This inspection visit took place on 12 March 2018 and was unannounced. The inspection was completed by one inspector. 23 Cecil Road is a care service and 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. Registering the Right Support CQC policy. At the last inspection in February 2016, the service was rated Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated 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.

The accommodation 23 Cecil Road is situated in Dronfield. It is a large house with a safe and secure garden. The property is close to shops and amenities which are utilised by the people living at the home. Each person has their own bedroom with an ensuite facility. There are shared spaces which include the lounge, a dining room and a kitchen. The home is registered for six people and at the time of our inspection five people were living in the home.

People were supported to work towards and complete major achievements in their lives. The service had continued to strengthen positive links with health care professionals and the local community shops and leisure opportunities.

Professionals involved in people's care confirmed that the service was focused on individual’s needs and the provider had been able to meet people's needs where other services had failed. The provider had used technology to support people with accessing information and to develop their methods of communication. People were supported to express their sexuality and provided with guidance and opportunities to socialise.

People and their family were involved in their own care planning and were able to contribute to the way in which they were supported. Care was completely centred and tailored to each individual.

The service was flexible and adapted to people's changing needs and desires, enabling positive outcomes for all concerned. Staff had gone the extra mile to ensure that people received the support to meet their achievements and aspirations.

The provider was involved with the development of a national initiative to try and prevent the over medication of people with learning disabilities, autism or both and this ethos was firmly embedded within the service. People were protected from harm and staff had received appropriate training. Risks were managed and people supported when they expressed themselves through behaviours which challenge. There was enough staff to support people’s needs and lessons had been learnt. The home was protected from the risk of infection.

People were able to make decisions and their own choices. When they had a long term illness guidance was obtained to follow best practice. Staff received training which was relevant to their role. Meals supported people nutritional requirements and choice. Health care professionals had been consulted to support people’s wellbeing. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People had established positive relationships with the staff. This supported them to remain independent and have daily choices. When required people could access an advocate to provide support and guidance on decision making. People’s privacy and dignity was maintained.

The service remains well led. Staff felt supported by the registered manager. They had a good understanding of the service and followed guidance in respect of their registration. People’s v

The inspection took place on 2 February, 2016, it was unannounced. The home was last inspected in April 2014 when it was compliant in all areas and no concerns were identified.

The home is located in the village of Dronfield in Derbyshire and provides care and support to up to six adults with a learning disability or autistic spectrum disorder. Some people have associated conditions that included sensory disability, epilepsy and behaviour that can put themselves or others at risk. At the time of our inspection six people were living at 23 Cecil Road.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 were happy, comfortable and relaxed with staff and said they felt safe. They received care and support from staff who were appropriately trained and confident to meet individual needs.

Formal supervision and appraisal sessions were in place which ensured staff were meeting regularly with their line manager and were accountable for their actions and professional development. Safe recruitment procedures were followed and appropriate pre-employment checks carried out, including evidence of identity and satisfactory written references. Staff were supported by the registered manager who worked with them to assist their continued professional development. There were sufficient staff on duty to meet people's needs and to keep them safe.

People's nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where people required special diets these were followed, though people were still allowed a choice of food within these restrictions.

Medicines were managed safely in accordance with current regulations and guidance by staff who had received appropriate training to help ensure safe practice. There were systems in place to ensure medicines had been stored, administered, audited and reviewed appropriately. People were able to access health and social care as required.

People were encouraged to make their own life choices and were being supported to make decisions in their best interests. The registered manager and staff had an understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

There was a formal complaints process in place. People were encouraged and supported to express their views about their care and staff responded to their concerns and wishes. Relatives and stakeholders were able to influence what happened to individuals.

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Our inspection team was made up of a lead inspector. Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at the records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. People told us that they felt safe. Staff had received training in safeguarding and staff understood how to safeguard the people they supported.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints and concerns. This reduced the risk to people and helped the service to continually improve. People were cared for in a service that was safe, clean and hygienic.

Risk assessments were in place in individual support plans in relation to activities of daily living. Staff personnel records contained all the information required which meant that the provider could demonstrate that the staff employed to work in the home were suitable and had the skills and experience needed to support the people living in the home.

Is the service effective?

One person we spoke with told us that they were happy with the staff and care they received and felt that their needs had been met. They said, "I'm very happy here, the staff are all good, I've no complaints, I like what they do". It was clear from what we saw and from speaking with staff that they understood people's care and support needs and they knew them well.

Staff had received training to meet the needs of the people living at 23, Cecil Road. People's health and care needs were assessed with them and some people chose to be involved in writing their plans of care. Specialist needs had been identified in care plans where required.

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. When we spoke with staff, we found that they were committed to the welfare of people who lived at 23, Cecil Road and were able to clearly describe how they supported them to achieve their goals. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with their wishes in support plans which were person centred. This meant that people's individual care needs had been met.

Is the service responsive?

People regularly completed a range of activities inside and outside the service. The staff at 23, Cecil Road supported people to attend local activities within the local community and to develop their independence as much as possible.

We saw that staff were able to respond to the different needs of the people living at the service, to support them in managing their behaviour, undertaking daily activities and having as much control and choice over the way they lived their life as they could.

Is the service well-led?

The service worked well with both other agencies and colleagues in other services managed by the provider to ensure that people who lived at 23, Cecil Road received their care in a joined up way. The service had a quality assurance system which included planned audits. There were systems for regular communication with staff, people who used the service and relatives to ensure that there were opportunities for feedback on the service provided.

Records seen by us showed that any identified shortfalls were addressed promptly and as a result the service was constantly improving. The staff told us that they felt that there was good team work at 23, Cecil Road and that they felt well supported by the manager and senior staff to undertake their role. We observed that people who used the service were well supported and their individual needs were met.

We spoke with people living at 23, Cecil Road, the manager and staff about people's care at the service. People were happy with the care they received. One person said, "I like all the staff. They help me to do things I like and I go out all the time."

We found care was planned and delivered in a way that helped ensure people's welfare and safety. Care plans included clear guidance for staff and risks that could affect people were assessed. We saw consent was being obtained for people's care, including the use of appropriate procedures where people lacked the capacity to make their own decisions.

We found the premises were safe, comfortable and well maintained. Adequate numbers of experienced and skilled staff were provided to deliver people's care.

We saw there was an effective sytems in place for responding to any concerns or complaints at the service.

People we spoke with were happy at 23, Cecil Road. One person told us, "It's a good place to live. Staff are really good too."

We saw that people's dignity and rights were respected at the home, and that care planning was detailed and personalised.

We found that suitable staff were recruited, and that they were well trained. We also found that staff were aware of how to protect people from abuse or neglect.

We saw that medication and quality assurance systems helped to ensure that the home was safe, and met people's needs.

People told us there were monthly house meetings held and they were involved in menu planning and shopping for the home.

People had key workers assigned to them and clearly knew who they were and had regular contact with them. People told us they planned activities and menu’s on a weekly basis with staff in the home.

One person told us about a holiday of their choice they were planning where staff was going to accompany them. Some people were supported to visit and spend time with their families.

One relative told us that staff at the home were friendly and helpful and expressed, they told us that they felt able to raise any concerns with confidence that they would be listened to.

One person told us they knew the staff well and that they were ‘nice and kind’.