The inspection visit took place on 19 May 2017 and was unannounced. We returned to speak with the provider on 01 June 2017, as they were out of the country at the time of our inspection.

The last comprehensive inspection of this service was carried out 15 December 2014, at which time we found the provider was meeting legal requirements.

During this inspection, we found the provider had continued to meet legal requirements and, as such showed consistent good practice.

Mr David Calwell – 13 Durham Avenue is a small home registered to provide care and accommodation for up to three persons who live with learning disabilities. The home is situated in a residential area of St Annes close to the sea front and within walking distance of a number of facilities and amenities. At the time of our inspection, three people were living at the home.

The provider understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they knew how to work within the law to support people who may lack capacity to make their own decisions. However, they had not recorded assessments of people’s capacity to make decisions. Additionally, decisions, which had been taken in people’s best interests, had not been recorded. We have made a recommendation about this.

We found the provider had systems to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

We looked at the recruitment of two staff members. We found appropriate checks had been undertaken before they had commenced their employment confirming they were safe to work with vulnerable people.

Staff spoken with and records seen confirmed an induction and training programme was in place. Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and social needs.

Individual risk assessments had been completed for people who lived at the home. This helped to ensure risks had been identified and measures put in place to reduce risks to people’s safety and wellbeing.

The environment was maintained, clean and hygienic when we visited. We saw staff followed infection control guidelines.

We found sufficient staffing levels were in place to provide support people required. We saw staff members could undertake tasks supporting people without feeling rushed.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were stored appropriately.

People’s nutritional needs were met by staff who knew their individual needs, likes and dislikes. People told us they were satisfied with the meals staff prepared for them.

The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they were happy and had no complaints.

Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

We found people had access to healthcare professionals and their healthcare needs had been met.

We observed staff supporting people with their care during the inspection visit. We saw they were kind, caring, patient and attentive.

The provider used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys and care reviews. The provider also spent time with each person who used the service every week. We found people were satisfied with the service they received.

We inspected 13 Durham Avenue Cavendish Road on 15 December 2014. This was an unannounced inspection which meant the staff and provider did not know we would be visiting.

Durham Road is a home for up to three people with learning disabilities. It is located in Lytham, close to amenities and with good transport links. The inspection was unannounced.

People using the service are protected from abuse because the provider has taken steps to minimise the risk of abuse. Decisions relating to people’s care are taken in consultation with people using the service, their next of kin and other healthcare professionals which ensured their rights were protected.

There were enough staff available at the service and staffing levels are determined according to people’s individual needs. We saw that extra staff are provided where people’s needs change and they require extra support.

Staff receive training that is relevant when supporting people with learning disabilities. Staff are supported through strong links with community healthcare professionals to ensure people receive effective care relating to their diet and their on going healthcare needs.

There was a friendly, relaxed atmosphere at the home. People told us they enjoyed living there and their relatives told us that staff were caring and compassionate. People are able to take part in activities that they enjoy and receive support from staff if required.

Where people using the service lack capacity to understand certain decisions relating to their care and treatment, if appropriate, best interest meetings are held which involve family members, independent mental capacity advocates, and social workers.

We looked at the systems for medicines management and saw that the records relating to medicines held at the home are accurate and up to date. People receive the correct medicines at the right time. Staff working at the home receive appropriate training in the area of medication administration.

Three people living at the service were at the home when we visited. They were welcoming and wanted to talk with us throughout the inspection. Two staff members on duty were also present at the service and we spoke with them throughout the visit.

During the inspection we looked at how people’s needs were being reviewed and risks were being managed. We looked at the records of people living there to see how this was being done. One person wanted to show us their plan of care. Records showed people needs were being reviewed and risks managed. Staff told us residents had been living at the home for a number of years and they had a good understanding of their individual needs, likes and dislikes. Comments included, “We update the records regularly, especially when there are any changes”. Also, “All the staff know peoples needs and get updates all the time. It’s a small home and we have been together for a long time”.

Observations we made confirmed people responded positively with staff and were being supported in a way which suited them. We saw they were able to communicate their wishes with staff members and these were clearly understood. People were moving around the home freely and doing things they wanted to do without restriction.

During the inspection we viewed the environment. We also looked at service and maintenance records. People living at the home showed us around and wanted us to see their individual rooms.

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People living at Durham Avenue had limited communication levels. This did not detract the amount of information we gained about their experiences living there. We used observations between the staff and people using the service, as well as talking to residents and staff members on duty.

There were two staff members on duty at the time of arrival. We had given the home short notice of the visit to ensure they were available on site to carry out the inspection. People changed their plans to go out to accommodate this.

When we arrived the three people using the service were in the dining/ kitchen area. They made us feel welcome and were interested in why we were visiting their home. We talked with all three people throughout the inspection period. People talked to us when we were viewing records and we shared information with them. People were communicating with each other and staff members. It was a relaxed and open atmosphere.

People told us they were looking forward to going out. When we asked a staff member where they were going to go, they told us it was the residents choice and each day could be different.

We spoke to people living at the home, but in view of the limited communication needs of the people who use the service, we relied on observations between the staff and people who use the service, information provided by the staff and the service provider.

We spoke with two staff during our visit, as well as one of the registered providers Staff were very positive about working in the home and praised the teamwork and supportive atmosphere.

People living at Durham Avenue, were able to express their views in their own way and staff were seen to support this.

Information the home provided to us prior to the site review told us they have the necessary policies and procedures in place which are up to date to manage any allegations of abuse, and for the protection of people using the service.

The provider told us they completed in-house assessments which took account of the views and comments of people who use the service, family, relatives and staff

members.

We spoke to staff on duty about how medication is managed. They told us those responsible for medication have received training in this area. "It's only a small staff team and we have all had training on med's".

We were told by staff that they will be all going on holiday soon. Service users were excited about this and told us where they were going. Staff told us the planning and decision making for holidays is done as a group and we saw evidence of this in the care planning record we looked at.