We carried out an inspection of Denmark Street on 11 and 24 January 2017. We carried out a telephone interviews with staff on 3, 9 and 10 February 2017. The first day of the inspection was unannounced. This was the first inspection of Denmark Street.

Denmark Street provides accommodation and personal care for up to five people with a learning disability and / or mental health needs. There are also two supported living services, where people receive personal care within their own home. There were eight people using these services on the day of our inspection.

There was a registered manager in post. A registered manager is a person who has registered with the CQC 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 using the service told us they felt safe and were well cared for. Staff took steps to safeguard vulnerable adults and promoted their human rights. Incidents were dealt with appropriately, which helped to keep people safe.

The accommodation provided was suitably adapted for the people who lived there. The building was safe, clean and well maintained. Minor maintenance items were highlighted to the registered manager to resolve. Risks associated with the building and in people’s own home’s, along with working practices were assessed and steps taken to reduce the likelihood of harm occurring.

We observed staff acted in a courteous, professional and safe manner when supporting people. Staffing levels were sufficient to safely meet people’s needs. The provider had a system to ensure new staff were subject to thorough recruitment checks.

Medicines, including topical medicines (creams applied to the skin) were safely managed.

Arrangements were in place to assess people’s mental capacity and identify if decisions needed to be taken on their behalf in their best interests. People’s mental capacity was considered through relevant areas of care, such as with decisions about finances, medicines and supervision when outside the home. Staff sought people’s consent before providing care.

Staff had completed safety and care related training relevant to their roles and the needs of people using the service. Further training was planned to ensure their skills and knowledge were up to date. Staff said they were well supported by the registered manager. Staff performance was supervised and assessed.

People’s nutritional and hydration (eating and drinking) status was assessed and plans of care put in place where support was needed. People’s health needs were identified and external professionals involved if necessary. This ensured people’s general medical needs were met promptly. People were provided with assistance to access healthcare services.

Staff displayed an attentive, caring and supportive attitude. We observed staff interacted positively with people. We saw that staff treated people with respect and explained clearly to us how privacy, dignity and confidentiality were maintained. Staff were able to communicate effectively with the people using the Denmark Street services.

Activities were offered on a group and one to one basis. Staff worked collaboratively with local day care services or accessed alternative funding to offer additional activities. Staff understood the needs of people and care plans and associated documentation were clear and person centred.

People using the service and staff spoke well of the registered manager and their leadership. Systems were in place to assess and monitor the quality of the service, which included feedback from people receiving care and oversight from the care provider. Several incidents had not been notified to the Care Quality Commission (CQC) in line with legal requirements. Where incidents are not notified to CQC the rating for that key question is limited to inadequate or