59 Hatherley Road provides accommodation and personal care for up to three people living with a learning disability. The home is situated on a quiet residential street. It comprises of a lounge/dining room, kitchen, three bedrooms and a bathroom. People have access to a private back garden.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Staff focused on the care needs of each individual and adapted their approach and level of support as required. Staff knew people’s individual communication skills, abilities and preferences. We observed that the staff approach was caring and kind. They talked to people with dignity and respect and supported people to make decisions about their life and day to day needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were consulted about the meals they would like to eat. They contributed towards household chores and enjoyed a range of activities in the home and in the local community. People and their relative’s views were encouraged and valued. Staff acted promptly when concerns were raised.

People had detailed care plans which reflected their abilities and support requirements. People’s risks had been assessed and were being monitored.

The systems to manage people’s finances had been reviewed and updated. People benefited from a safe service where staff understood their safeguarding responsibilities and to support people to manage their personal risks. Referrals to health care professionals had been made appropriately when additional support was needed. Peoples’ medicines were managed and administered safely.

The service followed safe recruitment practices. There were sufficient numbers of skilled and trained staff to meet people’s health and welfare needs. Staff felt supported by the registered and deputy manager. Quality assurance systems were in place to monitor the quality of service being delivered and the running of the home.

Further information is in the detailed findings below.

This inspection took place on 5 November 2015. The inspection was announced as we wanted to ensure people and staff would be at the home as they are often out in the community. 59 Hatherley Road Residential Home provides accommodation and personal care for up to three people with a learning disability. The home is situated on a quiet residential street. It comprises of a lounge/dining room, kitchen, three bedrooms and a bathroom. People have access to a secure back garden.

At the time of the inspection the service had a registered manager. 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 enjoyed living at the home. They told us they felt safe and relaxed living there. However people’s personal finances were not managed effectively. The financial records of people’s day to day money transactions had not been recorded correctly.

Staff knew people well and had a kind approach. They spoke to people in a respectful and dignified manner. People’s care and supports needs had been well documented. Staff were responsive to their needs. People were supported to maintain a healthy lifestyle. They enjoyed a varied diet. They were encouraged to make choices about their meals and daily activities. Records showed that people had been appropriately referred to health care services when needed. People received their prescribed medicines as required.

Staff employment histories and criminal backgrounds had been checked to ensure that people were cared for by suitable staff. Staff were supported and trained to meet people’s needs. An on call system was available to staff who worked in the evenings and at weekends for advice and support.

The home was well led. The registered manager led by example and addressed any poor practice. They were often present in the home and knew people and staff well. The quality of service being provided was regularly monitored by the registered manager and the provider. The registered manager was supported by the provider and other managers within the organisation.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

An adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

As part of this inspection we spoke with the registered manager, two members of staff and two people who lived in the home. We reviewed the care records relating to the management of the home which included two care records, daily care records, accident and incident records and quality assurance systems. We observed staff interacting with people who lived in the home.

Below is a summary of what we found. The summary describes what people who lived in the home and staff told us, what we observed and the records we looked at.

Is the service safe?

People were safe because staff understood the needs of the people who lived in the home. Care was delivered as planned in people’s care records. The home was cleaned and maintained. The registered manager and staff were aware of their role to prevent people who lived in the home from coming to harm. There were effective systems in place to ensure that risks associated with mishandling of people’s medication had been reduced. Emergency procedures were in place should they be needed.

Is the service effective?

People received an effective service because staff had a good understanding of people's needs. People looked relaxed and at ease with the staff. We saw staff giving people choice and involving them in the day to day activities around the home. People were involved in planning and preparing meals. We saw that staff were confident and knowledgeable in caring for people. One staff member said “The training we get here is good”.

Is the service caring?

People received a service which was caring because people's wishes were acknowledged and respected. As people’s needs changed, staff knew how to manage and adapt their care effectively. We saw staff giving people information so they could make an informed decision about an activity. Staff were observed communicating with people in a kind and sensitive way.

Is the service responsive?

This service was responsive because people received support and care when they needed it. We saw that a person who visited the home was treated with dignity and respect. People’s health was regularly monitored and reviewed by the local GPs. Referrals were quickly made to health services when people’s needs changed.

A complaints policy was in place. The registered manager managed complaints and concerns on a day to day basis. People told us they felt they could raise a concern with any of the staff.

Is the service well-led?

The service was well led as there were effective arrangements in place to review and monitor care practices in the home. The management team understood the principles of quality assurance to improve the service and quality of life for people who lived in the home. The registered manager consulted with people, their relatives and staff about the service provided. Actions to improve the home and service provided were carried out as a result of their feedback.

Each person who used the service had a specific care plan in place detailing how staff helped with offering choice and involvement in decision making. The home is registered for care for three people, however at the time of our visited only two people were using the service. We looked at the care files for the two people who used the service. We also spoke to one person who used the service as well as two members of staff. Both care files had individual care plans and risk assessments in place. These had been reviewed on a regular basis. These documents reflected people’s needs and were person centred.

People were cared for by appropriate staff who had all received safeguarding training. They were aware of their own roles and responsibilities with regards to keeping people safe.

We spoke to one person who used the service. They told us “the staff help me with my personal care, I like it here”. We saw the results of quality surveys for 2012 and they all had positive results. The comments included “there is a good relationship between staff and people using the service”. “Quality of care provision is good and people who use the service are always well dressed”. “There is a good level of engagement in the local community”.

We reviewed the care files for all three people and found them to be comprehensive and up to date. Each file contained specific information individual to each person. Food and activity charts were completed daily. People were encouraged to participate in the weekly food shopping and other activities included bingo, day centre, arts and crafts and church groups. The care plans and risk assessments were current and reviewed regularly. One person was very keen to show us the care plans she had written for herself with help from the staff. We also saw an example of where staff had helped a person who used the service to write to their family.

We spoke to all three people who used the service and all expressed how happy they were living at the home. They also had very good relationships with the staff. We observed communication between staff and people was very friendly but respectful.