About the service: 137 Wall Hill Road is registered to provide accommodation and personal care for up to five people with learning disabilities. At the time of inspection, four people were using the service. 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.

People’s experience of using this service: People continued to receive safe care. Staff understood safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place to manage risks within people’s lives, whilst also promoting their independence.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out. Staffing support matched the level of assessed needs within the service during our inspection.

Training was provided to ensure staff had the skills, knowledge and support they needed to perform their roles. Specialist training was provided to make sure that people’s needs were met and they were supported effectively.

Staff were well supported by the registered manager, and had regular one to one supervisions. The staff we spoke with were positive about the senior staff and management in place.

People's consent was gained before any care was provided. 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

Staff continued to treat people with kindness, dignity and respect and spent time getting to know them. Care plans reflected people’s likes and dislikes, and staff spoke with people in a friendly manner.

People and their relatives were involved in care planning as much as they were able to be, and were able to contribute to the way in which people were supported. People and their families were involved in reviewing people’s care and making any necessary changes.

A process was in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly and lessons were learned through positive communication.

The service continued to be well managed. The provider had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required.

Rating at last inspection: Good (report published 22/09/2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We undertook this unannounced inspection on 7 April 2016. The last inspection was completed on 20 June 2013 and the service was meeting the regulations we assessed.

137 Wall Hill Road provides accommodation for up to five people who have a learning disability. At the time of the inspection there were five people living at the home.

The service has a registered manager in place. A registered manager is a person who is registered with The Care Quality Commission to manage the service. Like registered providers they are ‘registered persons’. Registered persons have legal responsibilities for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered manager and all the staff we spoke with were passionate about providing a service that placed people and their families at the very heart of the service. This was confirmed with us by two health care professionals we spoke with and through speaking with relatives.

All the staff we spoke with said that the registered manager and registered provider were dedicated, supportive and approachable. They said whatever people needed was provided to ensure people had the best quality of life they could achieve.

We observed that people who lived in the home were settled and contented. Relatives told us they only had positive experiences and praise for this service.

Staff treated people as individuals with dignity and respect. Staff were knowledgeable about people’s likes, dislikes, preferences and care needs. They approached people in a calm, friendly manner which people responded to positively.

Staff we spoke with told us how they encouraged and supported people to make decisions for themselves, which ensured people were able to live the life they chose.

New staff to the service completed a comprehensive induction period to ensure that they had the skills and knowledge to support people. Staff received regular training to update their skills and to keep in line with current best practice.

Staff had received training about how to ensure people’s rights were respected and how to safeguard people from abuse. They were able to describe the different types of abuse that may occur and said they would report any issues straight away. This helped to protect people.

Risk assessments and detailed care plans were in place. This helped staff to deliver the care and support that people needed in the way they preferred.

There were robust medication systems in place. Medicines were only given to people by staff who had completed the appropriate training. Regular observations were completed with staff who gave medicine to ensure that they continued to do so in a safe manner.

People were offered appropriate food and fluids to maintain their nutrition. Staff took pride in serving appetising and nutritious food. Those who required prompting or support to eat were assisted by patient and attentive staff which ensured that people’s nutritional needs were met.

Spontaneous activities took place, staff spent quality time with people to give them emotional support and comfort.

Staffing levels were reviewed and adjusted as necessary by the registered manager to meet people’s needs.

Regular checks were completed by the manager and the provider to ensure that care provided was of high quality and was done safely. Equipment used within the home was regularly maintained which meant that it was safe.

We saw that most people living at 137 Wall Hill Road were unable to tell us about their experiences of the service. We therefore spoke with two family members and observed the care being provided to people. We also spoke with two members of staff and the manager who supported people.

We found consent was sought from family members regarding their relatives planning of care.

Relatives we spoke with told us that the care that was discussed with them matched the care that was being provided to their family members. They also told us they were regularly kept up to date about the changes to their family member’s care.

We saw that the care plans were person centred and reflected people’s individual needs. We found the members of staff supported people as detailed within their care plans. We noted staff were compassionate and caring when supporting people. We found that staff had involved appropriate health professionals to review their support needs and help support that person.

We noted the home was clean and there was a cleaning schedule which staff followed. We saw checks were made to review the cleanliness of the home.

We saw the provider ensured that the appropriate checks were undertaken before a new member of staff was employed. The manager showed us the induction plan which new staff had to complete during their employment at 137 Wall Hill Road.

We found the service was well led and had systems in place to monitor the quality of service being provided.

We saw that people living at 137 Wall Hill Road were unable to tell us about their experiences of the service. We therefore spoke with two family members and observed the care being provided to people. We also spoke with two members of staff and the manager who supported people.

Relatives we spoke with told us that the care that was discussed with them matched the care that was being provided to their family members. They also told us they were regularly kept up to date about the changes to their family member’s care.

We saw that the care plans were person centred and reflected the people’s individual needs. We saw members of staff supported people as detailed within their care plans. We saw care plans were easy to read and had pictures to help people understand their care plan.

Relatives we spoke with told us that staff were friendly and supported the needs of their family members well. We saw staff knew what people's care needs were and how they needed to be supported.

We spoke with the staff members about what they thought abuse was and they showed they had a good awareness of the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding potential abuse.

We saw the provider had a system in place to monitor the quality of the service provided. We saw audits had been completed and analysed to identify where any areas of improvement might be required.