Hudson Street is one of 14 services owned by Milewood Healthcare Limited. The service provides accommodation and personal care for up to 12 people with learning disabilities or autistic spectrum disorder. Accommodation is provided in two adjacent terraced houses in the seaside town of Whitby on the North Yorkshire coast. On the day of inspection, there were 12 people living at Hudson Street.

The service had 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.

This inspection took place on 25 October 2016. At our previous inspection on 11 June 2015, we saw that people were not safe because there was inadequate maintenance and a lack of cleanliness. In addition, audits carried out had not identified these as areas for improvement.

At this inspection, improvements had been made and the service was safely maintained and clean. Audits had improved and the registered manager had drawn up action plans arising from the results of these.

Medicines were safely handled to protect people. The registered manager assessed risks in consultation with people and plans were put in place to minimise these. Risk plans were subject to regular review with people involved.

Staff were able to tell us what they would do to ensure people were safe and people told us they felt safe at the service. The service had sufficient suitable staff to care for people and staff were safely recruited.

The environment was safe for people, though their individual rooms were at times disorganised and cluttered which could lead to risks around fire safety and trip hazards. However, staff explained they worked alongside people to support them to maintain their environment safely and we saw that they intervened when necessary to protect people.

People were protected by the infection control procedures in the service.

Staff supported people appropriately when they had behaviour which may challenge others and they consulted with people about their risk plans.

Staff had received suitable training to ensure that people received care appropriate for their needs.

Staff had received up to date training in Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff understood that people should be consulted about their care and they understood the principles of the MCA and DoLS. People were protected around their mental capacity.

People’s preferences around food and drink were recorded. People were supported to eat healthy meals and they told us they enjoyed the food. Specialist advice around people’s nutrition, medical care and mental health needs was sought and advice was followed.

People were treated with kindness and compassion. We saw staff had a good rapport with people whilst treating them with dignity and respect. Staff had knowledge and understanding of people’s needs. Care plans provided detailed information about people’s individual needs and preferences. Records and observations provided evidence that people were treated in a way which encouraged them to feel valued and cared about.

People were supported to engage in daily activities they enjoyed and which supported them towards independence. Daily activities were in line with people’s preferences and interests. Staff were responsive to people’s wishes and understood their personal histories and social networks so they could support them in the way they preferred. Care plans were kept up to date and reviewed each month. People were given opportunities to take part in drawing up their care plans, their reviews and to give their views which were acted upon.

People told us their complaints were responded to and the results of complaint investigations were recorded. Everyone we s

This inspection took place on 18 June 2015 and was unannounced. The last inspection was on 11 June 2013 and no breaches of regulations were identified at that inspection.

Hudson Street is one of fourteen services owned by Milewood Healthcare Limited. The service provides accommodation and personal care for up to 12 people with learning disabilities or autistic spectrum disorder. Accommodation is provided in two adjacent terraced houses in the seaside town of Whitby on the North Yorkshire coast. On the day of our inspection there were 12 people living at the service.

There was a registered manager employed at this service. 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 the service was not always cleaned to a high standard which was a breach of Regulation 12 of the Health and Social Care Act 2008(Regulated Activities) 2014. You can see what action we told the provider to take at the back of the full version of the report.

We also made a recommendation that the provider should look at good practice when auditing the service as the issue of cleanliness was not identified and addressed properly.

Staff were recruited safely and there were sufficient numbers to meet people needs. They had been trained in subjects that were relevant to their roles.

Care and support was person centred and there were plans and risk assessments in place which reflected this. Medicines were managed safely. People had access to health and social care professionals when it was necessary.

People had a choice of what they wished to eat and were supported to prepare food if necessary. They could eat wherever and whenever they chose.

People’s safety was taken into account by the service because the registered manager had ensured that staff were aware of abuse and how they could recognise and report any events.

The service worked within the principles of the Mental Capacity Act 2005.Peoples consent was sought when appropriate and this was recorded in care records. Deprivation of liberty safeguards had been authorised in some cases and these were reviewed in line with current guidance.

Staff were friendly and respectful. They supported people who used the service to undertake a variety of activities within the local community.

We observed the culture of the service to be caring and person centred.

We saw that people were able to make their own decisions. We spoke with an advocate and a health care professional on the day of inspection. They told us that staff were very knowledgeable about the people they were supporting. The advocate told us that people were directed towards the advocacy service if they needed support in making decisions. Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005.

We saw that care and support was delivered in a way that ensured people remained safe whilst looking at their goals. People who used the service told us they could confidently discuss their plans and the actions being taken to meet each goal. From the care files and discussion with the staff, we confirmed that a wide range of healthcare professionals provided support.

We saw that medication was managed appropriately and in a safe way.

The environment was properly maintained and any necessary repairs were carried out once they had been identified. There was a fire risk assessment in place and the fire exits were clearly signed. Staff told us they received regular training in fire safety.

There was a comprehensive system for looking at the quality of the service provided. Regular audits of the system were carried out by the manager and by people from outside the service. Actions identified during the audits formed part of the service business plan. This meant that the service continued to develop.

During the visit, we spoke with four people who used the service and we asked specifically about the choices they were offered, what the care was like, and what people thought about the staff. One person told us that they felt safe and staff supported them when they had seizures. Another person said “I love it; I have been here eight years.”

People told us how moving to the home had been a wise decision, as they had learnt skills that would assist them to live independently in the community.

We spoke with a healthcare professional who visited the home. They said the service provided positive, consistent care with good outcomes for people.

People living at Hudson Street said that there was always a member of staff available to help them. One person said 'the staff are all nice' and 'you can have a laugh with them' another person said 'I like living here, you can get out and go to places' Another person said 'I can’t go out without a member of staff but they always make sure I can get out when I want to' People told us that they enjoy a varied social life and go out into the local community. They said they can do things as part of the group or on their own and staff helped them with this.