This inspection took place on 16 January 2018 and was announced.

Muston Road (the service) is a residential care home for four people with a learning disability or physical disability. It is a large detached property situated on a main road into Filey and is within walking distance of the town centre. There are three large bedrooms and a separate flat with its own facilities. A large private and secluded garden is situated to the rear of the property. At the time of our inspection there were three people who used the service.

People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The service had 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 using the service can live as ordinary a life as any citizen.

At our last inspection, we rated the service good. 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.

At this inspection we found the service remained Good.

The provider had a registered manager in post. A registered manager is a person who has registered with the 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 2008 and associated Regulations about how the service is run.

People were safe and well cared for. The registered manager followed robust recruitment checks, to employ suitable people. There were sufficient staff employed to assist people in a timely way. People’s medicines were managed safely.

Staff had completed relevant training or were booked on a refresher course where needed. We found that they received supervision, to fulfil their roles effectively.

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

People enjoyed good food. Their health needs were identified and staff worked with other professionals, to ensure these needs were met.

People’s independence was promoted. The service provided people with care that met their wishes and choices, whilst protecting their privacy and dignity.

Staff were knowledgeable about people’s individual care needs and care plans were person-centred and detailed. People participated in a wide range of activities within the service and in the community, and they also enjoyed the company of others in the service.

The service was well managed and organised. The registered manager assessed and monitored the quality of care provided to people. People, relatives and staff were asked for their views and their suggestions were used to continuously improve the service.

Events requiring notification had been reported to CQC. The service met all relevant fundamental standards we inspect against.

Further information is in the detailed findings below

This inspection took place on 21 October 2015 and was unannounced. At the last inspection on 20 August 2013 we found the service was meeting the regulations we inspected.

Muston Road provides residential care for up to four people who have a learning disability. On the day of the inspection there were four people living in the home. The home is located in the seaside town of Filey. The home is a large domestic house set within its own grounds with a car park. The gardens have seating areas, an area of lawn with flower beds and raised vegetable beds. The staff office is located upstairs and is an integral part of the home.

The home had a registered manager in post. 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 were not able to communicate verbally with the people who lived at the home. We made observations about care, spoke with relatives and staff and looked at records to make our judgements.

Staff were able to tell us what they would do to ensure people were safe. Health care professionals and relatives said that they felt people were safe at the home. The home had sufficient suitable staff to care for people safely and they were safely recruited. Risks were well assessed with people’s involvement and the service promoted independence. People were protected by the way the service reduced the risk of cross infection and how they handled medicines.

Staff had received training to ensure that people received care appropriate for their needs. Training was up to date in mandatory areas, such as infection control, health and safety, food hygiene and medicine handling and also in specialist areas of health care appropriate for the people who lived at the service. Staff had regular supervision to support them to give care that met people’s needs.

Staff had received up to date training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff understood that people should be consulted about their care and that they should assume that a person had capacity to make decisions. They understood what needed to happen to protect the best interests of people who lacked the capacity to make certain decisions.

People’s needs around food and drink were met and appropriate professional advice had been followed. Staff recognised that meal and snack times were an important social and sensory opportunity and made sure that people’s dining experience added to the quality of their lives. Health care professionals were consulted as necessary and those we consulted with said that the service involved them appropriately and followed their advice.

People were treated with kindness and compassion. Relatives told us that staff went the extra mile and were focused on the individuals in their care. Staff had a good rapport with people while treating them with dignity and respect. Staff had a detailed knowledge and understanding of people’s needs and we saw that people were content and relaxed around staff.

Care plans provided detailed information about people’s individual needs and preferences and how these should be met. People’s care needs were met and their lives were full of interesting activities and pastimes. Staff understood people’s life journeys so far and had a clear understanding of their preferences and future wishes. Staff worked well with people to improve their independence and to expand their experience through supporting them to try new things and to work towards goals.

Complaints and concerns were addressed, and the actions were recorded with plans for future learning to improve the care for people.

Quality assurance systems were in place to improve the care offered in the home.  People who were significant to those who lived at the home felt they and their relatives were consulted about the way the home was managed and that the registered manager and staff maintained close communication with them about changes which affected their relatives.

We saw from the rota’s that there were sufficient staff on duty during the day. Staff told us that, dependent on the number of people in the house there was a minimum of six staff on duty.

Staff told us that the level of staffing ensured that people who used the service were able to go out in to the community twice a day. They told us the number of incidents of challenging behaviour had reduced as the tension in the house had been reduced by ensuring the staffing levels were consistent.

We spoke with two relatives after we visited the home. Both relatives were complimentary about staff and told us they were approachable and kind. One person told us "They have settled in really well, I am very pleased” another person told us “Being here is the best thing that has happened to X”

We saw that people were treated with respect and dignity. Staff offered choices and gave people time to make a decision. We saw that people were able to access the local and wider communities. People were protected from the risk of abuse because staff had received training in safeguarding people. We saw that the manager had dealt with any safeguarding concerns appropriately.

We saw that the home assessed people's care needs and developed care plans which were reviewed. Risk assessments were in place.

On the second day of our inspection we decided to visit the home at 8.45 pm to gain a wider view of the service provided. This was part of an out of normal hours pilot project being undertaken in the North East region..

Staff told us that they were concerned about low staffing levels and that this had affected the care and support people received. They told us that people’s health and welfare had been affected by the shortages. We observed that, despite staff shortages, care staff supported each other to meet the needs of the people who lived at the home, had a good knowledge of people’s care needs and provided individualised care and support.

The home monitored the quality of it's service through surveys and internal systems so that improvements could be identified and put in place.

We spoke with three members of staff and a health professional to help us in reaching a judgement about the care provided at the home. We also looked at the records to support what staff were doing.

We saw that people were encouraged to make day to day decisions for themselves. They were supported to make appropriate decisions when they were not able to do this for themselves. People's individual lifestyles were promoted. A healthcare professional said " The communication between us and the home have been excellent and helped us to make a good placement"

The care plans were comprehensive and included information about their wishes and aspirations as well as the help and support they needed.

We saw that the home was well maintained and there was maintenance programme in place to ensure it remained a safe place to live.

There were enough staff on duty to help people live their own lives. People who lived in the home were relaxed and could access all areas of the home.