High Street is a care home providing personal care and accommodation for six people with a learning disability. It is an extended and adapted bungalow with accessible gardens. At the time if the inspection six people were using the service.

At the last inspection, the service was rated Good

At this inspection we found the service remained Good.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns.

People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff with the correct skill mix on duty to support people with their needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Effective infection control measures were in place to protect people.

Any accidents/incidents or errors had been used as a learning opportunity.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people.

Staff received an induction process and on-going training. They had attended a variety of training to ensure that they were able to provide care based on current practice when supporting people. They were also supported with regular supervisions.

People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.

People were supported to access a variety of health professionals when required, including opticians and doctors to make sure that they received additional healthcare to meet their needs.

The building had been adapted to meet the needs of the people who lived there.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times. Care plans were written in a person centred way and were responsive to people’s needs. People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place and accessible to all. Complaints had been responded to appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

People are 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 support this practice.

Further information is in the detailed findings below

We considered all the evidence we had gathered under the outcomes we had inspected to answer the questions we always ask; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Is the service safe?

An infection control policy was in place and staff had completed training in infection control. They understood the procedures needed to limit the spread of infection.

The premises were suitable for the needs of the people who used the service and there were procedures in place to reduce environmental hazards.

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Is the service effective?

Each person had a support plan and risk assessments that were regularly updated and contained the information necessary to provide safe and effective care.

Staff had undertaken the training necessary to have the knowledge and skills to provide appropriate care. .

Is the service caring?

We saw very positive interactions between staff and the people who used the service. Staff knew the people very well and were able to interpret non-verbal cues as was clear from the positive response they received from people when they provided support. We saw staff handle personal issues very sensitively preserving the dignity of the people who used the service.

Is the service responsive?

Action was taken to address issues identified in quality audits to improve the service.

Is the service well led?

A systematic approach to quality assurance was in place

Staff had access to training appropriate to their job roles and they had opportunities for development.

The service worked with other agencies and services to make sure people had access to specialist support and care.

During our visit on 28 May 2013, we spoke with two care staff and the registered manager. People had complex needs and were not able to directly communicate with us about their experiences. To help us assess people's experiences we observed the interactions between staff and people living at the service during the course of our visit. We observed that staff were caring and knowledgeable about the people they cared for. People were taking part in various activities and moved around the home as they wished.

When staff had to assist someone, they were respectful and aware of the individual’s communication needs. We observed that people were able to express their wishes when it came to personal care, such as being assisted to use the toilet and their consent was implied when the offer of assistance was accepted. Staff demonstrated they were aware of people's capacity and ability to consent.

We looked at the system in place to assist people in maintaining a healthy diet and lifestyle. There was a robust system in place to establish people's dietary needs and where necessary healthcare professionals were involved in assessing people's needs.

The provider had put in place a system for managing people's concerns and complaints. The information on how to complain was also made available to people who lived at the service in a pictorial format.

The focus of the service had been to make experiences for people as inclusive as they could be within the abilities of the individual. The communication by care staff was respectful and person centred.

The care plans contained assessments regarding the ability of people to make choices in relation to their needs. We saw Mental Capacity Act 2005 assessments were completed for some individuals where they lacked the ability to consent to care or treatment.

All the staff on shift were able to identify the types of abuse and the process to be followed if they needed to report any concerns.

Mandatory training such as Safeguarding of Vulnerable Adults, moving and and handling and medication administration had been provided and attended by staff as part of the annual training programme.The staff we spoke with were very motivated to undertake vocational qualifications and had worked hard to complete these in the last 8 months.

The manager completed monthly service audits which were then sent to the provider's head office for consideration.

This inspection took place on 17, 18 & 22 December 2015 and was unannounced.

The inspection was carried out by one inspector.

High Street is registered to provide accommodation with personal care for up to six people who have a learning disability. It is part of the Fremantle Trust. On the day of our inspection six people were using the service.

There was a registered manger 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.

People felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and how to report them.

People had risk assessments in place to enable them to be as independent as they could be.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs.

Effective recruitment processes were in place and followed by the service.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

Staff received a comprehensive induction process and ongoing training. They were well supported by the registered manager and had regular one to one time for supervisions.

Staff had attended a variety of training to ensure they were able to provide care based on current practice when supporting people.

Staff gained consent before supporting people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people.

People were able to make choices about the food and drink they had, and staff gave support when required.

People were supported to access a variety of health professionals when required, including dentist, opticians and specialists.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well.

People and relatives where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests.

A complaints procedure was in place and accessible to all. People knew how to complain.

Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.