St Anne’s Community Services - Boroughbridge Road is a residential care home and provides support for three people with learning disabilities. 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.

The service is provided in a large Victorian style house and located in a residential road close to a range of community amenities and facilities in Knaresborough. At the time of our inspection there were three people living there. A registered manager was in post.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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.

People had risk assessments in place that identified any potential hazards to their well-being. Accidents and incidents were analysed to reduce the risk of reoccurrence. Medicines were stored and administered safely and the premises were well maintained to keep people safe. There were enough staff to meet people's needs and safe recruitment practices helped to prevent unsuitable staff from working at the service.

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 action they should take if abuse was suspected. They were confident the registered manager would address any concerns.

Staff were kind and caring and respected people's privacy and dignity. Care was person centred and people were provided with choice. Staff included people, listened to how they liked to be supported and knew what their preferences were. Staff knew people well and promoted their independence. People are 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 were provided with sufficient food and drink to maintain their health and wellbeing. Staff supported people to access healthcare professionals and services. They also supported people to follow their interests and take an active part in the wider community. There were individual activity plans in place for each person based on their preferences and needs. Staff were aware of people's individual communication needs and used the most accessible means to share information about their support with them.

The registered manager and provider monitored the quality of service provided to ensure that people received a safe and effective service which met their needs.

Further information is in the detailed findings below.

This inspection took place on 10 December 2015 and was announced. The last inspection took place in August 2014 when the service was found to be meeting the Regulations.

St Anne's Community Services – Boroughbridge Road provides residential care and support for up to three people with a learning disability. The service is located in a residential road close to a range of community amenities and facilities in Knaresborough. At the time of our inspection there werethree people living there.

A registered manager was in post. 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.

St Anne's Community Services - Boroughbridge Road provided good care and support for the people that lived there. People were encouraged to lead fulfilling lives in line with their own preferences and choices. The emphasis was on supporting people to be as independent as possible. People were involved in making decisions about their care and how the service was run. Each person had an advocate who supported them in expressing their views. Care and support plans contained clear and up to date information about how people wanted their needs met. There were good opportunities for people to discuss any concerns or ideas that they had.

People were supported in having their day to day health needs met. Health services such as dentists, GPs and opticians were used as required and there were close links with other services such as the local North Yorkshire County Council Learning Disability Team.

Staff were knowledgeable about the needs of each person and how they preferred to live their lives. Staff received the training they needed and were supported through regular supervision meetings with the registered manager. There were safe recruitment practices in place for new staff and there were a sufficient number of staff on duty to meet people’s needs.

There were good systems in place to keep people safe. Staff were confident about their responsibilities in relation to safeguarding and also knew who they could contact regarding any concerns they had about the service. There was a positive approach to risk taking so that people could be as independent as possible. Risks in peoples’ day to day lives had been identified and measures put in place to keep people safe. The focus was on how each person benefited from the activity undertaken.

The staff team were aware of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS are safeguards put in place to protect people where their freedom of movement is restricted. All the people at the service had a DoLS authorisation due to the level of supervision provided by staff. Staff had been trained in the MCA and had a good awareness of issues relating to capacity and consent.

The service was well led. The registered manager was responsible for managing other services and so did not spend all their time at St Anne's Community Services - Boroughbridge Road . Staff told us that the service was well managed and that there was good support. The registered manager promoted a culture of respect, involvement and independence. There were good systems in place to make sure that the quality of care was maintained and areas that required improvement were identified and necessary action taken.

One inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with the staff and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Some people who used the service had difficulty communicating and were not able to verbally tell us their experiences. We used a number of different methods to help us to understand their experiences including talking with staff, looking at records and observing the care being delivered.

Is the service safe?

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents. This reduced the risks to people and helped the service to continuously improve.

When people were identified as being at risk, their care plans showed the actions that would be required to manage these risks.

The service had policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Staff received safeguarding and Mental Capacity Act training. This meant people would be safeguarded as required.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in developing their plans of care, wherever possible. From speaking with staff they were able to demonstrate a good understanding of people’s care and support needs.

Suitable arrangements were in place for staff to receive updated training to ensure they had the skills, knowledge and experience to meet the needs of people who used the service.

Is the service caring?

We saw staff were attentive and respectful when speaking with or supporting people. The home had a relaxed and comfortable atmosphere. We saw that there was some good humoured banter between people living at the home and staff. People looked well cared for and we observed good care practices taking place.

Is the service responsive?

People’s needs were assessed and records we looked at showed they received support from health care professionals.

People’s preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Suitable arrangements were in place for staff to receive updated training to ensure they had the skills, knowledge and experience to meet the needs of people who used the service. This ensured that the outcomes for people would continue to improve.

We saw the staff team acted in a professional manner and responded appropriately to people’s care needs. We saw them explain to people what they were going to do and asked permission before they carried out any support or care.

The service carried out annual surveys that included seeking the views of people who used the service. We saw the service used questionnaires in their survey and they had been made available in an easy to read format.

Is the service well-led?

The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better had been addressed promptly. As a result we could see that the quality of the service was continuously improving.

Staff we spoke with were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and the quality assurance systems in place. This helped to ensure that people received a good quality service. They told us the manager was supportive and responsive.

Effective management systems were in place to promote and safeguard people's safety and welfare. For example, health and safety records and peoples care records were up to date and had been reviewed regularly.

We were not able to communicate fully with people living at the home due to their complex communication needs. However we used a number of different methods to help us understand the experiences of people using the service including talking to people and observing the care provided. We saw staff being friendly and warm towards people. People appeared relaxed and comfortable in their surroundings; with staff and the activities they were engaged in. We saw that staff supported people to make choices about their daily living.

We saw from people's care plans that people were supported to live as independently as possible. The home had carried out an assessment of the needs of each person to enable appropriate care and support to be given.

We saw that the people were cared for in a clean, hygienic environment. There were good cleaning routines in place and staff were aware of how to minimise the spread of infection in the home. This was important to help make sure that people were protected from the risk of infection, or other illnesses.

We found that staff overall were well trained and supported to do their jobs well. We also saw that regular checks were carried out by senior management, to monitor the quality of the service.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex communication needs. Our methods included talking to people who use the service, observing the care and support provided, talking to staff and looking at records.

People indicated to us that they were happy and well looked after at Boroughbridge Road. People told us about the things they enjoyed doing with support from the staff, such as going out for coffee, going horse riding, doing jigsaws, gardening and going to local social clubs.

During our visit we observed the way staff interacted and supported people. Staff interacted well with the people using the service. For example, communicating appropriately and asking what people wanted to do. The people who live at the service seemed comfortable and happy with the way staff were supporting them.

People were not able or chose not to tell us about the support they receive. However during our visit we observed people making their own decision to move around the house have a drink. The interactions between them and the staff was positive and supportive.