has continued to sustain a good standard of care and support for those who lived at the home. The provider, the management and staff team were constantly striving to improve the service and this is demonstrated by their commitment towards those who live at 185 Watling Street Road.

People were able to live as they chose and this philosophy was clearly embedded within the visions and values of the service. Staff had a good understanding of people's needs and were able to provide person centred care in a compassionate and dignified way, which enabled people to receive the support they needed in the way they preferred.

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.

There was clear evidence of a solid management structure and a dedicated team approach, which continued to drive the service forward, in order to provide a good standard of care and support. Staff who had shown particular interests in specific areas, such as safeguarding, dignity, health and well-being and Dialectical Behaviour Therapy (DBT) were designated 'Champions'. These champions continued to play an essential role in developing best practice, sharing learning and acting as role models for other staff.

People who lived at 185 Watling Street Road told us they felt safe living at the home. Medicines were being appropriately managed and we found the environment to be clean, well maintained and safe for people to live in. Risk assessments had been conducted where necessary and staff we spoke with were confident to report any concerns about people's safety to the appropriate authorities.

Recruitment practices were robust and new staff were guided through an induction programme, followed by regular mandatory training modules throughout their employment.

There were sufficient staff on duty, who were kind and caring and had developed good relationships with people who used the service. We saw that people looked comfortable in the presence of staff members and seemed relaxed within their environment.

People were assisted in a gentle and supportive way. We noted that a homely and peaceful environment had been created for people to live in. Staff we spoke with all told us they were happy working at the home.

Further information is in the detailed findings below.

The service of 185 Watling Street Road is located in a residential area of Preston, close to the city centre. Care and support is provided for a maximum of nine adults with mental health conditions, learning disabilities or autistic spectrum disorder. Bedrooms are of single occupancy and all, with the exception of one, have en-suite facilities.

Pleasant communal areas are available, which are well decorated and well maintained. Public transport is available close by. On road parking is permitted and a variety of amenities are within easy reach, such as a post office, pubs, shops, supermarkets, churches, a leisure centre and newsagents.

The level of people’s needs vary from those who are quite independent and are being supported to be self-sufficient to those who require a great amount of support and care intervention.

This was the first inspection of the service. It was a full comprehensive unannounced visit and was conducted on 26 April 2016.

The registered manager was on duty 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.

We found recruitment practices to be robust. In-depth induction programmes were provided for all new employees and a wide range of training modules were available for the staff team. Staff members we spoke with were knowledgeable about the needs of those in their care.

Detailed assessments of people’s needs had been completed before a placement was arranged at 185 Watling Street Road. The planning of people’s care and support was person centred, providing staff with clear guidance about the needs of those who lived at the home and how these needs were to be best met. Records showed that individuals were empowered and fully involved in making decisions about how they wished to live. Risk assessments had been conducted, which were detailed and outlined the best course of action, in order to reduce the level of potential risk. This helped to protect people from harm.

We found that people’s dignity was consistently promoted and their privacy was always respected. Staff members approached those who lived at 185 Watling Street Road in a kind, gentle and friendly manner. People were supported to maintain their independence as much as possible and were relaxed and comfortable.

People were supported to express their views and were able to access advocacy services, should they wish to do so. An advocate is an independent person, who will act on behalf of those needing support to make decisions.

The staff team were confident in reporting any concerns about a person’s safety in relation to the Mental Capacity Act 2015 (MCA) and Deprivation of Liberty Safeguards (DoLS). Mental capacity assessments had been conducted for all those who lived at the home, which determined that no-one lacked the capacity to make any decisions and everyone was able to ‘come and go’ as they pleased, without any undue restrictions being placed on their freedom.

People told us they felt safe living at 185 Watling Street Road. Their human rights were properly recognised, respected and promoted. Accident records were appropriately maintained and these were kept in line with data protection guidelines. A contingency plan provided staff with guidance about what they needed to do in the event of an environmental emergency, such as power failure or severe weather conditions. Systems and equipment within the home had been serviced to ensure they were safe and fit for use.

People received their medicines in a safe manner, although we did discuss some minor issues with the registered manager, which were addressed immediately. Weekly checks and monthly audits were carried out on medicine records. This helped ensure that any e