Cambridgeshire County Council – 40/44 Russell Street, Cambridge provides short stay and long term accommodation and personal care for up to nine people, who have learning disabilities. There are external and internal communal areas for people and their visitors to use. The service is divided into three areas: a four bed house for people who live at the service, a four bed house for people who have short stays at the service, and a flat for one person who can live semi-independently.

This unannounced inspection took place on 22 September 2016. There were six people receiving care at that time.

The service had a registered manager in place. 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 registered manager was also registered to run another of the provider’s services, Cambridge Supported Living Scheme, from the same address.

People were supported to safely manage their other prescribed medicines. There were systems in place to ensure people’s safety was managed effectively. Staff were aware of the actions to take to report their concerns. People’s risks were assessed and measures were in place to minimise the risk of harm occurring. Staff were aware of the procedures for reporting concerns and of how to protect people from harm.

Staff were only employed after comprehensive and satisfactory pre-employment checks had been obtained. There were sufficient staff to ensure people’s needs were met safely. Staff were well trained and had the skills and knowledge they needed to support people. Staff were well supported by the registered manager.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that there were formal systems in place to assess people’s capacity for decision making and applications had been made to the authorising agencies for people who needed these safeguards. People’s rights to make decisions about their care were respected. Where people did not have the mental capacity to make decisions, they had been supported in the decision making process. Staff were aware of the key legal requirements of the MCA and DoLS.

People’s health, care and nutritional needs were effectively met. People were provided with a balanced diet and staff were aware of people’s dietary needs. People had access to the health care services they needed.

People received care and support from staff who were kind, patient, compassionate and caring. Staff treated people with dignity and respect. People and their relatives were encouraged to be involved in decisions about the service provided. People were involved in every day decisions about their care.

People’s care records were detailed and provided staff with sufficient guidance to ensure consistent care to each person. People were supported to engage in varied social and recreational activities. People were supported to maintain relationships that were important to them.

The registered manager was experienced and staff were managed to provide people with safe and appropriate care. The registered manager was approachable and supportive. People had access to information on how to make a complaint. The service had an effective quality assurance system that was used to drive and sustain improvement.

During our inspection on 17 October 2013, we spoke with three members of staff, a relative and three people who lived at the service. The people we spoke with told us they were able to make choices about whether they wished to participate in activities. All people told us they enjoyed living at Russell Street.

We observed that, people showed they were content living at this home and that they had good relationships with the staff. They told us that they felt safe, and were satisfied with the service being provided. There was laughter and friendly banter between staff and people living in the home during our inspection.

Care records we looked at were well written and the people living in the home told us they understood the care and support being provided.

Medication administration procedures and records were well managed and checks carried out to prevent any errors.

Staffing levels were adequate to meet people’s needs and the staff felt well supported and received appropriate training to ensure their skills and knowledge remained up to date and in line with best practice.

People were given the opportunity to raise any concerns they had about their care and support.

People made positive comments about their care and the staff who supported them. One person who shared their care plan with us said they had signed their agreement to their care plan and had made decisions about their care arrangements.

One person said, "I am happy to be living here. The staff are OK and they listen to what I say". Another person explained to us that they had been given opportunities to be as independent as they could safely manage and that they had agreed to the risks that had been identified in relation to their needs.

We spoke with two people about safeguarding and they told us they felt safe living at the home and that staff had been kind to them.

People we spoke with were happy with the accommodation and support they received and we observed that interactions with staff were friendly and professional. Two relatives visiting the service stated that they were very pleased with the care that was given and that they were kept informed regularly about any changes to their relative's support needs and events in the home.

A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions we always ask:

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at. If you would like to see the evidence that supports the summary, please read the full report.

We used a number of different methods to help us understand the experiences of people using the service. Some of the people using the service had complex needs which meant they were not all able to tell us about their experiences. We spoke with one person who received a service, three people who visited the home regularly and six staff members.

Is the service safe?

Staff were provided with the knowledge they needed to ensure people’s rights were respected and taken into account when care was provided. This included training in the Mental Capacity Act 2005 and Deprivation of Liberty safeguards (DOLs). The staff we spoke with were clear about how they obtained people's consent to their care and support. They also spoke of the importance of people being supported to make informed choices about their lives and the involvement of advocates. This ensured that people who could not make choices for themselves were protected.

We saw that care plans and risk assessments were in place and were reviewed regularly. We noted that one person’s file did not contain an important document that informed health care professionals about a person’s needs. The manager told us that this did not impact on the care the person received because a member of staff who knew them well had accompanied them and provided the hospital staff with the information.

There were effective systems in place to reduce the risk and spread of infection. On the two days of our inspection the home looked clean and smelled fresh. We saw that the service had up to date policies on the prevention and control of infections and that staff had received training in this area.

We found there were effective recruitment and selection practices in place. This ensured that only suitable staff were appointed to provide care for people.

Is the service effective?

People and their relatives told us that they were very happy with the care that they, or the person they visited, received. One person who visited the home very regularly told us that staff understood the needs of the person they were visiting. They described how staff acknowledged and responded to the person’s non-verbal communication. Two other visitors told us that their relative was, “very happy” at the home and that the staff knew their relative “really well”.

The staff we spoke with clearly knew the people they were working with well and spoke about the importance of understanding each person’s individual preferences when providing care.

Is the service caring?

People and their relatives confirmed that they were consulted about, and happy with, the care and support they or their family member received. One person who visited the home very regularly described how staff acknowledged and responded to the person’s non-verbal communication.

People’s needs were assessed and care was planned and delivered in line with their individual care plans. The care plans we looked at were personalised and detailed and provided a good level of information for the staff providing care to people living at the home. The staff interactions with people that we saw were respectful and caring in their approach.

Is the service responsive?

We saw that the provider asked people, and their relatives, to complete annual feedback forms about the quality of the service provided. The feedback had not been completed for the year of our inspection. However, we found that the feedback forms for the previous year had been analysed and actions had been taken to address any issues raised.

The visitors we spoke with told us they had no concerns about the service. They told us they would feel confident raising any issues they had with senior staff and felt they would be listened to.

Is the service well-led?

A registered manager had been in post for over a year. At the time of our inspection the registered manager was on extended leave and the service was being managed by the deputy manager.

The staff we spoke with told us the senior staff were very approachable. They said they had received comprehensive induction, training and support which helped them to meet the needs of the people they provided care and support to.

The provider had an effective system in place to regularly assess and monitor the quality of service that people receive.

We saw there were various audits in place to ensure that standards were maintained. For example regular checks were made by seniors that people’s care plans had been updated. The provider may find it useful to note that there were some gaps in the completion of these.

We found that the provider was compliant with the regulations in all the areas we assessed. If you wish to see the evidence supporting our summary please read the full report.