St Peter’s Row provides accommodation and personal care for up to 15 younger adults with learning and physical disabilities. The accommodation is provided over two floors in a terrace of three houses which link together via corridors both upstairs and downstairs. Each house has its own kitchen, dining room, and lounge. The houses share a large garden. There were 14 people living there at the time of our inspection. At the last inspection in June 2015 the service was rated Good. At this inspection we found the service remained Good and met all relevant fundamental standards.

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm.

Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Appropriate steps had been taken to minimise risks for people while their independence was actively promoted.

There was a sufficient number of staff deployed to meet people’s needs. Thorough recruitment procedures were in place to ensure staff were of suitable character to carry out their role. Staff received essential training, additional training relevant to people’s individual needs, and regular one to one supervision sessions.

People were appropriately supported with the management of their medicines, attending appointments and were promptly referred to health care professionals when needed.

Staff knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with kindness and respect.

Staff promoted people’s independence, encouraged them to do as much as possible for themselves and make their own decisions. A local authority case manager who oversaw the wellbeing of some of the people in the service told us, “The care the staff provide is of a high standard, they always appear caring and put the person at the centre.”

Personal records included people’s individual care plans, likes and dislikes and preferred activities. These records helped staff deliver support that met people’s individual needs. Staff knew about people’s dietary preferences and restrictions, and involved them in choosing menus.

The registered manager was open and transparent in their approach. They placed emphasis on continuous improvement of the service. There was an effective system of monitoring checks and audits to identify any improvements that needed to be made. The registered manager acted on the results of these checks to improve the quality of the service and support.

Further information is in the detailed findings below.

We inspected 1-3 St Peter's Row on 21 May 2013 and found non – compliance in the area relating to records. This was a follow up inspection to check compliance against that area. We spoke with the manager during the inspection. We did not speak with people using the service on this occasion.

We spoke individually with six people who used the service, the registered manager, four members of staff and a social care professional.

People had given their consent to the care and support they received. They told us they were aware of their care records and that staff had consulted them about how they preferred to be supported.

People told us they liked living at the service. They said “it’s good, I love it” and “I love living here”. People said they did activities they liked at home and in the community. One person said “I do dancing and was in a dance show” and another “I have afternoon tea in Tonbridge or Tunbridge Wells”.

People told us they were being supported to be as independent as they could. One person was shortly moving to supported living and another person said “I clean and tidy my room myself”.

People told us they liked the staff and they were satisfied with the support they received. They said they knew they could go to staff if they had any concerns. We saw that when this had happened their concerns had been addressed.

People’s records were stored securely and were detailed. However we found that some information in them had not always been reviewed when it should have been.

We used a number of different methods to help us understand the experiences of people using the service as some people had complex needs which meant they were not always able to tell us about their experiences themselves. As well as speaking with people we observed how people interacted with staff, we spoke with staff and the registered manager, and read documents and records including care plans and health records.

We spoke with four people using the service. They said they liked living at St Peters Row and liked the staff. Comments that people made included. “I like the staff “.

People said they chose what to do during the day. They told us about some of the activities they did during the day and during evenings and weekends and said they enjoyed them. They said they went to activities at the on site day centre, in the community, to evening clubs and to work. People told us about holidays they had been on this year and had enjoyed. Two people said they had especially enjoyed a disco when they were on holiday.

People said they liked their bedrooms, they chose their own colour schemes and items for the rooms.

People said they liked the meals, showed us samples of menus and explained that staff had information so they knew what people liked and what was on the menu each day. They told us they chose what to eat.

We spoke with three people who lived in the home during our visit. People told us they were very happy living at St Peters Row. They said it was “absolutely fantastic.” “I like it here.” “I love being with all my friends and staff.” “I love it here, we do fun things and we always go out and about.” People told us their privacy and dignity was respected and staff always knocked on their bedroom doors. People said they felt safe at the home. They told us they were not always able to do the activities they wanted to when there were not enough staff on duty.

This inspection was carried out on 08 and 09 June 2015 by one inspector and an Expert by Experience. It was an announced inspection. Forty-eight hours’ notice of the inspection was given to ensure that the people who lived in the service were prepared to receive unfamiliar visitors.

Not all the people living at the service were able to express themselves verbally. Some people used specialised equipment to express themselves and others used body language.

The service is registered to provide accommodation and support for up to 15 people with learning disabilities who require nursing or personal care. There were 15 people living there at the time of our inspection. The accommodation was split into three separate units within the same building. One unit accommodated people who had higher dependency needs.

There was a 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.

Staff were trained in how to protect people from abuse and harm. They were aware of the procedures to follow in case of abuse or suspicion of abuse, whistle blowing and bullying.

Risk assessments were centred on the needs of the individual. They included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how risks of re-occurrence could be reduced.

There were enough qualified, skilled and experienced staff to meet people's needs. Staffing levels were calculated according to people’s changing needs and ensured continuity of one to one support. Thorough recruitment practice was followed to ensure staff were suitable for their role.

Staff were trained in the safe administration of medicines. Records relevant to the administration of medicines or the supervision of medicines were monitored. This ensured they were accurately kept and medicines were administered to people and taken by people safely according to their individual needs.

Staff knew each person well and understood how to meet their support needs. Each person’s needs and personal preferences had been assessed before care was provided and were continually reviewed. This ensured that the staff could provide care in a way that met people’s particular needs and wishes.

Staff had completed the training they needed to support people in a safe way. They had the opportunity to receive further training specific to the needs of the people they supported. All members of care staff received regular one to one supervision sessions to ensure they were supported while they carried out their role. They received an annual appraisal of their performance and training needs.

All care staff and management were trained in the principles of the Mental Capacity Act 2005 (MCA) and were knowledgeable about the requirements of the legislation. People’s mental capacity was assessed and meetings were held in their best interest when appropriate.

Staff sought and obtained people’s consent before they provided support. When people declined or changed their mind, their wishes were respected.

Staff supported people with their planning of menus, activities and holidays. They ensured people made informed choices that promoted their health. Staff knew about people’s dietary preferences and restrictions.

People told us that staff communicated effectively with them, responded to their needs promptly and treated them with kindness and respect. People were satisfied with how their support was delivered. Clear information about the service, the management, the facilities, and how to complain was provided to people. Information was available in a format that met people’s needs.

People were referred to health care professionals when needed and in a timely way. Personal records included people’s individual plans of care, likes and dislikes and preferred activities.

The registered manager and the staff’s approach promoted people’s independence and encouraged them to do as much as possible for themselves and make their own decisions. Comments from relatives included, “This is an excellent place.”

People’s privacy was respected and people were assisted in a way that respected their dignity and individuality.

People’s individual assessments and care plans were reviewed regularly with their participation or their representatives’ involvement. A relative told us, “We are invited to participate in reviews”. People’s care plans were updated when their needs changed to make sure people received the support they needed.

The provider took account of people’s complaints, comments and suggestions. People’s views were sought and acted upon. The provider sent questionnaires regularly to people, their legal representatives and healthcare professionals. The results were analysed and action was taken in response to people’s views.

Staff told us they felt valued and supported under the manager’s leadership. The manager notified the Care Quality Commission of any significant events that affected people or the service. Comprehensive quality assurance audits were carried out to identify how the service could improve and action was taken to implement improvements.