14 Church Road is a bungalow in the residential area of Wawne on the outskirts of the city of Hull. It has two bedrooms, a lounge, a dining area and a kitchen. It provides a service to a maximum of 2 younger adults with autism or learning disability.

At the last inspection on 11 August 2015, the service was rated Good.

At this inspection we found the service remained Good.

People were supported by staff who understood the importance of protecting them from harm. Staff had received training in how to identify abuse and report this to the appropriate authorities.

Staff who had been recruited safely were provided in enough numbers to meet the needs of the people who used the service.

People were provided with wholesome and nutritionally balanced diet which was of their choosing.

Staff were provided with training in how to meet people’s needs and were supported to gain further qualifications.

People were supported to access health care professionals when needed.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff had a good understanding of people’s needs and were kind and caring. They understood the importance of respecting people’s dignity and upholding their right to privacy.

People were supported to enjoy a wide range of activities of their choosing that included individual group and holiday events.

People received care which was tailored to their individual needs.

People who used the service, and those who had an interest in their welfare and wellbeing, were asked for their views about how the service was run.

Regular audits were carried out to ensure the service was safe and well run and quality assurance meant the service was evaluated and improved for people.

Further information is in the detailed findings below.

This inspection took place on 11 August 2015 and was an announced inspection. Due to the size of the service the people living in the service and the manager may have been unavailable if the visit was unannounced. We therefore gave the service short notice of our visit.

We previously visited the service on 4 December 2014 and we found that the registered provider did not meet the regulations we assessed. There was a breach of Regulation 20 of the Health and Social Care Act 2008, and a breach of Regulation 10 of the Health and Social Care Act 2008. The 2010 regulations were replaced by the 2014 regulations on 1 April 2015. Therefore regulations 20 and 10 were both replaced by regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014.

14 Church Road is a bungalow in a residential area of the city of Hull. It has two bedrooms, a lounge, a dining area and a kitchen. It provides a service to a maximum of 2 younger adults with autism or learning disability.

The registered provider is required to have a registered manager in post. On the day of the inspection there was a manager registered by 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.

We found that people were protected from the risks of harm or abuse because the registered provider had effective systems in place to manage issues of a safeguarding nature. Staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.

Staff had been employed following the service’s recruitment and selection policies to ensure that only people considered suitable to work with vulnerable people had been employed. We saw that there were sufficient numbers of staff on duty to meet people’s needs.

Medicines were administered safely by trained staff and the arrangements for ordering, storage and recording were appropriate.

People’s nutritional needs had been assessed. We saw there was a choice available at mealtime and we saw that people had been consulted about food and drink .

People had individual care records, which focused on them as a person. We saw that people could choose how they spent their time. The care we observed throughout our visit demonstrated a real person centred ethos.

There had been no formal complaints made to the service during the previous twelve months but there were systems in place to manage complaints if they were received.

Staff told us that they thought the service was well led. The quality audits undertaken by the service were designed to identify any areas of improvement to staff practice that would improve safety and the care provided to people who lived at the service.

The inspection took place on 4 December 2014 and was an announced inspection. We gave short notice of our visit. This was due to the nature and size of the service and that the manager and people living in the home may be unavailable if we had visited unannounced.

The last inspection of this service was on 15 April 2013 when the service was meeting all of the relevant requirements.

14 Church Road is a bungalow in a residential area. It has two bedrooms, a lounge, a dining area and a kitchen. It provides a service for up to two to younger adults with autism or learning disability.

There was not a registered manager in post, although an application for this has been received by the commission. A registered manager is a person who has registered with the Care Quality Commission (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 and associated Regulations about how the service is run.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS are part of the Mental Capacity Act 2005 (MCA) legislation which is designed to ensure that the human rights of people who may lack capacity to make decisions are protected. The manager told us how the one person living in the home had been supported with this.

Improvements were needed to some of the documents and paperwork held within the home to ensure these were up to date and complete. This was a breach of regulation 20 of the Health and Social Care Act 2008 and you can see what action we told the provider to take at the back of the full version of this report.

The quality assurance systems required improvements to make sure they were effective in reviewing the systems in the home when meeting people’s needs. This was a breach of regulation 10 of the Health and Social Care Act 2008 and you can see what action we told the provider to take at the back of the full version of this report.

Systems were in place to support people to take risks in their lives and to be protected from harm.

People were supported by staff who had had been checked to help make sure they were suitable to work with vulnerable people.

People were supported by the right amount of staff and this had been determined based on their individual needs.

People were supported with any medication needs although some improvements were required with the paperwork and policies for this.

People were supported by staff who received an induction and training to help them have the skills and knowledge to support people effectively. However, paperwork for this required improvement.

People were supported with the meeting of their dietary and health needs. Although some minor improvements were required with the paperwork for this.

We observed staff to be polite and caring. Feedback was that staff had developed positive relationships with the person.

People’s individual choices and decisions were respected and people were treated with respect and dignity. Staff had a good knowledge of the individual’s needs and preferences. They supported the person to make choices in their daily life and to undertake their preferred activities.

Systems were in place for people to be consulted about the home and staff felt there was a good culture.

As part of this inspection we looked at two previous concerns. Previously agency staff had not received the correct induction and training to ensure that they could safely meet the person’s needs. We saw records and staff told us how the provider ensured that they only employed staff with the correct skills to be able to support the person.

The person who lived in the home told us that they were happy with the support they received and that staff were polite to them.

We observed that the person who lived in the home was supported to be independent and make decisions about their everyday activities and needs.

Staff reflected a good knowledge about the individual and their needs, informing us that the person would tell them their needs and also that they would find this information in their care plan.

We saw that the person was supported through a person centred approach to care planning, although these files required some organisation.

Staff had been trained in and had a good knowledge of handling potential abuse issues. Additionally staff had attended a variety of training and felt well supported.

There was a quality assurance system in place that ensured that regular health and safety checks were completed in the home. However, surveys of people who lived in the home and their representatives had not been completed. Consequently the provider may not be aware of their opinions on how well they felt the service was meeting the person’s needs.

We spoke with the person who used the service. They told us they had received support from several members of staff but in recent weeks the support had been provided by three agency staff. The person told us the staff treated them with respect and they were free to make choices about their lives. Comments included, “The staff are great, they come outside and have a cigarette with me, take me to the pub and give me space when I need it.”

The person who used the service told us staff supported them to complete domestic tasks such as cleaning their bedroom, laundry, grocery shopping and cooking meals.

The person who used the service told us they had visited their doctor and community nurse. They said they received their medicines on time.

We found that not all staff had the relevant training, knowledge and experience in specific areas such as safeguarding adults from abuse and the conditions affecting the person who used the service. We also found that a risk assessment and management plan covering behaviours that challenged the service had not been completed. This meant the person who used the service was not protected from harm and staff did not have guidance in how to manage a difficult situation.

We found that as the service was new questionnaires had not been completed. However, the company had a quality assurance process that consisted of questionnaires and audits of the systems used in the service.