This inspection took place on 9 May 2017 and was unannounced. This meant the provider did not know we would be visiting. The registered manager was not available on day one of the inspection so we completed a second day of inspection on 16 May 2017 when they were available. This day was announced. We last inspected the service on 24 March 2015 and found the provider was rated ‘Good.’ They were meeting all the fundamental standards we inspected against.

Potensial Limited – 2 Belgrave Terrace is based in South Shields in a Victorian terraced house close to the town centre and local amenities. The service can accommodate up to eight people with learning disabilities. At the time of the inspection seven people lived at the home.

There was an established registered manager in post at the time 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.

The administration of routine medicines was managed safely. It was identified that detailed protocols were needed for ‘as and when required’ medicines.

People’s support hours had been individually commissioned and staff rotas reflected this. The staff team was well-established and there had been no recruitment since the last inspection. A procedure for safe recruitment was in place.

Risk assessments were in place which mitigated risk, and staff understood how to safeguard people from abuse. Care plans were person centred, and detailed. We found one care plan for one person which lacked detail but staff had the necessary knowledge to ensure the person was safe.

Staff training was up to date, and they had completed training in relation to the specific needs of the people they support, including autism, diabetes and behaviours that challenge.

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 support this practice.

Health action plans were in place and there was evidence that people were supported to access relevant healthcare professionals.

People were involved in meal planning and were encouraged and supported to choose a healthy, well balanced diet.

We observed warm and caring relationships between people and staff. There was a welcoming atmosphere, and lots of laughter and fun was shared between people and staff. Staff were respectful when speaking with people and engaged them in day to day activity.

Some people attended day services for some of their week, whilst another person had a voluntary job. Other people were actively choosing how they spent their time.

Complaints were recorded and investigated.

A range of quality audits were completed by the registered manager who had assessed areas such as support plans, risk assessments and behaviour management plans as being excellent. The regional director completed a monthly quality audit which the registered manager used to produce a service action plan. There was also a ‘North East Quality Action Plan.’ This was an organisational plan aimed at improving quality and consistency across all services in the North East.

This inspection took place on 24 March 2015 and was unannounced. This meant the provider did not know we would be visiting. We last inspected the service on 17 December 2013 and found the provider was not meeting legal requirements in relation to safety and suitability of premises. The provider submitted an action plan and we found that appropriate improvements had been made.

Potensial Limited – 2 Belgrave Terrace is based in South Shields in a Victorian terraced house close to the town centre and local amenities. The service can accommodate up to eight people with learning disabilities. At the time of the inspection seven people lived at the home.

There was an established registered manager in post at the time 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 understood safeguarding procedures and policies were available for staff to refer to as needed. People received pictorial, easy read information on abuse and bullying and knew to tell someone if they were concerned.

Accidents and incidents were recorded and monitored. Records included potential triggers for any incidents and any behaviour strategies to assist staff to manage the situation.

Risk assessments were in place and included information on referrals to occupational therapy for mobility assessments or specialist equipment.

Emergency plans were in place and each person had a personal emergency evacuation plan which detailed plans should 2 Belgrave Terrace not be habitable. The fire brigade had been involved with the completion of the fire risk assessment.

Everyone we spoke with said they thought there were enough staff to support people and meet their needs. Everyone was aware that the local authority funded a specific number of one to one support hours for people and staff worked with people to ensure they received one to one support at times where it was of most value to people. For example at the weekend to go out on an activity or to attend social events.

Recruitment procedures were robust and people were involved in deciding who they wanted to support them. References and disclosure and barring service checks were completed before anyone was offered employment.

Staff were trained in the administration of medicines and appropriate care plans and risk assessments were in place. Where people had been prescribed ‘as and when required’ medicines protocols were in place and administration had to be authorised by the deputy or registered manager.

Staff told us they were supported very well and attended regular supervision and team meetings. Annual appraisals were held with people to review performance over the past year.

Training was provided to ensure staff were knowledgeable of the skills needed to support people. This included training in dementia and diabetes as well as infection control, risk assessment and challenging behaviour.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Staff had taken time to explain to one person what having an authorised DoLS in place meant to them and the person understood this and accepted the reasoning behind it.

People said the food was good and they were able to choose what they wanted to eat. We saw people were involved in deciding what shopping was needed and had been involved in the decision to move away from a set menu so people could be actively involved in decision making around choice of meals.

Health action plans and hospital passports had been completed with people which gave a record of healthcare professionals who were involved in people’s care. A community nurse told us, “They are good at referring people.”

People were encouraged and supported to be involved in decision making and we saw information was available for people in a pictorial format using plain English. This included individual charters which explained people’s rights and responsibilities.

Care records were individual to the person and everyone had a person centred plan which recorded their hopes and dreams for the future. People were encouraged to celebrate their achievements.

People were involved in planning their care and signed documents to say they had been included in reviews on a quarterly basis. Outcomes were recorded and people’s progress was noted as achievements.

A pictorial complaints policy was in place and people knew how to complain if they needed to.

The registered manager was seen working alongside care staff to support people and there was a genuine emphasis on team working. Local authority commissioners said, “Staff are very willing to share best practice and learn from others.”

A variety of audits were completed in order to drive quality and service improvement and the registered manager had a clear vision about the need to support people to be independent, active members of the local community.

We spoke with two people and one relative during our visit to 2 Belgrave Terrace and they all said they were happy with the service they received. One person told us “The staff are lovely, they know how to look after me and we have just been out for our Christmas meal”. Another person told us “It’s so quiet and peaceful, they asked me if I wanted to go on holiday to Blackpool but I said no as I love my bedroom.”

A relative we spoke with said the care was “Very good, they look after my relative 24/7, I have no complaints and they manage all of their hospital appointments. The staff are amenable and supportive.”

We found that people were involved in deciding what care and support they needed and they were kept safe from the risk of abuse. People were cared for by staff who were trained and supported to an appropriate standard. The provider had systems in place to identify risks and monitor the quality of service provided.

We found the provider had not ensured that people were protected against the risks of unsafe or unsuitable premises.

We spoke with people who live at 2 Belgrave Terrace, as well as the staff team and the registered manager.

One person told us they "liked living here" and enjoyed spending time in their room "watching DVDs".

Another person told us they had been out at work today and discussed their where they worked and their duties. They also told us they were going out to visit a friend after they had finished their evening tea.

We visited the home unannounced on 31st August 2011 and spoke with a number of the people who live here, as well as members of the staff team and the registered manager.

One of the people living here told us this was the “best place I’ve lived”. They said they enjoyed going out to work and seeing their friends and family regularly. They also enjoyed looking after their own room which they kept very clean and tidy.

Another person told us they were very happy here and liked the staff and enjoyed going on holiday with them.