66 Dudley Street provides accommodation and personal care to a maximum of six people who lived with a learning disability and/or associated needs. At the time of our inspection six people lived at the home.

At our last inspection of March 2015 the service was rated good. At this inspection, the rating remained good.

The manager was registered with us as is required by law and was present on the day. 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 received safe care and were supported to take their medicines safely and as they had been prescribed. Staff had received training in how to protect people from abuse and harm. Risks to people were assessed and guidance was available for staff to follow to ensure people were protected from accidents and injury.

People received effective support from staff who knew how to meet their individual needs. People were supported to have choices in their daily lives. Staff ensured that people were supported in the least restrictive ways. People were offered food and drink that they enjoyed and had access to appropriate healthcare services.

The care people received was kind and helpful. People were encouraged and enabled to be involved as much as possible in making decisions about how their support needs were met. Visitors were made to feel welcome and people were enabled to have contact with their family.

The service was responsive and involved people in developing their care plan so that their individual preferences and abilities were known. People were supported to take part in the leisure activities that they enjoyed. Arrangements were in place to obtain the views of people and their relatives. A complaints procedure was available for people and their relatives to use if they had the need.

The service was well-led. Checks and monitoring of the quality of the service were undertaken regularly to ensure that the service was run in the best interests of the people who lived there. People and staff confirmed the leadership skills of the registered manager were good. The registered manager was visible within the service and had a good insight of people’s needs.

The provider is registered to accommodate and deliver personal care to six people. People who live there may have a learning disability or associated need.

Our inspection was unannounced and took place on 2 March 2015. At our last inspection in July 2013 the provider was meeting all of the regulations that we assessed.

A manager was registered with us as is required by law. 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.

Staff followed the provider’s procedures to ensure the risk of harm to people was reduced and that people received care and support in a safe way. We found that where people received support from staff with taking prescribed medicines, this was done in a way that minimised any risk to them.

People and their relatives told us that staff were available to meet their [or their family members] individual needs. We found that staff were trained and competent to support the people who lived there effectively and safely. Staff told us and records confirmed that they received induction training and the support they needed to ensure they did their job safely.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). We found that the registered manager was meeting the requirements set out in the MCA and DoLS to ensure that people received care in line with their best interests and were not unlawfully restricted.

Staff supported people with their nutrition and health care needs. We found that people were able to make decisions about their care and they and their families were involved in how their care was planned and delivered. Systems were in place for people and their relatives to raise their concerns or complaints.

People were encouraged, enabled and supported to engage in a range of recreational activities which they enjoyed. Staff supported people to keep in contact with their family as this was important to them.

Staff supported people to be as independent as possible. People were encouraged and supported to undertake daily tasks and attend to their own personal hygiene needs.

All people received assessment and treatment when needed from a range of health care professionals including their GP, specialist consultants and nurses which helped to promote their health and well-being.

People we spoke with communicated to us that the quality of service was good. This was confirmed by the majority of relatives we spoke with. The management of the service was stable, with processes in place to monitor the quality of the service.

There were six people living at the home on the day of our inspection. No one knew we would be visiting. We spoke with three people who were living there although communication with some people was very limited. One person said, “I do like it here”. Another person smiled when asked if they liked living there which indicated that they did.

Because some of the people living at the home had complex needs, not everyone was able to tell us about their experiences. We used a number of different methods to help us understand the experiences of these people which included observation. We spent time sitting in communal areas to observe the care that people received. We saw good interactions between the staff and people who lived at the home and we saw that people were given choices. We saw that people were at ease with the staff.

We found that people were offered varied and nutritious food. Where concerns had been identified referrals had been made to health care professionals to prevent malnutrition.

We saw that people's needs had been assessed by a range of health professionals including; specialist doctors, the dietician and the optician. This meant that people's health care needs had been monitored and met.

We found that systems were in place for staff to raise and report concerns that they may have to prevent abuse and harm to the people who lived there.

Although there had been a shortfall in staffing numbers improvements were being made to make sure that there would be enough staff to care for the people living there and keep them safe.

We saw that complaints processes were in place for people to use if they were not happy with the service provided.

There were six people living at the home on the day of our inspection. No one knew we would be visiting. We spoke with three people who lived there, one visitor and four members of staff.

Due to their health conditions and complex needs not all people living there were able to verbally share with us their views about the care they received. We were able to look at other areas for evidence to support their experience which included observation and sampling care records.

The three people we spoke with told us positive things about the home. One person told us "I like it here”. Another person told us that they "Really liked living there and that they liked the staff."

We saw that staff spent time with people and gave them individual attention. We saw that there were positive relationships between staff and people living at the home. When staff approached people, people responded by smiling which showed that they were comfortable with the staff.

We saw that staff treated people with respect and dignity. People told us and we saw that choices were offered and that people’s views were sought and taken into consideration.

We found that people's needs had been assessed by a wide range of health professionals including speech and language therapists, physiotherapists, specialist doctors and the optician. We saw that people’s weight was being monitored and that action was being taken where people were over weight or needed to gain weight. This meant that people's health care needs had been monitored and met.

Staff had received a range of training which included caring for people with a learning disability and abuse awareness training, so that they had up to date knowledge and skills in order to support the people who lived at the home and keep them safe. Staff we spoke with knew about people’s needs and personal wishes. This meant that care could be provided in the way that people wanted it to be.

We saw that a wide range community based and in-house activities were offered daily to suit people's individual needs and choices. People told us that they enjoyed these. One person said “I went to the Sea Life centre last week, I really loved it there”. Another person told us that they were going on holiday soon and were looking forward to that.

We saw that attention had been paid to the risks associated with people's behaviour that might have challenged the service. People had been assessed by appropriate professional health care staff who gave staff guidance on how to manage behaviour to help keep people calmer and safer.

We saw that systems were in place to report concerns and protect people from harm. Staff we spoke with gave us a good account of what they would do if they thought a person was at risk of harm or was being abused.

We saw that medication systems were in place to prevent risks and errors. We saw that medication had been administered as it had been prescribed by the doctor.

We saw that the cleanliness of the premises had improved since our previous inspection. We saw that decoration was being undertaken which made the home a pleasant place for people to live in. People told us that they liked the dining room which had been redecorated.

We sampled personal records for three members of staff. We found that recruitment checking processes were robust and thorough which meant that unsuitable staff were less likely to be appointed so people were at less risk of harm.

There were systems in place to monitor how the home was run to ensure people received a quality service. People we spoke with told us that they liked their home.

During our two visits only one person was available for us to speak to as the others were either out of the building or resting.

The person told us “I’m always involved in my care and care plan. The staff are good and care for me how I want to be cared for". “ I know how to complain, the staff have told me. I have the complaints papers. If I was unhappy I will tell staff or the manager”. “I like my bedroom. I chose the colours myself. It is clean and I help to keep it clean”.