Stakesby Road 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.

Stakesby Road is situated in Whitby and accommodates up to three people who have profound and multiple learning disabilities. 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.

Inspection site visits took place on 26 March and 11 April 2018 and were announced. At the time of this inspection, the service was providing support to two people.

At the last comprehensive inspection in October 2015 we found the service was meeting requirements and awarded a rating of good. At this inspection we found the registered manager and staff team had developed the service further to achieve an outstanding rating.

There was a manager in post who had registered with the Care Quality Commission. They assisted throughout the inspection process. 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.

Discussions with staff demonstrated they were extremely passionate about the people they supported, building effective communication and improving the quality of life people had. Staff spoke with empathy and enthusiasm as they explained future activities planned and improvements people had made with their health and well-being. Staff approached and responded to people as individuals, tailoring how to do this based on their in-depth knowledge of the person. This meant we observed meaningful relationships based on trust and mutual respect.

Staff described the importance of people being able to have meaningful, private communication with relatives. Photographs of activities and daily events were taken by staff and placed in a memory book. This gave relatives the opportunity to stimulate meaningful conversations with the person about their week without staff being present.

Potential barriers to communication were addressed through staff’s in depth understanding of people’s unique communication styles which were detailed in people’s care records. People had access to a range of technology as well as communication boards, picture cards and photographs.

It was clear staff understood the importance of maximising the opportunities for people to experience sensory stimuli such as touch.

People were encouraged to form goals towards their independence such as becoming more active and were supported to work towards these through keeping them under review. Case studies were produced by staff to record progress and what the outcomes for people were.

Respect and regard for privacy and dignity were at the core of the service’s culture and values. Staff had received training in how to treat people with respect and kindness. The ethos of the home was to make people feel special and that their lives and feelings mattered.

Relatives, staff and people were equal partners in designing the care people wanted in the way they wanted it. Staff gathered each person's life history and used this to develop positive relationships and design care which included the person's preferences. Support plans were written in an exceptionally person-centred way with detailed instructions on how to provide care which was appropriate to the person.

The service had a creative approach in supporting people to make their own decisions. The use of technology was embraced to enable p

This inspection took place on 20 October 2015 and was unannounced. We last inspected the service on 14 June 2014 and there were no breaches of regulation.

Stakesby Road is one of the services provided by the Wilf Ward Family Trust who have services throughout the Yorkshire and Humber region. Stakesby Road provides long term accommodation to three adults who have a learning disability, autism and/or a physical disability. There were two people using the service on the day of our inspection.

There was a registered manager employed at this service. 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 experienced in the care of people with a learning disability.

Although people could not communicate well verbally we could see from their interactions with staff that they felt safe and were relaxed. Other people we spoke with told us that they felt people were safe.

Medicines were safely managed and administered by staff.

Servicing and maintenance checks were carried out by staff which protected people who used the service from injuries caused by equipment. Where there had been accidents these had been recorded and where necessary investigated.

Staff were trained to safeguard people and knew what to do if they witnessed abuse. They were also working within the principles of the Mental Capacity Act 2005 which meant that they were making sure people had support in place if they needed to be assisted with decision making. Staff meetings were held every four weeks.

People’s health and wellbeing was maintained because staff accessed advice and support from healthcare professionals.

The staff were caring and supportive of people. They treated them with respect. People took part in a variety of activities supported by staff. These were recorded on to communication boards to use when families visited.

There was an effective quality assurance system in place which meant that the service was continually improving.

People who used the service had limited communication skills, however specialist equipment had been obtained that enabled them to express their wishes. Visitors told us that staff involved them in the care and support of their relatives. One said "They have looked after XXXX for 20 years and they always involved us in what is going on".

We saw that staff were knowledgeable about the people they supported and provided support in line with the person's care plan.

Stakesby Road was a domestic dwelling and all areas of the home we seen to be accessible to people who lived there. There were suitable adaptations in place that enabled care to be provided in a sensitive way. The home was clean and staff were seen to follow infection control instructions to minimise the possibility of cross infection.

The service had a comprehensive system in place to monitor the quality of the service provided.

The care plans contained an assessment of the individual's communication preferences and a mental capacity assessment. By identifying the preferred methods of communication the staff had enabled each person to make as many choices about their day to day activities as they were able. We observed staff interactions with people using the service and they used simple language, specialist communication equipment and pictorial prompts.

Relatives told us they had been fully involved in the initial assessment and subsequent care planning process. They told us this had happened over a long period of time allowing their relative the chance to get to know the staff and other people in the home. They also told us they were invited to regular reviews of the care plan to ensure it remained appropriate.

Staff told us they had a three week menu based on people's likes and dislikes. A choice was available at mealtimes and staff used pictures of different meals to determine what each person wanted.

People receive their medication appropriately.

We saw the staff rota's for the home. The staffing levels provided were seen to be appropriate for the level of individual needs. On the day of the inspection three members of staff were on duty for three people.

We saw a copy of the complaints policy. It provided clear guidance on what to do if someone had a complaint. There were also clear guidelines of how the organisation would respond to any complaints received.