About the service: Ash Street is part of Arden College that provides specialist further education for young people aged 16-25 years of age with learning disabilities. Ash Street can provide accommodation for three young adults aged over 18 who attend the college and there are support staff 24 hours per day. Accommodation can be term time only and outside of term time if required. At the time of our inspection there were two people living at the home and attending the college and one person staying at weekends for respite care.

People’s experience of using this service:

Comments indicated that Ash Street was safe, and people enjoyed living there and attending college. Medication was managed safely and only administered by staff who had they correct training to do so. Staff were recruited safely, and checks were made on their character and suitability to work with vulnerable people. Risk assessment were clear, reviewed often, and contained information which described how to reduce the risks occurring. The environment had underdone contractual checks to ensure it was safe. There was some agency staff being used, however, these were only used following an induction process, and the same staff were often requested. Staff we spoke with could clearly describe the process for safeguarding people from abuse.

The registered manager was following the principles of the Mental Capacity Act 2005. We did discuss that some information around consent and best interest decisions would benefit from being clearer in support plans. The registered manager took this feedback on board. People were supported by staff who were skilled and had undergone all mandatory training. Staff also engaged in regular supervision. People made their own meals supported by staff and using recipe picture cards. The staff engaged with other health and social care professionals to ensure people had access to appropriate health care.

Staff were caring. We received positive comments regarding the staff’s approach and the way they respected people’s privacy and dignity. People were encouraged as much as possible to be involved in their support plans.

Support plans were personalised and were written in a way which encouraged staff to promote people’s independence and diverse needs. Complaints were recorded and responded to in line with the organisation’s procedures.

The registered manager worked a part of the team and staff said they were a good source of support. The registered manager was visible during our inspection and responded positively to feedback. There were a range of audits in place which scrutinised service provision and any changes were implemented as needed. There was positive partnership working between Ash Street and Arden College to ensure people received safe and consistent support.

Rating at last inspection: The service was last rated good, report published October 2016.

Why we inspected: This was a planned comprehensive inspection based on the ratings at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This announced inspection was conducted on 13 & 14 September 2016.

We gave the provider 48 hours’ notice that we would be coming as service is a small home for adults with adults with learning disabilities and we wanted to be sure someone would be in.

Ash Street is part of Arden College that provides specialist further education for young people aged 16-25 years of age with learning disabilities. Ash Street can provide accommodation for three young adults aged over 18 who attend the college and there are support staff 24 hours per day. Accommodation can be term time only and outside of term time if required. At the time of our inspection there were three people living at the home and attending the college.

The inspection was conducted by an adult social care inspector.

A registered manager was 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.

We spoke to family members of people living at the home who told us they felt their relative was safe and well cared for. People we spoke with told us they felt safe and staff knew what actions to take if they thought that anyone had been harmed in any way.

There were safe procedures in place to ensure staff were recruited and checked to ensure they were suitable to work with vulnerable adults.

Procedures relating to the safe storage and administration of medication were in place in the home and checked regularly to ensure no errors had occurred.

Arrangements were in place to check the safety of the building by external contractors and a log of these were kept on file for us to check.

Staff understood the need to respect people’s choices and decisions if they had the capacity to do so. Assessments had been carried out and reviewed regarding people’s individual capacity to make care decisions. Where people did not have capacity, this was documented appropriately and decisions were made in their best interest with the involvement of family members and relevant health care professionals. This showed the provider understood and was adhering to the Mental Capacity Act 2005.This is legislation to protect and empower people who may not be able to make their own decisions.

The provider was meeting their requirements set out in the Deprivation of Liberty Safeguards (DoLS). DoLS is part of the Mental Capacity Act (2005).

People’s bedrooms were individually decorated to their own tastes. People who could not communicate verbally were encouraged to express their views through physical gestures, body language, Makaton and British Sign Language.

People were supported to purchase and prepare the food and drink that they chose. People who lived at the home, their relatives and other professionals had been involved in the assessment and planning of their care. Care records were detailed and gave staff the information they required so that they were aware of how to meet people’s needs.

There was a complaints procedure in place and people felt confident to raise any concerns either with the staff, the deputy manager or the registered manager.

Staff were trained and skilled in all mandatory subjects, and additional training which was taking place within the organisation at the college. Staff we spoke with were able to explain their development plans to us in detail and told us they enjoyed the training they received. Staff told us they could approach the management team anytime and ask for additional support and advice.

Staff said they benefited from regular one to one supervision and appraisal from their manager. Staff spoke highly about the registered manager.

Managers were able to evidence a series of quality assurance processes and audits carried out.

On the day of our visit we spoke with a staff member and head of care within the organisation. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced living at 23 Ash Street. No other staff were on duty at the time of the inspection. The four students/residents were not available as they were attending Arden College.

During the inspection we viewed the environment including the kitchen area and looked at care and maintenance records. We also saw records of how the service sought the views of residents, families and staff.

The staff member we spoke with had an awareness of the residents care needs and support plan. A staff member said, “Each care support plan is person centred and worked through with the student.”

The member of staff told us students were responsible for the cleanliness of the building and were supported by staff members. “Each student has a planned routine of domestic tasks, with oversight from staff. We do this to promote life skills and independence.”

Prior to our visit we contacted Sefton contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

People at the home attended college each day and sometimes returned late. We therefore announced our inspection, so we were able to meet people at the home and staff. Some people preferred not to meet with us, however we were able to speak with two people to see what they thought about the home. We spoke with some relatives and met with members of the management team and staff. We saw a number of care documents and observed the care and support people received. It was evident the staff provided people with the care and support they needed to ensure their well being. We observed good interaction between the staff and the people they supported. Communication aids were available for people to use in and outside of the home.

Staff told us about various activities people were involved with and how they supported people with daily life skills to promote their independence. People chatted freely with the staff and they appeared at ease and 'comfortable' with them. There was a relaxed atmosphere in the home.

Staff received training and support, so they had the skills and knowledge to provide safe care to people. A relative confirmed the staff were well trained.

The home had a complaints policy and procedure (in picture format), so people who used the service had the information they needed should they wish to raise a concern. Regular meetings were held at the home to enable people to give their views and be involved with choosing activities and menus, for example.

During our site visit we spoke to the manager, the learning manager, two staff members and a person living at the home. We also received comments from other professional agencies such as social services and Lancashire Council's Contracts Monitoring Team, to enable us to get an overview of the service.

The service is a small home and only one person was available at the time of the visit. However, comments we received from the person at the home and staff were positive. They included, “Everyone gets along well" and also, "We only want what’s best for the people living here." When asked about the staff the person said, “They are all good."

Staff spoken with said they felt the staff team worked well together and because most have been at the home for a number of years they know each other very well. One staff member said, "We all cover for each other when needed."

We talked to staff about the people living at the home and they had a good awareness of individuals' care needs and the importance of treating people with respect and dignity. One staff member said, “I have supported XX for three years and built up a friendship and relationship."

As part of the inspection process we spoke to social services for their view of how the home operates. Allthough there has been involvement recently in relation to safeguarding matters, they had no issues in respect of the delivery of care and the manager's response to safeguarding concerns.