We inspected Stockton-on-Tees Borough Council - 31 Oak Road on 27 October 2017. This was an unannounced inspection, which meant that staff and provider did not know we would be visiting.

At the last inspection in October 2015, the service was rated 'Good'. At this inspection we found the service remained 'Good'.

The home had a 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.

The service provides residential care for up to six adults who have a learning disability. At the time of the inspection there were six people who used the service.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place. Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. Medicines were managed safely with an effective system in place. Staff competencies, around administering medicines, were regularly checked. Appropriate checks of the building and maintenance systems had taken place to ensure health and safety was maintained.

There were sufficient staff on duty to meet the needs of people who used the service. Staff were available to provide one to one support and visits out in the community. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. A comprehensive training plan was in place and all staff had completed up to date training. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were able to choose meals of their choice and staff supported people to maintain their health and attend routine health care appointments.

Staff were calm, kind and gentle in their interactions with people and supported them to remain independent whilst maintaining their safety and welfare. People's privacy and dignity was maintained and staff were caring and compassionate as they supported people. Staff knew people in the home very well and involved them and their relatives in the planning of their care.

Support plans detailed people’s needs and preferences and were person-centred. Support plans were reviewed on a regular basis to ensure they contained up to date information that was meeting people’s care needs. People who used the service had access to a wide range of activities and leisure opportunities. The service had a clear process for handling complaints.

Staff told us they enjoyed working at the service and felt supported by the registered manager. Quality assurance processes were in place and regularly carried out by the registered manager and registered provider, to monitor and improve the quality of the service. The service worked with various health and social care agencies and sought professional advice to ensure individual needs were being met. Feedback was sought from people who used the service through regular meetings’. This information was analysed and action plans produced when needed.

We carried out this inspection on the 14 October 2015. The inspection was unannounced which meant the staff and registered provider did not know we would be visiting.

31 Oak Road is a six bedded care home for adults with a learning disability, which is situated in a housing estate within easy reach of local amenities. It is operated by Stockton Borough Council. At the time of our inspection four people were using the service.

The home had a registered manager in place and they have been in post since April 2014 and registered with the Care Quality Commission since October 2014. 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.

We found that medicines were stored and administered appropriately.

Staff we spoke with understood the principles and processes of safeguarding, as well as how to raise a safeguarding alert with the local authority. Staff said they would be confident to whistle blow (raise concerns about the home, staff practices or provider) if the need ever arose.

The registered manager had knowledge of the Mental Capacity Act [MCA] 2005 and Deprivation of Liberty Safeguards [DoLS]. The registered manager understood when an application should be made, and how to submit one. At the time of our visit there were three people that were subject to a DoLS authorisation.

Accidents and incidents were monitored each month to see if any trends were identified. At the time of our inspection the accidents and incidents were too few to identify any trends.

Staff did receive relevant training and competency assessments took place.

Staff had regular supervisions and appraisals to monitor their performance and told us they felt supported by the registered manager.

Staff were observed to know people well and to be caring and respected people’s privacy and dignity. People who used the service said that staff were caring and kind.

People were supported to access healthcare professionals and services.

People who used the service chose what activities they would like to take part in, and we were told that one person enjoyed taking ballroom dancing classes.

People living at the service said they felt safe within the home and with the staff who cared for them.

People’s care records were person centred. Person centred planning [PCP] provides a way of helping a person plan all aspects of their life and support, focusing on what’s important to the person. Care plans provided evidence of access to healthcare professionals and services. Care plans contained relevant risk assessments.

We found people were cared for by sufficient numbers of staff. Recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

We saw that the service was clean and tidy and there was plenty of personal protection equipment [PPE] available.

People were provided with a meal choice and enjoyed the food on offer. People could eat when and where they wanted.

Staff were supported by the registered manager and were able to raise any concerns with them. The service had a system in place for the management of complaints although had not received any.

We saw safety checks and certificates that were all within the last twelve months for items that had been serviced and checked such as fire equipment and water temperature checks.

The registered manager set out a monthly plan of what audits were to take place. However their was nothing documented to evidence that the audits had taken place.

During the inspection we spoke with the manager and two staff and also interacted with one person who was living at Oak Road. Verbal communication was limited; however they were able to respond with non verbal communication. They expressed that they were happy with the care and support provided to them.

We were able to observe the experiences of people who used the service. We saw that staff treated people with dignity and respect. Staff were attentive, gave reassurance and interacted well with people. We saw that staff communicated well with people and explained everything in a way that could be easily understood. Staff encouraged and supported people to make choices and to be independent.

We found that improvements had been made to people's care records. We saw that they had individual care and health action plans in place that were person centred and up to date. We found that improvement had been made to the way in which challenging behaviour was managed.

We found that staff receive the training, supervision and appraisal to enable to them to fulfil and develop their job role.

We found that there were good systems in place for monitoring the service and for involving people who live at Oak Road.

We spoke to people about life at Oak Road. People were extremely positive about the service they received and were complimentary about the staff. One person said,"I think it is great living here". "I go to the shops and to the pub to play the quiz".

Another person told us about going out to work/day services and meeting their key worker.

One person said "I like the staff very much".

An adult social care 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?

As part of this inspection we spoke with two of the four people who used the service, the manager and three care staff. We also reviewed records relating to the management of the home which included all four people’s care records, staff rotas, provider monitoring records, infection control audits, a range of other audits and staff communication records.

We spent time in home observing how people's care was delivered.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. People were cared for in an environment that was safe, clean and hygienic. We found that usually there were enough staff on duty during the day and night to meet people’s needs. Four people lived at the home and during the weekday two to three people attended day centres and college and over the weekend one person went home. We saw that it was customary for at least two staff to be on duty when people are at home. During the day during the week the deputy manager and a staff member were at the home.

On the day of our inspection the deputy manager was on leave but only one person who used the service should have been at home. However, due to unforeseen circumstances initially two then three people needed to be at the home. This led to the member of staff on duty being under pressure, however, the manager had made them aware that they were available should issues arise and could come to the home but they were not contacted.

One person chose to speak at length with us and told us, “There are normally enough staff around. I like all of the staff as they are helpful.”

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Staff had found that some of the people who used the service lacked capacity to make decisions. Although the home had not completed capacity assessments an external professional had completed the relevant documents. The manager told us the council was in the process of developing the tools staff needed to use to ensure the records were kept in line with the requirements of the Mental Capacity Act 2005. We saw that Deprivation of Liberty Safeguard (DoLS) authorisations had been appropriately applied for and monitored.

Is the service effective?

Both people we spoke with told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people’s care and support needs and that they knew them well. We found that activities were organised both within and outside the home. People went to day services, colleges and then with staff to the cinema, shops and local events. One person was able to travel independently. This person told us that they enjoyed going into town and did so most days.

Staff and the people we spoke with told us that the deputy manager was very approachable. Staff told us that the manager and deputy manager had made changes to the home, which were aimed at making sure people were able to reach their full potential. Staff had received training to meet the needs of the people living at the home.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers were patient and gave encouragement when supporting people. People told us they were able to do things at their own pace and were not rushed. Our observations confirmed this.

Is the service responsive?

People’s needs had been assessed before they moved into the home, however staff needed to become more adept at assessing potential risks people faced and provide more detail in the care records about how people’s needs could be met. Records confirmed people’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes.

Is the service well-led?

Staff had a good understanding of the ethos of the home and we saw that the manager and deputy manager had effective quality assurance processes in place. People told us they were asked for their feedback on the service they received. Staff told us they were clear about their roles and responsibilities. Staff said they were consulted with prior to changes being implemented and their views were taken into consideration.