87 Church Road is a residential care home for adults with learning disabilities. At the time of our inspection, there were five people living in the home.

At our last inspection we rated the service 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 serious 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.

People received support from staff who were kind and caring. People were positive about the care they received and spoke in positive terms about the staff. Our observations showed that staff were kind and respectful. People’s independence was encouraged.

People were able to take part in a range of activities according to their own needs and interest. This included support to meet religious or spiritual needs. People were able to make complaints when they had them and these were responded to. There was a complaints procedure produced in a format suited to people’s communication needs.

People were safe. Staff understood their responsibility to protect people from the risk of abuse and had received training in this. People received safe support with their medicines.

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 support this practice. People’s health needs were effectively met. People were supported to see healthcare professionals when they needed to.

The service was well led. There was a registered manager in place supported by an assistant team leader. There were systems in place to monitor the quality and safety of the service.

Further information is in the detailed findings below

87 Church Road provides accommodation and personal care for eight people. People who live at the home have a learning disability. There were six people accommodated at the time of the inspection. This was an unannounced inspection, which meant the staff and provider did not know we would be visiting.

There was 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.

People were involved in making decisions on how they wanted to be supported on a daily basis. Where decisions were more complex such as that relating to medical health then best interest meetings were held with the staff and other health professionals.

People were encouraged and supported to lead active lifestyles both in their home and the local community. They had opportunities to take part in a variety of activities.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management, checks on the environment and safe recruitment processes.

Sufficient staff supported the people living at the service. There were four staff vacant posts and these were being covered by regular bank, or agency staff. We were told it was important that staff were familiar to people as this could be unsettling.

People had a care plan that described how they wanted to be supported in an individualised way. These had been kept under review involving the person. Care was effective and responsive to people’s changing needs. There was information for support staff in recognising any relapses in people’s physical or mental health and guidance on what action should be taken to support the person.

Systems were in place to ensure that any complaints were responded to. People’s views were sought through an annual survey.

People were provided with a safe, effective, caring and responsive service that was well led. The organisation’s values and philosophy were clearly explained to staff and there was a positive culture where people were treated as individuals and their rights were respected.

A single 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?

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People were cared for in a clean and safe environment. The main doors to the building were secure and the garden was contained. There were enough staff on duty to meet the needs of the people who used the service. This included the registered manager and all staff had received relevant training in order to carry out their roles.

We saw that staff ensured people's personal safety was maintained by assisting them with activities when required. We saw that people's care plans detailed where their safety might be at risk, and what staff should do to prevent this.

CQC monitors the operation of the Deprivation of Liberty safeguards which applies to care homes. We were informed by the manager of one application that had been submitted in order to assist one person with the acquisition of a new wheelchair. This assessment had been completed in line with the provider's procedures.

Is the service effective?

People who were able to communicate with us were able to confirm that they were happy and well looked after. All of the people that we saw were clean, well dressed and were comfortable and well cared for. This was evidenced by observing people's facial expressions and body language.

Staff told us that had received training relevant to their role and we saw evidence of this. This was further confirmed during scenario conversations with staff. It was clear when we spoke with staff and from the interactions that we observed that staff fully understood people's care needs and that they knew them well. We saw this when we observed staff helping one person with a drink.

Is the service caring?

All of the staff that we saw and spoke with were kind and attentive to people's needs. They spoke gently to people and gave people time to respond. The atmosphere was calm and unhurried and we saw that people were encouraged to be as independent as possible. One member of staff told us "I love the atmosphere here, it's like a big family" and another member of staff told us "I love being here to help people". On the day of our inspection, five people were returning from a holiday with staff. One person told us, with help from staff that they had enjoyed the time away, particularly the hotel entertainment.

Is the service responsive?

The records that we looked at confirmed that people's individual care needs and preferences had been recorded and that care had been planned accordingly.

We saw that activities were planned for people in accordance with their personal choices and that these were offered as individual activities or as part of a group.

We saw that people were encouraged to maintain relationships with friends and relatives and we heard from staff how trips had been planned for people in order to make this happen.

Is the service well-led?

The manager and the staff understood the principles of quality assurance and we saw evidence of audits and surveys that had been undertaken in the past twelve months. We saw minutes of staff meetings that showed that staff regularly discussed ways of improving the service they provided for people. As an example we saw that garden maintenance had been discussed in order to improve the environment for people.

This was a planned inspection. However, we followed up areas of non compliance relating to the care and welfare of people and the quality monitoring systems that were in place from our inspection in October 2012. The provider had taken appropriate action in relation to both of these areas.

The individuals living at 87 Church Road have a learning disability and some complex needs. This meant that it was difficult to fully seek their views as many of the individuals used non verbal communication. We saw that people looked well cared for and appeared happy and relaxed in the company of staff.

People were supported to be involved in decisions about their care, more complex decisions were made within the legal framework. This ensured that decisions made in the best interest of the person involved other professionals.

People's care and welfare needs were being met. This included health and personal care. The provider stored, managed and administered medication safely. We observed medication being audited and administered safely.

All the people we spoke with indicated they were happy with the staff. The provider made sure that thorough recruitment checks were made on all staff before they were employed.

Some people were unable to tell us how they were cared for due to their learning disability and some people have non verbal communication skills. For these people we carried out observations of their care. We observed staff to see how they interacted with the people in their care, we saw that staffs communication was polite and caring.

We spoke to a visitor, they told us that they visited on a weekly basis and had no concerns about the care and support given to their daughter. They told us “staff here are wonderful, they do a marvellous job and my daughter is well looked after”.

People’s ability to consent to their care or treatment had been assessed and recorded, where people required support for more complex decisions advice would be sought.

When we visited 87 Church Road in February this year we reported that improvements were needed for recording within care plans and risk assessments. We found at this inspection that out of the four people’s records we looked at, three people’s care plans and risk assessments had not been reviewed or updated since August 2011 and therefore it was unclear whether the information recorded was up to date.

Appropriate arrangements were in place in relation to the handling and administration of medicine and medicines were kept safely. Clear procedures were in place to support people to raise concerns about their care and the service they received.

We spoke with two individuals and they said they were able to make decisions about their everyday lives and about aspects of the running of the home for example, menu choices and décor.

People said that the staff knew how to care for them and they liked living at the home. They said they had a key worker (a named member of staff) who spent time with them, went on shopping trips with them and arranged their annual holiday.

We were told that they did interesting activities during the day and they had day packages with external organisations.

People knew who to approach with complaints and they felt safe living at the home.

During our visit we observed the way staff spoke to people living at the home. We saw staff used a friendly approach and the individuals responded well to this approach. Staff discussed the day’s events with people and they were happy to speak with the staff.