What life is like for people using this service:

• People continued to receive safe care. People were safe and staff knew how to keep them safe from harm. The provider had a recruitment process to ensure they had enough staff to support people safely. People received their medicines as it was prescribed. Staff followed infection control guidance and had access to personal protective equipment. Accidents and incidents were noted and trends monitored to reduce the amount of accidents.

• People continued to receive effective care. Staff were supported and had the skills and knowledge to meet people’s needs. 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’s nutritional needs were met and they received enough to eat and drink to ensure they had a healthy diet. People accessed health care when needed.

• People continued to receive care from staff who were kind and caring. Staff supported and encouraged people to be involve in how decision were made about their support. Relatives took a proactive role in the decision-making process to support people who were unable to communicate their views. Staff were caring, compassionate and kind. People’s privacy dignity and independence were respected by staff.

• People continued to receive responsive care. People’s support needs were assessed and planned with their or their relative’s involvement to ensure they received the support they needed. People’s support was individualised and reviewed with people or their relative’s involvement. People were supported to take part in activities of interest and their preferences, likes and dislikes were known to staff. The provider had a complaint process which people were aware of to share any concerns.

• The service continued to be well managed. The environment was welcoming, warm, comfortable and clean. The registered manager was known and made themselves available. People’s relatives shared their views by completing a provider questionnaire about the service. Spot checks and audits were taking place to ensure the quality of the service was maintained.

More information is in the Detailed Findings below.

Rating at last inspection:

• Rated Good (Report published 27/01/2016).

About the service:

• Attwood Street is a small care home providing personal care and accommodation for up to five people who have a learning disability or sensory impairment. At this inspection five people lived within the service.

Why we inspected:

• This was a planned inspection based on the rating at the last inspection. The service remained Good overall.

Follow up:

• We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Our inspection was unannounced and took place on 16 December 2015.Our last inspection of this service took place on 21 October 2013. The provider was meeting all regulations at the last inspection.

Attwood Street is registered to provide accommodation for five people with learning disabilities or autistic spectrum disorder, physical disabilities and sensory impairments. At the time of the inspection there were five people living at the home.

The home had 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.

We saw that people felt safe and that staff had an understanding of how to identify and report abuse.

We saw that the registered manager could demonstrate learning from accidents and incidents and used this to make changes where required.

We saw that there were a suitable amount of staff with the skills and training required to meet people’s needs.

Medication was stored and administered in a safe way.

We saw that people’s capacity to make decisions had been made in line with the Mental Capacity Act 2005.

People were given choices at mealtimes and were supported to have enough food and drink.

People’s health needs were met as they were supported to access a range of healthcare support.

Staff had a kind and caring approach and supported people to maintain their independence.

People and their relatives were involved in the planning and review of their care.

People were supported to take part on activities that they had chosen, based on their interests.

Relatives were aware of how to make complaints and were encouraged to provide feedback on the home through questionnaires.

The registered manager completed quality assurance audits to ensure the quality of the service provided was maintained.

During our inspection we observed interactions between staff and each of the five people using the service. We spoke with three relatives and five members of staff including the registered manager. Our observations indicated close, positive relationships between people using the service and staff who responded to people's needs. We saw examples of people's privacy and dignity being respected. This was the positive view expressed when we spoke to three relatives.

We found that people were relaxed with staff and able to express themselves by non-verbal means. Positive efforts were made to involve people in daily decisions about their care, making choices wherever possible and promoting independence.

We saw that people were supported to make every day decisions. Where they were unable to make more complex decisions for themselves the provider acted in accordance with the legal requirements of the Mental Capacity Act 2005.

People's care records contained detailed information about their needs and they had access to a range of health and social care professionals. Risk assessments for each person were in place and regularly reviewed. This meant that care and treatment was planned in a way that ensured each person's safety and wellbeing.

People were supported by well trained, competent staff who had detailed knowledge of their needs.

Appropriate systems were in place to monitor quality. People's views of the service were sought and acted upon.

At the time of our inspection there were five people living in the home. All of the people had complex communication needs, therefore we spent time observing how staff interacted with them, and saw that they were well supported by trained staff who knew them well. A relative told us, “The staff are really good, I’ve seen lots of improvements with my relative doing things for themselves which they didn’t do before”.

People had comprehensive care plans which identified the support they needed with all areas of their care. Advice from other professionals ensured people's complex health needs were met.

Staff knew how to safeguard people from harm and felt confident that if they had to report any abuse, action would be taken to protect people.

People had a pleasant living environment which had the specialist adaptations and equipment they needed.

We saw people's needs were met by staff who had the support and specialist training they needed to understand and meet people's needs.