This inspection took place on 31 January 2018 and was announced. We announced the inspection as the service is very small and we wanted to make sure people and staff would be available. We visited the home on 31 January 2018 and we also telephoned a relative on the 2 February 2018.

Frederick Street is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Frederick Street accommodated three people at the time of the inspection.

The service was last inspected on December 2015 and the rating for this inspection was Good. At this inspection we found the service remained Good.

Risks to people arising from their health and support needs as well as those relating to the premises were assessed, and plans were in place to minimise them. We have made a recommendation about fire and evacuation drills.

People received their medicine safely and were supported to access the support of health care professionals when needed. The provider had taken steps to minimise the risk of abuse because staff knew how to identify and report it.

There were enough staff to meet people's needs. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Staff told us they received training to be able to carry out their role. Staff received effective supervision and a yearly appraisal. We have made a recommendation about training.

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 received a varied and nutritional diet.

The interactions between people and staff showed that staff knew the people really well.

Care was planned and delivered in way that responded to people’s assessed needs. Care plans contained detailed information about people’s personal preferences and wishes as well as their life histories.

The management team were approachable and they and the staff team worked in collaboration with external agencies to provide good outcomes for people. Processes were in place to assess and monitor the quality of the service provided and drive improvement.

Further information is in the detailed findings below.

The inspection took place on 7 December and 21 December 2015. The first day of the inspection was unannounced which meant that the staff and registered provider did not know that we would be visiting. We informed the registered provider of our visit on 21 December 2015.

We last inspected the service in January 2014 and found that it was not in breach of any regulations at that time.

Real Life Options - 2 Frederick Street provides residential care and support for up to three people who live with a learning disability. 2 Frederick Street is a purpose built bungalow. People who use the service live in one half of the building; in the other half of the building (4 Frederick Street) the registered providers run a supported living service Externally there is a well maintained and specially adapted garden. 2 Frederick Street is situated close to local amenities within a 5 minute walk to the town centre and a 15 minute drive to a large retail park which has a cinema, restaurants and bowling.

The home had a registered manager in place. 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 the time of our inspection the registered manager for the service was also acting as a divisional manager for the provider. We were told that this was a temporary arrangement that had been formally put in place from 1 June 2015 and was due to cease in January 2016. Whilst the registered manager was performing this additional role a senior member of staff from had been tasked with overseeing the day to day running of the home. The registered manager still had regular involvement and visited the service at least once or twice a week.

During our inspection we saw that people were relaxed and smiling and engaged with staff in a positive way. From our observations it was clear that staff knew the people who lived at the service well and we saw that they responded to their care needs accordingly.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of the action they should take if they suspected abuse was taking place. Staff were aware of whistle blowing procedures and all said they felt confident to report any concerns without fear of recrimination. The registered provider has a whistle blowing hotline and information regarding this was clearly displayed within the home.

We looked at care plans and found that they were written in a person centred way and included easy read documents and pictures. The care records we viewed showed us that people had appropriate access to health care professionals such as dentists and opticians. We saw that individual risk assessments were not in place in place to cover all of the key risks specific to the person however we saw evidence that this was addressed following our visit.

We observed that people were encouraged to be independent and to participate in activities that were meaningful to them. We saw people having their nails painted and engaging in craft activities during our inspection. We were also told that in good weather people enjoyed spending time in the garden. People were supported to go out into the local community and during our visit one person went to a local shop with staff.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken prior to staff starting work. The checks included obtaining references from previous employers to ensure that staff were safe to work with vulnerable people.

Staff received appropriate training and demonstr

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

People living at the home had complex needs and were not able to communicate verbally their views and experiences to us. We were able to observe people’s experiences of living in the home and their interactions with each other and the staff. During our visit we observed that care was provided in accordance with people’s care plan, particularly in relation to communication and management of behaviour.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We found that where people did not have the capacity to consent, staff worked in line with legal requirements.

We found that people experienced care, treatment and support that met their needs and protected their rights. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Staff had received appropriate professional development, and, from time to time, were enabled to obtain further relevant qualifications. The provider had in place a complaints procedure and comments and complaints people made were responded to appropriately.

We were not able to gain the views of people who used the service. During our inspection visit we observed care, talked to staff and reviewed the care records.