About the service: Bedford Road is a residential care home. This service supports people with autism; The service is registered to care for three people; there were two people using the service at the time of the inspection.

People’s experience of using this service:

The service applied the principles and of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support in the promotion of choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Bedford Road is located in an area that enabled people using the service to participate in their own local community.

Staffing levels were appropriately managed and people received care from consistent, regular staff. Enough staff were employed each day to meet people's needs, keep them safe and give them the opportunity to take part in their chosen activity.

Staff received a range of training appropriate to their role and people’s needs and were supported by the registered manager though regular supervision.

Risks that people faced had been assessed and those identified were safely managed. Medicines were managed safely. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm. The environment was safe and in a good state of repair and decoration.

People were encouraged and supported to eat and drink well and supported to access healthcare when needed. People were offered choice and control and where able consented to their care and support. Pictures and photographs were used to facilitate effective communication.

The leadership of the service promoted a positive culture that was person-centred and inclusive. We received positive feedback about the quality of care and support people received and the overall management of the service from their relatives. The registered manager and the staff team showed a desire to improve on the service provided and in turn the quality of life experiences for the people at Bedford Road. Effective systems were in place to check the quality and safety of the service.

Rating at last inspection: At the last inspection the service was rated Good (Report published 18 October 2016).

Why we inspected: This was a planned inspection to confirm that this service remained Good.

Follow up: We will continue to monitor the service through the information we receive. 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

The inspection visit at Bedford Road took place on 19 September 2016 and was announced. We informed the registered manager we would be coming. This was because the home was small and we wanted to ensure people were available to talk with us.

Bedford Road is situated in the residential area of Bootle, Liverpool. The service is operated by Autism Initiatives and provides accommodation for persons who require nursing or personal care for up to three adults who are living with autism. The residential care home is located close to public transport links, leisure and shopping facilities. At the time of our inspection there were two people living at the home.

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.

At the last inspection on 05 February 2014, we found the provider was meeting the requirements of the regulations inspected.

During this inspection, staff had received abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure.

We found staffing levels were suitable with an appropriate skill mix to meet the needs of people who used the service.

The provider had recruitment and selection procedures to minimise the risk of inappropriate employees working with vulnerable people. Checks had been completed prior to any staff commencing work at the service. This was confirmed from discussions with staff.

Staff responsible for administering medicines were trained to ensure they were competent and had the skills required. There were appropriate arrangements for storing medicines safely.

Staff received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

People’s representatives told us they were involved in their care and had discussed and consented to their care. We found staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People told us they were happy with the meals available to them. We saw regular snacks and drinks were available between meals to ensure people received adequate nutrition and hydration.

We found people had access to healthcare professionals and their healthcare needs were met. We saw the management team had responded promptly when people had experienced health problems.

Comments we received demonstrated people were satisfied with their care. The management and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care and support to people who lived at Bedford Road.

Care plans were organised and identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

People told us they were happy with the activities organised by staff at Bedford Road. Staff members who knew the people and knew what they liked to do and what they did not like arranged activities.

A complaints procedure was available and people we spoke with said they knew who to complain to if they had any problems.

Staff spoken with felt the registered manager was accessible, supportive, approachable, listened, and acted on concerns raised.

The registered manager had sought feedback from people who lived at the home and staff. They had consulted with people and their relatives. They had observed people’s mood and behaviours as an indicator of the quality of

The provider had systems in place to gain and review consent from people using services or their representatives. Monthly meetings ensured people`s needs and wishes were listened to and respected. There were arrangements in place to deal with foreseeable emergencies, for example in the event of a staff absence through sickness. We were told `we have never had a problem getting a shift covered - we ring around all permanent and bank staff until we get cover.` People were protected against the risks associated with medication because the provider had appropriate arrangements in place to manage it in a safe manner.

During our inspection we noted staff members had received a high-level of training which ensured all people using services received good quality care and were kept safe at all times. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others. There were also procedures in place that monitored the quality of service people received at Bedford Road.

The people who use the service could not tell us about their experiences of using it or comment about the care and support they received, due to a variety of complex needs. However we spent time observing the interaction between the people who lived at the home and the staff and also spoke with one relative.

We observed the care being provided to the people in the home. We saw that people were encouraged to be independent around the home and in the activities they took part in. One person had their own vehicle and staff supported them to access the community. We saw care and support being provided that was appropriate to the person's needs.

We looked at the care records and found they contained all of the relevant documents to support a person safely. We looked at staff files, training and supervision records. We spoke with the registered manager and two support staff employed at the home.

The feedback received from the members of staff and the relative of one person who lived at the home were all positive. Some of the comments from the person's relative were, “The staff have a good relationship with X (persons name) and us,” “The staff had to work really hard with them when they first moved into Bedford Road,” and “Staff are very good at keeping us informed about X (persons name).