The inspection took place on 27 September 2017 and was announced.

Salisbury Terrace is registered to provide accommodation for up to three people who have a learning disability and autism who need support with their personal care. On the day of our inspection there were three people living at the service. The accommodation is provided over three floors of a large terraced house in a residential area in the outskirts of Liverpool. Access to the building and upper floors are by way of stairs.

At the last inspection on 2 July 2015 the service was rated Good. At this inspection we found the service remained Good.

The service had a relaxed and homely feel and people could move freely around the service as they chose. People were supported to have maximum choice and control over their lives and participate in activities they enjoyed.

People’s individual needs had been assessed and used to develop support plans. These provided staff with guidance about the care and support people needed and how they wanted this to be provided. People were consulted about their care to ensure wishes and preferences were met. People received their medicine safely and were supported to access the support of health care professionals when needed.

People received a varied and nutritional diet that met their preferences and were also supported to eat out at their choice of restaurants and cafes.

People were supported by a consistent staff team who knew them well. Staff had been recruited safely and had the skills and experience to meet people’s needs and provide effective care. People were protected from the risk of abuse because staff understood how to identify and report it.

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

The management team were approachable and professional and staff felt any concerns would be taken seriously and acted on. 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.

Salisbury Terrace is a small home registered to provide accommodation with personal care for three people. The home is operated by Autism Initiatives, a charity that specialises in supporting people with autism.

The house is rented from Liverpool Housing Trust and is a four bedroom terraced property with accommodation over three floors. Located in a residential area of Wavertree, the house fits in with neighbouring properties and is in keeping with the principle of supporting people to live ordinary lifestyles in their local community. Shared space includes a lounge, dining kitchen, shower room and bathroom. Outside there is an enclosed back garden with some parking available on-street at the front of the house. The people living at the home have a bedroom of their own with the fourth bedroom used as an office and sleep-in room for staff.

This was an unannounced inspection carried out on 13 April 2015. During the inspection we met with the three people who lived at the home and spoke with three members of staff. We also spoke with the 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. Following the inspection we spoke with relatives of two of the people who lived at the home.

We last inspected the home in November 2013. At that inspection we looked at the support people received with meals and their care and welfare. We also looked at the premises, staffing and record keeping. We found that the provider had met regulations in these areas.

The home met the requirements of the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS).

People living at Salisbury Terrace appeared comfortable with the staff team and in their environment. Relatives told us they were happy with the support people received and felt they were happy and safe living there.

Care plans contained comprehensive information to inform staff about people's support needs. This included information about their health, personal goals and how they communicated.

People were supported to choose their meals and were involved in planning, shopping for and preparing their food and drink.

Medication practices at the home were safe. Medication was stored safely and people received their medication as prescribed and on time.

Staff knew how to identify and report any potential incidents of abuse. No referrals for safeguarding adults investigations had occurred since our last inspection in November 2013. A clear procedure was in place for dealing with complaints and relatives told us they would feel comfortable raising any concerns they had.

A system was in place for recruiting new staff to work for the organisation. This included carrying out checks to help ensure the person was suitable to work with people who may be vulnerable.

There was a stable staff team working at Salisbury Terrace who knew the people living there well. Sufficient staff worked at the home to support people with their daily lives.

Staff had received the support and training they needed to support people safely and well.

Quality assurance systems were in place to assess the quality of the service provided and identify area for improvement.

Records were stored safely and were up to date.

During our visit we used a number of different methods to find out what it was like for the people who lived at 12 Salisbury Terrace. We spoke to four people about the home this included the senior support worker, two support staff and a bank support worker. We spoke to two of the relatives of the people who lived at 12 Salisbury Terrace by telephone.

One of the relatives we spoke to told us “They saved his life really, he was very hard to handle, I honestly think what would have happened to him...I can’t speak highly enough of the staff”.

There were three people who lived at the home, they all had complex needs and were unable to contribute to our report.

We observed interaction between all of the people who lived at 12 Salisbury Terrace and staff on duty and it was clear that their needs were well known to staff. It appeared that people living there were happy and content and they were given the support they needed.

We asked staff what it was like working at 12 Salisbury Terrace and one staff member told us:

“I think it’s a really good staff team, everyone works together, pull their weight do equal share”.

During our visit we met the three people living at 12 Salisbury Terrace and spoke with three members of staff. We also spent time observing the support provided to people. Following our visit we spoke with relatives of two of the people who lived at Salisbury Terrace.

Relatives told us that they had been kept informed of relevant information regarding their relative. One relative explained that as far as possible staff had supported people to make their own decisions, where this was not possible they had consulted with relatives.

We found that people had received the support they had needed to meet their personal and healthcare needs. We also found that people had received support to increase their everyday living skills, maintain their hobbies and get out and about in their local community.

Staff had a good knowledge of the individual choices and needs of the people living at Salisbury Terrace and had received the training and support they had needed to undertake their role effectively.

Relatives told us that they had been satisfied with the service provided at 12 Salisbury Terrace. Their comments included, “I can’t speak highly enough of them” and “very pleased”.