134 Ashland Road provides accommodation and personal care for up to 10 people with learning disabilities and physical disabilities. At the time of our inspection eight people were living at the service.

At our last inspection in May 2015, the service was rated ‘Good’. At this inspection we found that the service remained ‘Good’ for being safe, effective, responsive and well-led, however ‘Outstanding’ was identified for caring.

People remained safe. Staff were aware of their role and responsibility in protecting people from avoidable harm. They had attended appropriate safeguarding training and had policies and procedures to support them. Risks associated to people’s needs including the premises and environment, were regularly reviewed and staff were aware of how to reduce known risks. Staffing levels were sufficient and regularly reviewed to ensure they were appropriate. Staff were appropriately recruited. The storage and management of medicines were found to be safe. Some minor concerns were identified that included one topical cream being out of date, and some records were not consistently completed as required, and immediate action was taken to address this.

People continued to receive an effective service. Staff received an appropriate induction, ongoing training, support and opportunities to review their work. Staff understood the principles of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards that protected people’s human rights. People were supported to maintain good health and nutrition and received support to access primary and specialist healthcare services.

People received excellent care. Staff went above and beyond to support people at the end of their life. They ensured people experienced a dignified and peaceful end to their life where their wishes and religious needs were met. Staff supported people to fulfil their dreams and gave them opportunities to enrich their life. Good communication was used by staff that reflected people’s preferred communication methods and independence and involvement was promoted as fully as possible.

People continued to receive a responsive service. Assessments were completed and support plans developed to support staff to provide a personalised service based on people’s needs, routines and interests. Some information and records were not as detailed as others or consistently completed. People had access to the complaint policy and procedure. Where concerns had been raised they had been responded to appropriately.

The service continued to be well-led. The provider had arrangements in place for monitoring and assessing the quality of care people experienced. These included seeking and acting upon the views for people who used the service and others. The registered manager was aware that some improvements were required with record keeping.

134 Ashland Road provides accommodation and personal care for up to 10 people with learning disabilities. 10 people were living at the home at the time of our inspection. This was an unannounced inspection, carried out on 5 and 6 May 2015.

A registered manager was in post at the time of our inspection. 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.

People living at the home were safe. Systems were in place for the provider to make safeguarding referrals when needed so that they could be investigated. Staff supported people in a safe way. Risk assessments were completed regarding people’s care.

The building and equipment were safe. People received their medicines in a safe way. However, written protocols were not always in place for PRN ‘as required’ medicines when needed.

There were enough staff present during our inspection to provide safe care. Robust recruitment checks were completed. Staff felt supported and had received an induction, supervision, appraisals and training. Staff were due to attend some refresher training and arrangements were in place for this.

The provider applied the principles of the Mental Capacity Act 2005. The registered manager understood their responsibility in relation to the Deprivation of Liberty Safeguards.

People received enough to eat and drink. Care staff knew about people’s eating and drinking needs. People were supported to maintain good health and referrals were made to health care professionals for additional support when needed.

Staff treated people in a caring way and promoted people’s dignity and respected their privacy. People were involved in day to day decisions about their care. Staff knew people well and offered them choices and respected people’s decisions. People were supported to take part in social activities.

A complaints procedure was in place. Staff felt comfortable to speak with the registered manager if they had concerns. The registered manager was very approachable and knew people well who lived at the home.

There was a positive and open culture in the home. Effective systems were in place to monitor the service.