We inspected this service on 30 October 2018. The inspection was unannounced and carried out by two inspectors and an expert by experience.

The service is a ‘care home’ operated by Polesworth Group Homes; a non-profit and independent provider of support for people with learning disabilities. The service; 64-66 Long Street consists of two houses which have been converted into one house.

Long Street is one of eight services provided by Polesworth Group Homes Limited. The service provides accommodation with personal care for up to six adults. People in residential care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection visit, there were five people living at the home. The sixth bedroom is used as a staff room and there were no plans for more than five people to live at the service.

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.

There was a registered manager in post. They had been registered with us for this service since 2001. The registered manager was also registered with us to manage the provider’s supported living service and one other residential care home. 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.

At our last inspection in January 2016 we rated the service as Good. At this inspection, we found the quality of the care had been maintained and people continued to receive a service that was caring, effective and responsive to their needs. Whilst the safety of the service was, overall, maintained, some areas of risk management required improvements, and we therefore rated the safety of the service as ‘Requires Improvement’. The overall rating continues to be Good.

Staff were ‘lone workers’ at the service which meant there was just one staff member on shift. The provider’s other services were within close proximity to the service and staff felt they could call upon them, or on-call managers, for support if needed. The provider had recognised people’s care and support needs were changing, as people became older, and shared their future plans with us about staffing arrangements at the home.

Staff had the appropriate levels of skill, experience and support to meet people’s needs and provide effective care. Staff knew people well and, overall, individual risk management plans were in place for staff to follow. However, the provider needed to make some improvements to mitigate potential risks of harm or injury to people. Staff knew what action to take in the event of an emergency.

Staff understood their responsibilities to protect people from the risks of abuse. Staff had received ‘safeguarding’ training and would raise concerns under the provider’s safeguarding policies. The provider checked staff’s suitability to deliver care and support during the recruitment process. Staff received training and used their skills, knowledge and experience to provide safe care to people.

People were encouraged and supported to maintain good health. Staff supported people to access healthcare services whenever needed. People received their prescribed medicines.

Staff had received training in the Mental Capacity Act 2005 and worked within the principles of the Act. Managers understood their responsibilities under the Act and when ‘best interests’ meetings should take place.

Staff

This inspection took place on 14 January 2016 and was announced.

64-66 Long Street is a residential care home designed to support up to six people with a learning disability.

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.

People were comfortable with the staff who supported them. Relatives were confident people were safe living in the home. Staff received training in how to safeguard people from abuse and were supported by the provider’s safeguarding policies and procedures. Staff understood what action they should take in order to protect people from abuse. Risks to people’s safety were identified, minimised and flexed towards individual needs so people could be supported in the least restrictive way possible and build their independence.

People were supported with their medicines by staff that were trained and assessed as competent to give medicines safely. Medicines were given in a timely way and as prescribed. Regular checks of medicines helped ensure any issues were identified and action could be taken as a result.

There were enough staff to meet people’s needs. The provider conducted pre-employment checks prior to staff starting work to ensure their suitability to support people who lived in the home. Staff told us they had not been able to work until these checks had been completed.

The provider had developed a capacity assessment tool so they could assess people’s capacity if this was necessary. Staff and the registered manager had a good understanding of the Mental Capacity Act, and the need to seek informed consent from people before delivering care and support wherever possible.

People told us staff were respectful and treated them with dignity and respect. We also saw this in interactions between people and records confirmed how people’s privacy and dignity was maintained. People were supported to make choices about their day to day lives. For example, they could choose what to eat and drink and when, and were supported to maintain any activities, interests and relationships that were important to them.

People had access to health professionals whenever necessary, and we saw that the care and support provided in the home was in line with what had been recommended. People’s care records were written in a way which helped staff to deliver personalised care, which focussed on the achievement of outcomes. People were involved in how their care and support was delivered, and they were able to decide how they wanted their needs to be met.

Relatives told us they were able to raise any concerns with the registered manager. They felt these would be listened to and responded to effectively and in a timely way. Staff told us the management team were approachable and responsive to their ideas and suggestions. There were systems to monitor the quality of the support provided in the home. The provider ensured that recommended actions were clearly documented and acted upon by undertaking regular unannounced visits to the home.

When we visited 64 Long Street we met and spoke with two people who lived in the home, the deputy manager, the registered manager and a senior support worker.

People we spoke with told us that they were happy in their home. The also told us that they liked the staff that supported. One person commented, "I like the staff, they are very nice."

We saw that relationships between people, staff and the managers were positive and friendly and people appeared relaxed and comfortable in their surroundings.

People had care plans in place that contained information to assist staff with meeting their care and support needs. A staff member we spoke with knew about people's needs and was able to tell us about them. We saw that people were being supported to lead active lifestyles with a variety of outings and activities arranged.

The home presented as clean and tidy, with procedures in place to reduce the risk of cross infection.

Systems were in place to ensure that medicines were managed appropriately on people's behalf.

When we visited 64 Long Street we spoke with each of the five people living there, staff on duty and the assistant manager.

We found that staff knew people as individuals and understood their personal needs and ways of communicating those needs. Staff treated people kindly and respectfully and included them in conversation, asking for their input. We saw that people were relaxed and at ease with staff and within their home environment.

We looked at the care planning documentation for two of the people using the service to see how their care was provided and managed. This was well detailed and up to date. We talked with staff who demonstrated they were aware of people’s care and support needs. Staff said they were trained to help them understand how to meet people’s needs and give the support they needed.

People using the service told us they liked living at the home and felt well cared for. People commented they generally got on well with each other and the staff. One person said, “We mostly get on well with each, I can go to my room if I want to be alone.” Another person commented, “I have no worries, I have friends here and we all get along.”

We spoke with two staff during our visit. Staff were very motivated, caring and positive about working in the home and praised the teamwork and supportive atmosphere.