22 Abbey Drive (West) is registered to provide accommodation and personal care for up to six younger adults with a learning disability and or autistic spectrum disorder related conditions. The service is a large, semi-detached, period property in a central location in the town, close to all local amenities. Accommodation is provided over two floors with stairs access to the first floor. On the day of our inspection there were three people living at the service, two of whom attended the local Linkage college facility full-time.

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 a learning disability and/or autism using the service can live as ordinary life as any citizen.

We last inspected the service on 1 December 2015 and the service was rated as Good with one area rated as Outstanding. At this inspection we found the service remained Good with one area rated as Outstanding.

There was an exceptionally person-centred culture apparent within the service with care tailored to meet the needs, wishes and aspirations of each individual. People were well supported to have maximum choice and control of their lives to achieve their potential and to express their views. People received outstanding care and support from a well-trained, well-supported and motivated group of staff.

The service fostered and maintained strong links with external organisations and within the local community. There was a strong emphasis on key principles of care such as compassion, inclusion, respect, dignity and enablement. Comments from relatives were very complimentary and consistent stating they were extremely happy with the care and support the service provided. Some considered the progress their family members had made far exceeded their expectations. They also told us communication with support and college staff was excellent.

We found personalised programmes and flexible staffing arrangements enabled people to learn to live fulfilled and meaningful lives. Staff knew people well and were skilled at ensuring they were safe whilst encouraging them to stretch their potential and achieve as much independence as possible. People participated in a range of vocational, educational and personal development programmes at the organisation’s college facility. They also accessed a range of community facilities and completed activities within the service. They were encouraged to follow and develop social interests and be active and healthy. All programmes and support were geared towards promoting the person’s independence, inclusion and support them into adulthood.

Care plans had been developed to provide guidance for staff to support in the positive management of behaviours that may challenge the service and others. This was based on least restrictive practice guidance to support people safety.

Systems in place minimised the risk of harm to people. These included effective risk assessment of people’s needs, safeguarding matters, management of medicines, safe recruitment and effective management of accidents and incidents. The environment was well maintained and the provider had ensured all appropriate safety checks had been made.

People’s health and nutritional needs were met. People were supported to attend appointments and access community health care professionals for advice and treatment when required. The menus were developed with people where possible and provided them with a variety of nutritious meals.

Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made. When restrictions on a person’s liberty were necessary the registered manager had ensured the correct application had been made to protect the person’s legal rights.

There was a quality monitoring system i

22 Abbey Drive (West) is registered to provide accommodation for persons who require nursing and personal care for up to six younger adults with a learning disability and or autistic spectrum disorder related conditions. The younger adults attend the local Linkage college facility full time and the service is closed during college holidays. The service is a large detached period property in a central location in the town close to all local amenities. Accommodation is provided over two floors with stairs access to the first floor.

The service had a registered manager in post. 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.

This inspection took place on 1 December 2015. At the last inspection on 11 October 2013, the registered provider was compliant with all the regulations we assessed.

During the inspection we saw staff were attentive and very caring when supporting people. Comments from relatives were very complimentary and consistent stating they were extremely happy with the care, treatment and support the service provided. Relatives felt every opportunity was provided to safely maximise people’s independence. They also told us communication with support and college staff was excellent.

The service developed and maintained strong links with external organisations and within the local community. There was a strong emphasis on key principles of care such as compassion, inclusion, respect, dignity and enablement.

The safety of people who used the service was taken seriously and managers and staff were well aware of their responsibility to protect people’s health and wellbeing. People we spoke with told us they felt safe living in the home.

We found people’s care plans were written in a way that clearly described their care, treatment and support needs. These were regularly evaluated, reviewed and updated. The care plan format was easy for people to understand by the use of pictures and symbols. We saw evidence to demonstrate that people and their relatives were involved in their care planning.

The staff understood the procedures they needed to follow to ensure people were kept safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

Our observations during the inspection showed us people were supported by sufficient numbers of staff. We saw staff were responsive to people’s needs. We saw there was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff.

Staff were enabled to become skilled practitioners through a system of induction, training, and continual professional development.

People’s nutritional needs were met and people were supported to shop for food supplies and were assisted to prepare meals. We saw staff monitored people’s health and responded quickly to any concerns. People received their medicines as prescribed and had access to a range of professionals for advice, treatment and support.

People participated in a range of vocational, educational and personal development programmes at the organisation’s college facility. They also accessed a range of community facilities and completed activities within the service. They were encouraged to follow and develop social interests and be active and healthy. All programmes and support were geared to maximise the person’s independence and support them into adulthood.

People who used the service were encouraged to make their own decisions. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made.

There was strong leadership which put people first, set high expectations for staff and led by example. There was an open culture and a clear vision and values, which were put into practice. Staff were proud to work for the service and felt valued for their work. A positive culture was demonstrated by the attitudes of staff and management when we talked with them about how they supported people.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Relatives and people who used the service told us that they were always involved in decision making and had copies of all records for areas where consent had been given.

Comments included, “The staff are very good and constantly keep us up to date with everything that is going on.” “I trust them completely with my relative." and “This is the first time that the staff have concentrated on them as an individual and their achievements, rather than the negative aspects of their behaviour.”

People were happy with the care they received and told us they saw a range of health professionals for advice and treatment.

We found that staff helped to make sure health and social care was well coordinated and provided by a range of professionals.

We found that staff had completed training in the safe handling and administering of medication and that audits of the medication systems were carried out, to ensure accurate records were maintained.

We found that the numbers of staff provided was based on individual need and regularly reviewed to ensure that there was adequate support available to meet the needs of the people who used the service.

People who used the service told us that overall they were happy with the service provided and that they were confident appropriate action would be taken, to deal with any concerns should they arise.

People told us they were happy with the care and support that they received. People's comments included: "I really like it in this house. They do respect and listen to me," and " Our dignity is respected at all times."

One person told us about the weekly meetings in place to decide menus, leisure activities and allocation of tasks which promoted independent living skills: "We always sit down together and talk about what we want to eat, evening and weekend leisure and any problems in the house.” “If someone doesn’t come to the meeting the staff will make sure that they get to know what has gone on.”

People spoke positively about their care and support, comments included: "The care is good. It is a home from home and we are treated like adults and we are listened to.” “I have only been here since September, I have loads of friends and a great social life and I have been made to feel welcome here.”

People spoke positively about the staff that worked with them. They said: "Staff are very helpful and they want to know what we think about things, they always involve us in everything.”