Mediline Supported Living Swallow Street (known to people as Swallow Street) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Swallow Street provides care and support for up to five adults with a learning disability/or a mental health problem. The house is a purpose-built bungalow within a residential area of Longsight, Manchester. Accommodation comprises of five single occupancy bedrooms and spacious communal areas including a lounge, kitchen and bathrooms. At the time of our inspection the house was fully occupied.

The care service has been developed and designed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection the service was rated good overall with requires improvement in the caring domain. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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.’

Staff received training appropriate to their role and were supported through regular supervisions and annual appraisals.

Medicines were administered as prescribed. People’s health and nutritional needs were met by the service. We have recommended that the service records the daily ambient room temperature, for the room in which the medication is stored (this was visually checked but not recorded).

A safe system for recruiting new staff was in place. The number of staff on duty varied depending on the needs of the people of the people.

At our last inspection we found that not everyone had a Personal Evacuation plan (PEEPS) in place. At this inspection all PEEPS were in place. The service was well maintained and clean throughout.

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

Person centred care plans and risk assessments were in place to guide staff on the support people needed and how to reduce any identified risks. For those who needed support with communication separate communication plans were in use.

At our last Inspection the service was rated requires improvement in caring. During this inspection we saw positive and caring interactions between staff and the people living at the service.

Information about people’s preferences, culture, likes and dislikes was clearly documented.

The registered manager had a thorough auditing system in place to monitor the quality of the service. All incidents and accidents were recorded and reviewed if required. The provider, through the area manager, also undertook quality checks and audits at the service.

We inspected this service on 16th December 2015 and carried out additional checks on the service at a regional office on 23rd December 2015.

This inspection was announced because we were aware that the registered manager was taking a period of planned leave and the people using the service were often out at their daily activities. We needed to be sure that someone would be available to speak with us. The acting manager was given 36 hours notice prior to the inspection taking place.

Swallow Street is registered to provide care and support for up to five adults with a learning disability and / or a mental health problem. The house is a purpose-built bungalow situated within a residential area of Longsight in Manchester. Accommodation comprises of single occupancy bedrooms and spacious communal areas including a lounge, kitchen and bathrooms. At the time of our inspection the house was fully occupied.

The registered manager was on a period of planned leave at the time of this inspection. The post was being covered by a registered manager from a similar service and this person was present for most of the inspection.

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.

Staff ratios were adequate to meet the needs of the people living in the home. People were able to access the community with support and pursue their own interests.

We found robust recruitment processes were in place to ensure the right people were recruited to the posts of support worker. Staff accessed mandatory training during their induction along with other relevant specialist training for the role. Staff were also encouraged and supported by the company to undertake courses for personal development and staff spoke highly about the training on offer.

Accident and incident reporting mechanisms were in place and we found medication administration and management was safe. There were appropriate controls and procedures in place to manage and prevent the spread of infections and both the registered manager and acting manager were nominated infection control champions.

Staff had completed training on the Mental Capacity Act and the Deprivation of Liberty Safeguards and best interest meetings were taking place.

Staff were able to tell us about the different preferences of individuals and recognised the importance of this in order to provide person-centred care. We heard people being asked for their consent before receiving support .

Staff had good relationships with people living in the home and treated them with dignity and respect although on occasions staff did not always engage with people and people were left to their own devices. Staff were always friendly, patient and polite in their interactions with people.

Support plans were person-centred and contained relevant assessments of risk tailored to individual’s specific needs. Support plans were up to date and contained sufficient detail to enable staff to meet people’s care and support needs. They contained information about the individual’s personality, their likes and dislikes and preferences around methods of communication.

Personal goals had been identified for individuals and these had been reviewed after a six month time frame. Staff encouraged people to be actively involved in their local community and those that wanted to go out were supported to do this.

People were involved with choosing the décor for their own personal spaces and we saw bedrooms in colours of pink and red with matching accessories and pictures chosen by the individual. People were given choices by staff and staff respected their decisions.

There was a mechanism in place for people to raise a concern or complaint in

Most of the people using the service were unable to communicate their wishes and feelings verbally. However, we did speak with one of the people who used the service. They said they liked living at the home and liked all of the staff. They said, "The staff are nice" and "the staff take me out to places that I like". We observed staff talked with people in a respectful way and they appeared relaxed in the home with the staff supporting them.

People’s emotional care needs were met through a range of social activities provided both in the community and in the home. Arrangements were being made for each person to go on holiday with the support of staff.

Staff consulted with health care professionals such as the person’s GP for advice and guidance when necessary. This meant people’s physical care needs were met.

We spoke with three support workers during the visit. They spoke about people in a respectful manner and had a good knowledge of people’s individual care needs and how they were met.

Staff were trained on how to safeguard people from abuse and harm and knew to report any signs or the suspicion of abuse to a senior member of staff.

A complaint procedure was available to the people who used the service and their relatives so they knew what to do if they were unhappy with the service they received.

We spoke with one of the people who used the service , another person’s relative and a number of health care professionals who regularly supported people in order to obtain their views of the service.

As part of this review of compliance we asked Manchester City Council contract department and LINKs* for their views. LINKs had no up to date information for this compliance review.

One of the people who used the service said she liked living at the home although she said it was noisy. She said, “I like living here. I go out to the day centre during the week and with the staff other days. The staff help me with things and they are all nice."

The relative we spoke with said he was very happy with the way his relative was being looked after. He said the staff are “kind and friendly”. He said, "My relative is very content. She seems very happy and I have no concerns at all. I’m very happy with the way she is looked after. The staff know her well and provide good care."

Visiting health care professionals and Manchester City Council contract department had no concerns to raise about the service. They said the home was well managed and the people who used the service were well supported. Health care professionals said staff were aware of peoples care needs and sought advice appropriately. They said they had developed good working relationships.

*LINKs is a network of individuals and organisations that have an interest in improving health and social care services. They are independent of the council, NHS and other service providers. LINKs aim to involve local people in the planning and delivery of services.