This inspection took place on 22 November 2017 and was unannounced. The service was previously inspected on 13 October 2016 and was at that time not meeting the regulations related to good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question well led to at least good. We found improvements had been made at this inspection to meet the relevant requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

St Anne's Community Services - Dewsbury 1 (known to staff, people who used the service and their relatives, as Oxford Road) is a ‘care home’. People in care homes receive accommodation and nursing or 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.

The home provides support and personal care for up to five adult’s aged18 upwards with a learning disability. The service is on the outskirts of Dewsbury town centre, which is easily accessible by public transport. On the day of our inspection there were five people living in the home.

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.

At the time of this inspection the service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 told us they felt safe. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence. Robust emergency plans were in place in the event of a fire or the need to evacuate the building.

A system was on place to ensure medicines were managed in a safe way for people.

Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse.

Sufficient staff were on duty to provide a good level of interaction and safe recruitment and selection processes were in place.

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 home supported this practice; mental capacity had been assessed when some decisions needed to be made, however, some best interest processes had not been evidenced. We made a recommendation about good practice where people may lack mental capacity to consent to certain decisions.

Staff told us they felt supported. Records showed they had received an induction, role specific training and regular supervision and appraisal. This meant staff were supported to fulfil their role effectively.

People told us they enjoyed their meals. People’s nutritional needs were met and they had access to a range of health professionals to maintain their health and well-being.

The service worked in partnership with community professionals and used good practice guidance to ensure staff had the information they needed to provide good quality care.

Staff were caring and supported people in a way that maintained their dignity, privacy and diverse needs. People told us staff were caring and we observed staff interacting with people in a caring, respectful manner. Observation of the staff showed they knew people well and could anticipate their needs.

People were supported to be as independent as possible throughout their daily lives.

People were involved in arranging their care and support and staff facilita

This inspection took place on 13 October 2016 and was unannounced. This meant the registered provider and staff did not know we would be visiting. The service was previously inspected in 12 September 2013 and was found to be compliant with all of the regulations inspected. During this inspection there were five people using the service.

St Anne’s Community Services, Dewsbury 1 is registered to provide accommodation and personal care for up to five people aged 18 and over with a learning disability. Accommodation is provided over two floors with a lounge and dining room with seating areas and people can choose to spend their time in one of the communal areas or in their own room. The service is situated in attractive grounds and is on the outskirts of Dewsbury town centre, which is easily accessible by public transport.

The service had a registered manager 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. The registered manager was on holiday during this inspection and the service deputy manager supported us throughout the inspection.

We found that there was a quality assurance system in place, but this had not highlighted the concerns we found during the inspection with risk assessing, care planning and risks associated with the home environment. This was a breach of Regulation 17 (2) (a) (b) (e) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.

The registered provider had a system in place for ordering, administering and disposing of medicines and this helped to ensure that people received their medicines as prescribed. However, some improvements were needed in the way that medicines were stored and recorded.

There was a system in place to complete individual risk assessments for people who used the service although we found these had not always been implemented in response to their needs.

We found staff were recruited safely and were employed in sufficient numbers to meet people’s needs. Staff had access to induction, training, supervision and performance development reviews (PDR) which supported them to feel skilled and confident when providing care to people.

We found there were policies and procedures in place to guide staff in how to safeguard people who used the service from harm and abuse. Staff received safeguarding training and knew how to protect people from abuse.

People told us they were very happy with the food provided. We observed people’s individual food and drink requirements were met and people were supported to access healthcare professionals where necessary.

Staff understood and were working within the principles of the Mental Capacity Act 2005.

Staff were observed to be, and described by people using the service as, kind and caring. We observed that staff had developed meaningful caring relationships with the people they supported.

People told us that staff listened to them and treated them with dignity and respect.

People’s needs were assessed and their care plans set out how these should be met. Plans reflected people’s preferences and focussed on giving people as much independence as possible. Staff were knowledgeable about people’s support needs and their interests and this enabled them to provide a personalised service.

People who used the service were supported where necessary to undertake a variety of activities within the local community.

People told us they knew how to express concerns or make a complaint, and they were confident their concerns would be listened to. There was a process in place to manage complaints that were received by the service.

We receive

We looked at the care records of three people who used the service. We found people's needs were assessed and care was planned and delivered in line with their individual plan.

We saw that the menu planning showed choice and variety were offered to people. We saw people had unrestricted access to the kitchen and could help themselves to drinks and food, including fruit, throughout the day.

We observed that the home was clean and did not have any unpleasant odours. We saw there were cleaning schedules in place which detailed the standard of cleanliness required and the frequency of cleaning.

We looked at three staff files and found evidence to show appropriate training was provided to staff. The staff we spoke with told us they received regular training and said they could ask for further training if they felt this was needed.

The provider had systems in place to identify, analyse and review risks or incidents. Information about quality and safety was gathered and monitored to identify risks and areas for improvement.

The people who used the service told us that they found the staff treated them well. We saw the staff in the home treated people with respect and dignity. The staff were respectful of peoples rights to choose and were keen to ensure that all people in the home were given options in what activities they chose and how they wanted to be supported.

We found that staff in the home involved people as much as possible in care planning and although this was well documented it was not clear from one of the plans whether anything had been done to meet all of the needs of the people using the service.

The staff we spoke to told us that they felt that the personal care of people using the service was increasing, especially around mobility. The provider may want to start addressing this issue as the people living in the home are getting older and their physical and personal care needs will start to increase.