Foresight Residential Limited 66 Leeds Road is a care home for ten adults with a learning disability and / or autistic spectrum disorder who also have sensory impairment. There were ten people living at the service when we visited.

We inspected on 7 June 2017 and the visit was unannounced, which meant the provider did not know we would be visiting.

At the last inspection in January 2015, the service was rated Good. At this inspection we found the service remained good.

Quality assurance checks in place were basic and did not include oversight from the provider. We have made a recommendation that the provider review their approach to quality assurance to include quality checks by them or their representative to ensure quality and safety of the service.

Staff worked within the principles of the Mental Capacity Act in every aspect of their work with people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Records relating to consent or decisions made in people’s best interests required development.

Staff had a good understanding of safeguarding and were aware of types of abuse and how to report incidents. They knew the people they supported well which resulted in people feeling safe and behaving in a confident way around staff.

There were robust recruitment processes in place to assist the manager in making safe decisions about who they employed. Staff received appropriate training. They were supported well through regular supervision and appraisal.

People’s medicines were managed safely. Risks to people’s health and safety had been identified and risk assessments were in place to guide staff. Regular servicing of equipment and checks of services such as gas, electric and water took place.

People told us they enjoyed good food and were supported to eat a healthy balanced diet. Where needed people’s nutrition was monitored by staff. People had good access to healthcare professionals to support all of their health needs.

The environment supported people’s needs and their personal space reflected their preferences and personalities. We saw that people mattered to staff and staff respected their privacy and dignity. People’s preferences were taken account of when planning their care and they could choose how that care was delivered.

Although care plans would benefit from being updated people’s needs were assessed and care plans reflected people’s preferences regarding their care and how they liked to spend their time. People had activities they took part in that were individual to them. Where they had friends or family they were supported to maintain those relationships in a meaningful way.

This inspection took place on 8 January 2015 and was unannounced.

The last inspection of this service was on 17 November 2013 and at that time the home was meeting all the regulations we inspected.

66 Leeds Road provides care and accommodation for up to 10 adults with a learning disability who may also have a sensory impairment and / or a physical disability. The home is in a residential area, close to Harrogate town centre and provides good access to local services and amenities.

It is set in private gardens, with car parking to the front of the home.

The home has a registered manager. 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 spoke positively about the home and said they liked the staff. They knew who they could speak with if they were worried or upset. People’s families told us the service was excellent on all counts and they had a high level of confidence in the registered manager and staff team.

Policies were in place for staff to identify potential risk and we found that appropriate steps were taken to minimise any risks that were identified.

Staff were aware of local safeguarding protocols and knew what action they should take to safeguard people in their care.

Staff were recruited safely and had received training to fulfil their roles and responsibilities appropriately. Staff worked flexibly to make sure there was always enough staff working at times to support people to follow their interests and pursuits.

Suitable arrangements were in place to support people take their medicines safely.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People’s nutritional needs were met. The timing of mealtimes was flexible to meet people’s preferences and we saw that people were offered choice in the food they were offered.

People received the health care support they required and had access to a range of professionals such as nurses, psychologists, optometrists and the speech and language therapy (SALT) team.

Effective managements systems were in place to assess the quality of the service and promote people’s wellbeing. People were supported to make choices about their lives and to maximise their independence. Information about the home was provided in an easy read format with pictorial symbols, large print, audio disc and braille.

During our visit we spent time observing how people were being cared for. We also spoke with people who were able to share their views and talked with the staff on duty. We observed staff supporting people in an appropriate manner, providing reassurance and support to those who needed it. One person told us, "We are looked after really well in this home.”

People's needs were assessed and their rights were respected by the staff. We saw that people were encouraged to make their own decisions or were supported by the staff to consider options available to them. We observed staff treating people in a dignified way and with understanding and kindness. We saw that people were supported to maintain their independence and observed a warm and friendly rapport between those living and working at the home.

People had care plans and risk assessments in place, which helped staff to understand and meet their needs.

We found people who used the service were safe and staff were aware of how to recognise and report any concerns about people’s safety and wellbeing. We saw staff were supported to maintain and develop their knowledge, abilities and skills.

We saw that there were sufficient staff on duty. Staff received training to ensure that they had the skills they needed to be able to look after people safely and competently. Staff told us they received plenty of training and that it was good. One member of staff told us, "We work together as a team. There is always someone to ask for guidance if you are unsure.” Another member of staff told us, “Our training is up to date; the manager makes sure we receive updates.”

There were quality monitoring systems in place, which included relatives and staff giving feedback about the care and treatment provided and routine audits (checks). This gave a good overview of the quality of the service and provided feedback which if required, could be acted upon by the provider. This also meant that the quality of the service was being kept under review.

We spoke with four people who lived at the home, who all spoke highly of the service, with comments including “it’s a nice place and I’m happy living here” and “the staff know me well and I get on with everybody”.

We also spoke with two visiting relatives who were positive about the service, saying “It’s fantastic, I’ve never had cause to complain in all the years my relative has lived here” and “I can tell my relative is happy here, and the staff do more than their duty”.

We observed that staff interacted with people living at the home in a relaxed, friendly manner.

We looked at the care plans for three people who live at the home. Records for each person showed that the home had carried out sufficient assessment of the needs of each person, to enable appropriate care and support to be given.

Staff told us they enjoyed working at the home, and had been given sufficient training to enable them to feel confident in their roles. Training and staff records showed that staff had suitable qualifications and skills, and that appropriate character checks had been carried out prior to a person being employed.

We looked at medication administration records and checked some people’s medication to make sure that the records were correct. In general, the home had sufficient procedures in place to ensure medication was managed safely.

People said they were happy to be living at 66 Leeds Road. One person said "It's what I want to do." They also told us they are involved in the planning of their care and are allowed to choose what they want to do during the week.

People told us that they were very happy with the care they were receiving. They also said if they wanted anything, they would ask the staff who would sort it out for them.

People said they felt safe in the home.

People said they were happy with the staff and the care that they provided. One person told us that "The staff are very caring" and another said "They are great."

People told us they were happy with the service and knew how to raise issues, should they have any. They also said the manager and members of staff were happy to see and talk to people at any time about anything.