20 -22 Middlesex Road is registered as one location, it comprises of two purpose built houses and one bungalow. The service is registered to provide care and accommodation for nine people who have a learning disability. It is located to the outskirts of the East of Hull with local facilities and amenities within walking distance.

At the last inspection on 6 and 7 August 2015, the service was rated Good. At this inspection, we found the service remained Good.

Not all of the people who used the service were able to speak with us or tell us their experiences about the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who were unable to share their views with us.

Staff understood the importance of protecting people they supported from harm. Staff had received training in how to identify abuse and report this to the appropriate authorities. Staff were recruited in a safe way and all checks were completed before they started work. The staff told us they had received an induction and essential training at the beginning of their employment and we saw this had been followed by periodic refresher training to update their knowledge and skills. Sufficient numbers of staff supported people.

People who used the service were supported to access health care professionals when needed and were supported to have maximum choice and control over their lives. Staff supported people in the least restrictive way possible the policies and procedures within the service supported this practice.

Staff had a good understanding of people's needs and were kind and caring. The service developed and maintained good links with external organisations and within the local community.

Complaints were investigated and resolved wherever possible to the complainant's satisfaction.

People who used the service and those who had an interest in their welfare and wellbeing, were asked for their views about how the service was run and the care they received. Regular audits were carried out to ensure the service was safe and well run.

Further information is in the detailed findings below.

This unannounced inspection took place on 6 and 7 August 2015. The service had a registered manager 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.

20 – 22 Middlesex Road is registered as one location, it comprises of two purpose built houses and 1 bungalow. The service is registered to provide care and accommodation for nine people who have a learning disability. It is located on the outskirts of Hull; local facilities and amenities are within walking distance.

The people who lived at the home had complex needs which meant they could not tell us their experiences. We used a number of different methods to help us understand the experiences of the people who used the service including the Short Observational Framework for Inspection [SOFI]. SOFI is a way of observing care to help us understand the experiences of people who could not

talk with us. Throughout the inspection we saw and heard people who used the service laughing and sharing jokes with members of staff. It was apparent staff were aware of people’s preferences for how care and support was to be delivered; we noted people who used the service actively looked for staff to be involved with activities and daily tasks. People were happy and relaxed in the service.

Staff had completed relevant training so they knew how to recognise signs of potential abuse, how to keep people safe from harm and how to report episodes of poor care. Records showed staff were recruited safely which helped to ensure they had not been deemed unsuitable to work with vulnerable people.

Suitable numbers of staff were deployed to meet the assessed needs of the people who used the service.

Medicines were managed safely. Policies were in place that provided guidance on the safe ordering, storage, administration and destruction of medication.

People’s nutritional needs were met. Staff monitored people’s food and fluid intake and took action when there were any concerns. People were supported to assist staff to prepare meals and to go shopping when possible. Staff responded quickly to changes in people’s health care needs. We saw evidence to confirm a number of relevant healthcare professionals were involved in the on-going care and treatment of people who used the service.

People’s needs were met by kind and attentive staff. People who used the service indicated that they liked the staff who supported them and people’s relatives were complimentary about staffs approach and level of competency.

People were encouraged to take part in a range of activities. During the inspection people were supported to attend a local autism centre, enjoy meals in the community and to attend the local market. Other people followed interests within the service such as drawing pictures, writing poems and watering their fruit plants and flowers.

Assessments of people’s health and social care needs took place and were used to develop personalised support plans that informed staff how to care for people who used the service using the least restrictive options.

Staff were supported through regular supervisions and staff meetings. Staff told us the registered manager was approachable and had an open door policy.

A programme of quality monitoring took place which consisted off audits, checks and questionnaires. We saw evidence to confirm when shortfalls were highlighted the registered manager took corrective action in a timely manner.