This inspection took place on 23 March 2018 and was unannounced. This meant the staff and provider did not know we would be visiting.

The Alan Shearer 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.

The Alan Shearer Centre provides residential and respite care across one site. The residential provision is a care home. A short break, respite service for people with a disability is also provided from a separate unit on the main site and is part of the residential provision. 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. A maximum of 20 people can be accommodated within both units. At the time of inspection five people were living at the service and eight people were staying for a short break.

At our last inspection in December 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good apart from the caring domain where evidence was available that showed this rating was exceeded to outstanding.

There was no evidence or information from our inspection and on-going 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.

Due to their health conditions and complex needs, not all of the people who used the service were able to share their views verbally about the support they received but we were able to gather the views of relatives. One relative said, "The care is excellent and their response [staff] to expected difficulties has been most positive which to me evidences their professionalism. Not only was their personal care of a high standard but it was the manner in which it was provided that sets this organisation apart from the others caring and respectful."

We saw that the service worked collaboratively with other healthcare professionals to ensure that people were supported to be involved in decision making as much as possible. This included creative consideration of various techniques that could better enable people to communicate their wishes.

People appeared safe and comfortable with the staff who supported them. There was an open, relaxed and friendly atmosphere around the service.

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 service supported this practice. People were given information in a format that helped them to understand and encourage their involvement in every day decision making.

Records were personalised, up-to-date and accurately reflected people's care and support needs. They provided staff with very detailed information to enable them to provide effective, person centred care to people who may not be able to communicate their needs verbally. Staff were informed and enthusiastic. They ensured people, whatever the level of need were kept stimulated and involved in their surrounding and they were introduced to new activities. Other people were supported to follow their interests and hobbies. People were supported to contribute and to be part of the local community.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

There were enough staff available to provide individual care and support to each person. Staff uphel

This was an unannounced inspection carried out on 11 December 2015.

We last inspected The Alan Shearer Centre in November 2013. At that inspection we found the service was meeting all the legal requirements in force at the time.

The Alan Shearer Centre provides short breaks and long term care for up to 20 people with learning and physical disabilities who require nursing or personal care.

A registered manager was in place. 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.

Due to their health conditions and complex needs not all of the people were able to share their views about the service they received. People appeared content and relaxed.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

Staff had received training and had a good understanding of the Mental Capacity Act 2005 and Best Interest Decision Making, when people were unable to make decisions themselves. There were other opportunities for staff to receive training to meet people’s care needs. Staff received supervision and appraisal.

People received their medicines in a safe and timely way. People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed.

Staff knew the people they were supporting well and there were enough staff on duty to provide individual care to people. Care was provided with patience and kindness and people’s privacy and dignity were respected. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care.

People’s nutritional needs were met and they received a choice of food. People were supported to be part of the local community. They were provided with opportunities to follow their interests and hobbies and were introduced to new activities.

People were supported to maintain some control in their lives. They were given information in a format that helped them to understand and encourage their involvement in every day decision making. A complaints procedure was available and written in a way to help people understand if they did not read.

Staff said the registered manager and management team were supportive and approachable. Communication was effective, ensuring people, their relatives and other relevant agencies were kept up to date about any changes in people’s care and support needs and the running of the service. There were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care.

At the time of our visit there were no people who used the service on the premises. We checked the questionnaires that had been sent by the service to people who used the service and their relatives.

We saw that people who used the service and their relatives were complimentary about the environment, staff and care provided. They said that they ‘…can totally relax when XX is at the Alan Shearer Centre, know he’ll receive the best possible care’ and ‘XX is so happy at Alan Shearer’s – safe, social and comfortable place’.

They made particular comments about the staff at the centre. They said ‘The staff come across as very caring’ and said that the manager ‘…is very helpful and does her best to accommodate our requests for specific dates. Very satisfied. Thanks.’

People who used the service and relatives had no concerns. They also said that the staff were ‘welcoming’ and they have an ‘understanding of individual needs’ and the service is ‘person centred’.

At the time of our visit there were no people who used the service at the service. We checked the questionnaires that had been sent by the service to people who used the service and their relatives.

We saw that people who used the service and their relatives were complimentary about the environment, staff and care provided. They said that they ‘had no concerns and if I did I would let them know’. Others said they had ‘complete satisfaction and full confidence in the staff’, ‘I find all the staff very approachable and pleasant and very professional’ and ‘nothing is a problem, very helpful’.

One person who used the service said ‘I love it and am so pleased at having the chance to stay here’.

Relatives of people who used the service said ‘I trust the staff 100% when it comes to … wellbeing and care, giving us peace of mind’, ‘the care my son receives is excellent, long may it continue’ and ‘… knows who his key worker is. He knows he can speak to any of the staff if he wants to at any time’.

At the time of our visit all but one of the young people were attending college or a day activity centre. One person waiting to go home following a three day break commented, "Happy with all staff support", and said he had enjoyed his stay at the centre. When asked what he enjoyed most about the centre he replied “going to the pub, watching the football, and playing games on his playstation console". The most recent survey carried out by the manager in 2010 found that: people liked the food, and they liked the centre. They said that the staff team helped them and some said what activities they liked. Relatives said that “the centre is a godsend” and what the whole centre has to offer is fantastic.

In this report the name of a registered manager appears who was not in post and not managing the regulated activity at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found-

Is the service safe?

The service assessed and managed risks to enable people’s care to be delivered safely.

There were robust arrangements for assisting people with taking their prescribed medicines. A relative told us, “The staff are definitely on the ball with medication”.

A robust recruitment process was followed when new staff were being employed.

Staff were thoroughly checked and vetted to make sure they were suitable to work with vulnerable people.

Personal records were accurate and well maintained, and protected people from receiving unsafe care.

Is the service effective?

People’s care was well planned and kept under regular review to check it remained effective.

People and their relatives told us they were very pleased with their care and support. Comments included, “There’s good continuity of staff, and I have confidence that they act in his best interests”; “He needs constant supervision, and gets this at the centre”; and, “He’s made lots of progress, and is out all the time, doing different activities.”

Is the service caring?

People’s care and support was planned and delivered in a very caring and sensitive manner. Care was tailored to individuals’ needs and wishes. Relatives told us staff were genuinely caring. Relatives’ comments included, “They have real compassion” and “The staff are just amazing.”

Is the service responsive?

People’s needs had been fully assessed before they started to use the service. Records and relatives’ comments confirmed that people’s care and support was provided in line with their individual preferences and diverse needs. People accessed a wide range of activities, both within the centre and in the community.

Is the service well-led?

The manager and staff had good understanding of the ethos of the service and their roles and responsibilities. Quality assurance processes were in place to check standards were maintained. People were routinely asked for their feedback about the service. Relatives told us they were very satisfied and had no concerns about the service.