This inspection took place on 25 and 26 October 2017; the first day of the inspection was unannounced. We had previously carried out an inspection at the service in September 2016. During that inspection we found a breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because medicines were not always safely managed. Following that inspection, the provider sent us a plan which set out the action they were taking to meet the regulations. During this inspection we confirmed the required improvements had been made in relation to how medicines were managed in the service.

Whalley Road is a residential care home that provides accommodation, nursing care, support and rehabilitation for up to nine people with a mental illness or learning disability. The home is situated in the Accrington area of Lancashire. Accommodation is provided in single en suite bedrooms.

The service had a registered manager in post. 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 2008 and associated Regulations about how the service is run. The registered manager had been responsible for managing the service since October 2016 and registered with CQC since 11 October 2017.

Staff had received training in safeguarding adults. They were able to tell us of the action they would take to protect people who used the service from the risk of abuse. The registered manager and staff were observed to have positive relationships with people living in the home.

One person who used the service told us they did not always feel safe in the home due to the behaviour of another individual. The registered manager told us they had taken action to involve external professionals and advocacy services in a review of this person’s care and support needs. This should help to ensure people felt safe living in the home.

Systems were in place to ensure staff were safely recruited. People who used the service told us staff provided the right level of support to meet their needs and to achieve their rehabilitation goals.

People were supported to have 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.

Robust systems were in place to ensure the safe handling of medicines. People were supported to take responsibility for their own medicines whenever possible.

Care records we reviewed included information about the risks people might experience. Care plans were in place to help ensure staff provided the level of support necessary to manage the identified risks. Care plans were regularly reviewed to address any changes in a person’s needs.

Regular checks took place to ensure the safety and cleanliness of the environment. People who used the service were responsible for cleaning their own bedrooms, with support from staff as necessary. Systems were also in place to reduce the risk of cross infection in the service.

Staff told us they received the induction, training and supervision they needed to be able to carry out their roles effectively. Staff demonstrated a commitment to providing high quality personalised care for the individuals who lived in the home.

Staff were able to demonstrate a good understanding of the legal frameworks under which people’s placements at Whalley Road were arranged. The registered manager had taken appropriate action to apply for restrictions in place in an individual’s best interests to be legally authorised.

People who used the service were encouraged to participate in activities which met their interests and helped to promote their health and well-being.

Records we reviewed showed that, where necessary, people were provided with support from staff to attend hea

We carried out an unannounced inspection of Whalley Road on the 21 and 22 September 2016. Whalley Road is a residential care home that provides accommodation, nursing care, support and enablement services for nine people suffer from a mental illness. The home is situated in the Accrington area of Lancashire.

The service had a registered manager in post. 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 2008 and associated Regulations about how the service is run.

The service was last inspected in May 2013 and was found to be meeting the regulations applicable at that time.

During this inspection we found the service to be in breach of Regulation 12 (2) (g) of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. This is relating to medicines management and the high number of medicines errors being made. You can see what action we told the provider to take at the back of this report.

The approach the registered manager was taking in relation to addressing medicines errors with staff was not proving to be effective.

During this inspection we received positive feedback from people who used the service, staff members and community professionals. People expressed satisfaction with the service provided and spoke very highly of the staff that supported them, referring to them as “Kind” and “Helpful”.

The provider ensured processes and procedures were in place to maintain a protect and suitable environment for all people using the service and their visitors. Detailed and up to date health/ safety checks and audits were completed on a regular basis. People indicated they felt safe living at the service. Suitable training was offered to staff to ensure they were competent in recognising the signs of abuse and could appropriately and confidently respond to any safeguarding concerns and notify the relevant authorities when required.

Over the two days of the inspection we found the service had adequate staffing levels. People indicated their needs were met appropriately and staff were always present around the service for people to talk to at any time. We observed regular staff interaction to support this.

We found a safe recruitment system in place. Appropriate steps were taken to verify new employees’ character and fitness to work. Following successful appointment to the role the provider ensured a robust induction plan was carried out which ensured staff were equipped with the correct skills and knowledge to effectively support people in an informed, confident and self-assured manner.

We saw the service had created detailed individual risk assessments for all people using the service. These risk assessments included daily living tasks, accessing the community alone and positive risk taking. Mental health and Home Office professionals were liaised with on a regular basis as part of the risk assessment process.

The provider had considered and implemented adequate documentation to support the development of the care planning process and support the delivery of care. Each plan was individual to the person's needs. Effective systems were implemented to maintain independence, by providing a detailed plan covering essential information support staff needed to follow. This ensured clear information was available about people's needs, wishes, feelings and health conditions. Care plans were kept under regular review.

Staff displayed an awareness of the Mental Capacity Act 2005 and had completed appropriate training. Appropriate referrals had been submitted to the local authority by the registered manager.

Staff spoken with were aware of the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may

We spoke with three people who used the service. All of the people we spoke with were very happy with the care they received. One person told us “They look after you very well here”. Another person commented, “The support I get here is marvellous”.

People were provided with care plans which were reviewed regularly and updated when required. People said they felt safe living in the home and were able to discuss concerns or issues with the staff if they wished to. We saw that the people using the service were involved in planning their care and are in control of how their support is provided for them.

Risk assessments were reviewed regularly in respect of the environment so that people and staff were safe.

Staff received training and supervision to enable them to carry out their roles effectively and care for the people they supported

People told us they were satisfied with the quality of care and support they received. We were told the staffing levels were sufficient to meet the needs of people and that the staff were professional, caring and friendly.

Three of the people we spoke with made various positive comments about the staff team:

"All of the staff have helped me achieve what I am doing now and will support me in achieving what I want to do."

"The staff have helped me settle in here and assisted me in every way they can.They have gone out of their way to make my life better"

People were provided with care plans which were reviewed regularly and updated when

required. People said they felt safe living in the home and were able to discuss concerns or issues with the staff if they wished to.

We saw that the people using the service are involved in planning their care and are in

control of how their support is provided for them.

Care plans are regularly reviewed so that people have the most appropriate support to

meet their needs and if these needs change, the support they receive is amended to

reflect those needs.

Risk assessments are reviewed regularly in respect of the person's needs, the

environment and behaviour so that service users and staff are safeguarded.