People we spoke with told us that they felt that staff supported them when they needed it. We saw through people's body language that people were comfortable with the staff.

There were robust measures in place to ensure people were safe. Risk assessments were in place specific to their individual needs and any behaviour they may present. They included detailed guidance for staff so people could be supported appropriately. Staff had received training in safeguarding adults from abuse and knew what to do if they saw or suspected abuse.

There was sufficient staff on duty to meet people's needs. Some people required staff support to access the community and take part in activities.

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. We found that staff had the skills, knowledge and experience to support people effectively and safely. Staff were supported by the manager through regular supervisions, annual appraisal and regular training. Staff meetings were held regularly.

Medicines were managed safely and people received their medicines as prescribed. Staff had been trained to administer medicines in order to ensure errors were kept to a minimum.

We found the home clean with no odours. The home was well maintained and in good decorative order. People's bedrooms were personalised.

Regular checks and tests, such as gas, electricity, water safety, fire drills, weekly fire alarm tests and external checks of fire fighting equipment, were completed to maintain safety in the home.

People's needs were assessed and reviewed regularly to reflect people's current health and support needs. Appointments were made regularly for the GP, dentist and optician to help to maintain good health. We saw that people were supported to achieve their outcomes.

People were supported to eat and drink enough to maintain a balanced diet. We saw that people were encouraged to eat healthily and adopt an active lifestyle.

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 supported this practice. People made decisions and choices in relation to their care, support received, daily routines and any activities they wished to take part in. Staff knew the people well and how they communicated their needs and choices, including their preferred daily routine.

People were supported to be as independent as possible in many aspects of their lives, including travelling, meal preparation, shopping and laundry. Staff spoke positively about people's independence and their achievements.

Clear records of people's daily routines helped to ensure staff supported people according to their preference. The use of a 'visual planner' provided reassurance for which staff were supporting a person each day.

Visitors were free to come to the home and see their family member when they wanted and people were supported to maintain contact with their families.

People received personalised care that was responsive to their needs. Care plans were written for the individual and informed staff of their preferences and wishes. We found they contained detailed information that enabled staff to meet people's needs. Support plans were completed to show the goals people wanted to achieve.

People in the home enjoyed a range of activities, with staff support. People accessed the community to enjoy amenities such as pub lunches, shopping, swimming, museums, and gardening.

There was a complaints policy in place but no complaints had been received since the last inspection in 2016. The policy was displayed in the home.

There was a person-centred and open culture in the home. Staff showed a commitment to provide support which achieved good outcomes for the people living in the home.

Quality assurance audits were completed by support staff and senior care staff which included, medication and health and safety.

There

This inspection took place on 8 December 2015 and was announced. We gave the provider 48 hours’ notice that we would be coming. This is to ensure the people we would need to speak to were available. This service was last inspected in October 2013, and was fully compliant.

Cambridge Road is situated in a residential area of Bootle. It is conveniently situated for local amenities and public transport. The home consists of three separate houses, two for single occupation and the other for two people. The two people living in one of the houses have their own bedroom and have access to communal areas which include a lounge, an office, a kitchen and a bathroom.

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 and relatives of people living at the home told us they felt safe.

There were appropriate safeguarding procedures in place to protect people from harm. These included thorough staff recruitment, staff training and systems for protecting people against the risks of abuse.

There were procedures in place for managing, storing, checking and administering medicines.

We observed caring and warm interactions between staff and the people who lived at the home. Staff were able to explain how they ensured people’s dignity, privacy and choice was upheld.

Assessments had been made and reviewed regarding people’s individual capacity to make specific care decisions. Where people did not have capacity, decisions were taken in ‘their best interest’ with the involvement of family members where appropriate and relevant health care professionals. This showed the provider 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) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests. At the time of this inspection, there was one application which had been authorised under DoLS for people’s freedoms and liberties to be restricted. We checked records and saw the process had been carried out correctly.

People’s health and social care needs had been appropriately assessed. Care plans provided detailed information for staff to help them provide the individual care people required. Identified risks associated with people’s care had been assessed and plans were in place to minimise the potential risks to the person.

There were effective systems in place to monitor and improve the quality of service through feedback from people who used the service and their families, staff meetings and a programme of audits and checks.

There were four people living at Cambridge Rd on the inspection. Two people lived in one house and one person in each of the other two houses. Staff support was in place 24 hours a day for the main house with support as needed for the other two houses.

We spoke with two of the four people living at Cambridge Rd. The other two people were out during the inspection. We also observed how people were supported by staff. We observed staff communicating with people. We saw that they were able to communicate effectively together. We observed people being treated with respect and dignity.

Person centred care records were in place providing information about people. These were updated frequently and showed that people were involved in decisions.

Cambridge Road was maintained and decorated for the comfort of the people living there. Bedrooms were personalised according to people’s wishes.

The home was staffed well enough to provide people with individual and group activities.

There were regular checks of the quality of the service and changes made if needed. People knew how to complain if they were unhappy with the support they received.

At the time we visited Cambridge Road only three people were available as others had gone out for the day. We spent time talking with one person and observing the support they received.

One person told us they enjoyed living at Cambridge Road and felt the staff were qualified and capable of supporting them correctly. They told us," The staff here are very good and well trained. They understand how to support me.”

We saw that people who lived at Cambridge Road prepared their own individual weekly menu and did their shopping, some with staff support. We spoke with one person who told us they went to the supermarket on their own to buy their food.

We found that the medication was stored in locked cabinets and dispensed correctly. One person managed their own medication in a safe environment. We saw a risk assessment which ensured they were capable of doing this.

Staff who worked at Cambridge Road were suitably trained to support the people they worked with. They had an individual training plan and had received training this year to assist them in their work.

We found the care records to be comprehensive up to date documents with evidence that people who lived at Cambridge Road had been involved in updating them, making the information in them relevant and accurate.

When writing our inspection reports we generally include the views and comments of the people using the service. This ensures we are reflecting their experiences and the support they receive. However, at the time we visited Cambridge Road only three people were available as others had gone out for the day. We spent time talking with them and observing the support they received. In order to maintain their right to privacy we have taken into account the things they told us but not referred to them directly within this report.

Overall the people we spoke with were happy with their care and accommodation and said they felt safe staying at Cambridge Road.