This announced inspection took place on 18 September 2017. At the previous inspection in June 2015 we found the service was meeting all the regulations we reviewed.

Edgar Street provides accommodation and personal care for six adults with learning disabilities; the service specialises in providing a service for women. At the time of the inspection there were six women accommodated in the home.

Edgar Street is a semi-detached domestic style house in a residential area on the outskirts of Accrington. It is close to local amenities and the town's amenities are within easy reach with a bus route and rail transport near to the home. Accommodation is in single occupancy bedrooms. There is a patio and garden for the use of people living in the home.

The provider had a registered manager in place as required by the conditions of their registration with the Care Quality Commission (CQC). 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 were supported by staff who were highly caring and compassionate. Staff knew people and their backgrounds well and used this knowledge to communicate effectively with them. Professionals and relatives commented about the exemplary way in which the staff team worked together, often going above and beyond what would normally be expected of them, to ensure people were able to achieve their goals and develop their potential.

People were treated with the utmost respect at all times. Staff protected their privacy, involved them in decisions about their care and promoted their independence.

The service was well-led. People who used the service were seen as central to the decision making process about how the home was run. The registered manager and staff demonstrated a commitment to providing the highest quality of care which enabled people to live their lives as fully as possible.

There were effective systems in place to monitor the quality and safety of the service. The registered manager demonstrated a clear commitment to continuing to drive forward improvements in the service for the benefit of the people who lived in the home.

The registered manager and staff had developed effective partnerships with other organisations. As a result people who used the service had access to specialist assessment. The outcomes of these assessments were used to ensure people were provided with the highest quality care and support.

There were enough staff deployed to meet people’s needs. Recruitment procedures helped ensure only suitable staff were employed. Staff knew the correct action to take to protect people from the risk of harm and supported them to receive their medicines safely.

Risk assessments were in place in relation to each individual’s care and health needs as well as any environmental risks; these helped to protect the health and welfare of people who used the service and staff.

People were cared for in a safe and clean environment. Staff had received appropriate training to manage the risk of cross infection in the home.

Staff received the induction, training and supervision necessary to help them to deliver effective care. People were 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 supported this practice.

People were supported to have a healthy diet. Systems were in place to help ensure people’s health and nutritional needs were met.

Staff had a good understanding of people’s needs and goals. They demonstrated a commitment to providing high quality support which was personalised and tailored to the needs of each individual. People who used the service told us they were able to make chan

At the time of our inspection four ladies lived at Edgar Street. Because of their arranged activities we were able to spend time with two of them. One spoke in some detail about Edgar Street.

We saw people chose their routines and daily activities and agreed to the support required. One person told us she planned the support she needed. She said, "I plan my support with the staff. I mainly need emotional support; I am very independent".

People we spoke with said they were very happy at Edgar Street and had active lives, such as going shopping, doing voluntary work, going to church, using leisure facilities and visiting family. People received the care, health care and support they needed. One person said, "I'm very happy here" and "The staff are all very nice and they give me the support I need".

Staff encouraged the ladies to eat healthily and to participate in meal preparation. With staff support they planned meals around healthy eating and also around their likes and dislikes. Records showed a good variety of meals were served.

We saw there were suitable procedures for safeguarding people from abuse and the staff we spoke with knew how to implement these procedures if needed. Most of the ladies were able to make a complaint if necessary and regularly voiced their views to staff.

Staff told us there were good training opportunities with updates as necessary. There was also a strong system of staff support with regular supervision and staff meetings.

Two of the four people currently residing at the home told us, "I am going to work now in a charity shop. I enjoy getting out “and “I am going out today. I am going into town. This is what I want to do. We just have to tell them where we are going”. People who used the service were encouraged to be independent and access the local community within a risk based framework.

People who used the service were involved in their care to ensure their wishes were accounted for.

People who used the service said they were encouraged to administer their own medication to help them retain their independence.

One person told us, "I like the cooking and helping in the garden. I want to work with older people but don’t like the charity shop. It’s boring but they don’t make me go. We get a choice of food and we eat what we want although staff will make it if I cannot be bothered”. People who used the service were able to make choices to help maximise their enjoyment.

People we spoke with told us that they were able to make decisions about their daily lives and staff encouraged them.

We carried out this inspection of Edgar Street Residential Home on 30 June and 1 July 2015. The inspection was unannounced on the first day. Edgar Street provides accommodation and personal care for six adults with learning disabilities. The service does not provide nursing care. At the time of the inspection there were six people accommodated in the home.

