Belmont Road is a residential home that provides care for one person who is living with a learning disability. At the last inspection in March 2015, the service was rated Good. At this inspection we found that the service remained Good, with an improvement of good to outstanding in the caring question.

The person continued to receive safe care. The person was protected from the risk of harm through safe staff recruitment processes and reviewed assessments of the risk to their safety. Sufficient numbers of staff were in place to provide the person with the support they needed. Safe medicine management processes were in place and the person received their prescribed medicines safely.

The principles of the Mental Capacity Act 2005 (MCA) were used effectively when decisions were made which the person lacked mental capacity to make for themselves. The person was encouraged to lead a healthy lifestyle and to follow a balanced diet. Staff were well trained and had the skills needed to carry out their role effectively. Staff received regular supervision of their work and felt supported by the management in their role. The person’s day to day health needs were met.

The person had an excellent relationship with the staff. The person was supported by staff who were very kind and caring and treated them with respect and dignity. The person was encouraged to lead as independent life as they were able to with care and support tailored to enable them to do so. Innovative methods were used to communicate with the person and there were individualised processes in place to help the person understand and to contribute to decisions about their care and support. There was a high emphasis on person centred care and staff were aware of the importance of encouraging the person to lead their life in the way they wanted.

The person was provided with the information they needed if they wished to speak with an independent advocate to support them with decisions about their care. The person had been supported to develop positive relationships with people from within the local community. The person was supported to enable them see their friends and family when they wanted to.

The person’s support records were detailed and personalised which enabled staff to support them in line with their personal preferences. An ‘easy read’ complaints process supported the person to make a complaint if they wished to. Effective systems were in place to manage any complaints that the provider may receive.

The service continued to be well-led. The registered manager carried out their role enthusiastically and professionally. The person’s relative, staff and professionals commented positively about their leadership. There was a positive ethos and an open culture at the home resulting in an enjoyable working environment for staff and a calm and friendly atmosphere for the person living there. Effective auditing processes were in place.

We carried out an announced inspection of the service on 10 March 2015. Belmont Road provides accommodation and support for one person who was living with a mental health condition. This inspection was announced to ensure we were able to meet with the person who used the service and to observe staff supporting them.

On the day of our inspection there was a registered manager in place.

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.

The risk of abuse to the person was reduced because staff were aware of the different types of abuse the person could face and knew who to report their concerns to. Risks to the person’s safety were regularly reviewed, whilst ensuring that support plans did not unnecessarily restrict the person’s freedom. There were enough staff to meet the person’s needs and there were safe recruitment procedures in place that ensured new staff had been appropriately vetted prior to commencing their role. Medicines were handled, stored and administered safely, although the reasons for administering ‘as needed’ medicines on occasions did need to be more clear.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The DoLS are part of the MCA. They aim to make sure that people are looked after in a way that does not restrict their freedom. The safeguards should ensure that a person is only deprived of their liberty in a safe and correct way, and that this is only done when it is in the best interests of the person and there is no other way to look after them. The registered manager was aware of the principles of DoLS and how these are implemented to maintain the person’s safety.

The person’s welfare was protected by staff who provided them with effective care and support. Staff received regular training and assessment of their work. Staff ensured that the person who used the service was encouraged to maintain a healthy diet and to make wise food choices that did not have an impact on their health. The person had regular access to external healthcare professionals such as their GP and dentist.

The person received support from staff who were caring and understood what they liked and disliked. There were processes in place that ensured the person’s views were regularly listened to and acted upon. Information about how they could access local independent advice about the support they received was also provided in a format they could understand. The person’s privacy and dignity was maintained at all times.

The person led an active social life, taking part in the activities that they wanted to do. They were encouraged by staff to meet new people and to attend local events to meet their friends. Adjustments had been made to the building to incorporate a massage room at the request of the person’s relative. Support plans and other relevant records were written in a person centred way that focused on how the person wanted their support to be provided. The person’s relative was happy with the complaints process and was confident that if they did need to make a complaint then it would be acted upon quickly.

The service was well led by the management team and staff understood their roles. The person who used the service, their relative and staff were encouraged to provide feedback on how the service could be improved. There were a number of quality assurances processes in place that regularly assessed the quality and effectiveness of the support provided.

We used a number of different methods to help us understand the experiences of the person using the service, because the person using the service had complex needs which meant they were not able to tell us about all of their experiences.

We spoke with the person using the service and observed them interacting with the staff. We also spoke with one relative, two members of staff and looked at care records and other information.

The person using the service told us they could make their own choices and do what they wanted to do. They also told us that staff were nice and that they asked them if it was okay before they did anything.

The relative told us that they were involved in the care planning and that staff always asked their relative for consent.

We found that the person’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We spoke with the person using the service and they told us they were happy living at the home. they said, “The staff are great.”

We found staff supported the person using the service to have a nutritious intake. The person using the service was also supported to be involved in food planning, shopping and preparation.

During our visit we found that people were protected from abuse or the risk of harm.

We spoke with the person using the service and asked them if they felt safe. They said, “I feel safe, the staff are nice.”

We found the home was clean and hygienic. One relative told us they had never had any concerns about the cleanliness of the home.

Belmont Road provides care for one person. We used a number of different methods to help us understand the experiences of the person using the service, because they had complex needs which meant they were not able to tell us about all of their experiences.

We observed how staff supported the person, communicated with them in a way they understood and helped them to make their own choices each day.

The person using the service told us there were lots of opportunities for them to be involved in the local community and participate in their preferred activities. They told us, "The staff are great." They also told us they felt safe and really liked their home.

The staff understood the persons needs and assessed any risks to their health and wellbeing.