Edgar Street is a semi-detached domestic style house in a residential area on the outskirts of Accrington. It is in close to local amenities and the town's amenities are within easy reach with a bus route and rail transport near to the home. Accommodation is in single occupancy bedrooms. There is a patio and garden for the residents' use.

At the previous inspection on 01 August 2013 we found the service was meeting all the regulations we looked at.

There was a registered manager in day to day charge of the home. 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 told us they felt safe. They had been guided on how to keep safe when they were out and about in the community and what they should do if they did not like how they were treated.

We found individual risks had been assessed and discussed with people. Staff had guidance on how to safely manage risks whilst ensuring people’s independence, rights and lifestyle choices were respected and they supported people to lead full and meaningful lives safely.

Staff expressed a good understanding of safeguarding and protection matters. They told us they were confident to take action if they witnessed or suspected any abusive or neglectful practice and had received training about the Mental Capacity Act 2005 (MCA 2005) and Deprivation of Liberty Safeguards (DoLS). The MCA 2005 and DoLS provide legal safeguards for people who may be unable to make decisions about their care. We noted appropriate DoLS applications had been made to ensure people were safe and their best interests were considered.

People using the service could be confident they would be protected from financial mismanagement. There were good procedures followed and staff guidance in place to support this. Confidentiality was also a key feature in staff contractual arrangements. This helped to make sure information shared about people was on a need to know basis.

A safe and fair recruitment process had been followed and proper checks had been completed before staff began working for the service. We found there were enough staff to meet people's needs in a flexible way. Arrangements were in place to provide management support with on call arrangements for evenings and weekends.

People were receiving safe support with their medicines. Staff responsible for supporting people with medicines had completed training. This had included an assessment to make sure they were capable in this task.

Arrangements were in place to promote the safety and security of the premises, this included reviewing and checking systems such as fire alarms. Staff had been trained to deal with emergencies.

People spoken with made positive comments about the staff who supported them. Staff were described as being very good and helpful. People were cared for by staff who had received a good standard of training and who were supported by the registered manager. People who used the service were involved in staff induction training.

Staff told us they worked very well as a team and were given enough information to care for people as they needed and wanted. Staff were knowledgeable about people’s individual needs and promoted people’s rights and choices. People using the service were seen to be valued and staff communicated very well with them. Achievements were celebrated.

Each person had an individual care plan. These were well written and sufficiently detailed to ensure people’s care was personalised. People’s changing needs were identified, recorded and regularly reviewed. People were given additional support when they required this and they had a key worker to support them. Referrals had been made to the relevant health and social care professionals for advice and support when people’s needs had changed. This meant people received prompt, co-ordinated and effective care.

Health and social care professionals we had contact with told us “I have visited a service user at the home on several occasions and met with the home manager. The staff team were observed to support the service user appropriately, being responsive to her needs.” Another gave details describing how the manager worked well with them to do care plans and risk assessments. They commented, “All the staff from Edgar St are a pleasure to work with and are very committed to the needs of people using their service”.

People we spoke with were satisfied with the support they received with nutrition. They told us they enjoyed their meals and could have what they wanted. People were supported to shop, prepare and cook meals and consideration had been given to healthy eating, likes, dislikes and dietary needs.

There were opportunities for involvement in meaningful activities both inside and outside the home. Activities provided people with appropriate skills whilst promoting enjoyment, improvement and independence. These included, for example, shopping trips, excursions and holidays, meals out, swimming, and domestic skills such as cleaning and baking. People told us they were supported to maintain contact with their friends and family. There were regular house meetings to discuss day to day matters, meals and activities.

There were suitable complaints processes in place. People were encouraged to voice any concerns in day to day discussions with staff and the registered manager, during their reviews, house meetings and in surveys. There was a formal complaints system to manage and respond to any issue of concern raised.

There were effective systems in place to assess and monitor the quality of the service. They included monthly checks of the medication systems, support plans, staff training, finance, nutrition, safety and the environment. There was evidence improvements had been made when any shortfalls had been noted.

Confidence was expressed in the management of the home by people using the service, staff and health and social care professionals who visited.

There were systems and processes in place to consult with people who used the service, other stakeholders and staff. Regular meetings and consultation surveys meant people had the opportunity to develop the service. Arrangements were in place to encourage and promote on-going communication, discussion and openness.