The inspection took place on 5 January 2017 and was unannounced. At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Cantley House is registered to provide accommodation and personal care for up to three people who have a learning disability or autistic spectrum disorder.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have the legal responsibility for meeting the requirements

in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act, 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect them. The management and staff understood their responsibility and made appropriate referrals for assessment.

Staff had completed training in how to protect people from harm and abuse and understood the different forms and potential signs of abuse. Staff told us they had confidence in the management team to deal with safeguarding issues promptly and effectively.

A thorough recruitment and selection process was in place which ensured staff had the right skills and experience to support people who used the service. Identity and background checks had been completed which included references from previous employers and a disclosure and barring service (DBS) check.

The arrangements for managing people's medicines were safe. Medicines were stored securely and there were clear policies in place for supporting people with their medicines. Medicine records were up to date with no gaps or inaccuracies.

People had opportunity to participate in a wide choice of activities. People were regularly involved in a range of activities on the day we visited. People were able to attend centres locally, which offered a range of activities.

People we spoke with said if they had any concerns or complaints they would feel confident discussing these with staff members or management. They were sure the correct action would be taken if they made a complaint.

Audits and checks were carried out to monitor all aspects of the service. An action plan was developed to highlight any areas which required improving.

We carried out an unannounced comprehensive inspection of this service on 14 October 2014 in which a breach of the legal requirements was found in relation to governance. This report relates to that breach. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Cantley House’ on our website at www.cqc.org.uk.

We carried out this focused inspection on 8 May 2015 to ensure improvements planned by the provider had been implemented to address this breach of Regulation. We found that action had been taken to improve the governance of service provision.

Cantley House is registered to provide personal care to people in supported living. The service aims to provide care and support to people with learning disabilities and autistic spectrum disorders. Care and support was co-ordinated from the service’s office which is based at the same address.

The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

At this focused inspection we found governance and audits had been improved. We saw a structured audit process was in place to help make sure staff and people who used the service were safe and the quality of all aspects of the service were regularly reviewed.

A staff training plan had been updated and a programme of mandatory training arranged. The provider had made these arrangements in consultation with the local authority.

We also saw improvements had been made with regards to recording the assessment of identified risks. Information about risks associated with people’s care now provided clearer guidance to staff about their role in supporting people’s safely.

At our last inspection we found where people needed assistance taking their medicines, records lacked specific information about the medicines administered by staff. At this visit we saw new medication administration forms had been introduced which recorded all the information required.

During our inspection we spoke with two people who used the service. People told us they were well looked after and liked the staff. We observed they appeared to be happy and relaxed at the home.

We saw evidence people were involved in decisions about their care and treatment. We found information recorded in the care plans relating to people's personal preferences and choices.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were supported in taking risks as part of an independent lifestyle, therefore risk assessments were in place to minimise any identified

risks or hazards.

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

There were effective systems in place to reduce the risk and spread of infection. We looked around the home. We found it was clean, tidy and free from odours.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. We found staff were very committed in ensuring people who used the service were well cared for.

There was an effective complaints system available. Staff told us people who used the service were always encouraged to raise any concerns they had with staff or the manager. We looked at a questionnaire completed by people who used the service or their relatives. The results about the standard of care people received were very positive.

We spoke with two people who used the service. They told us they were well looked after and staff were caring. One person told us: "I love my house." We found care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. One person told us they had been to Liverpool and really enjoyed it. Another person helped at a garage cleaning cars.

We found people were supported to eat and drink sufficient amounts to meet their needs. People had a choice of food which took account of their individual preferences, needs and cultural requirements. One person said they liked a Sunday roast. Another person enjoyed cooking Chinese food.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We found staff had a good understanding of people's medication needs.

We found the provider has taken steps to provide care in an environment that was suitably designed and adequately maintained. We saw people who used the service had bedrooms which were personalised to meet their individual choices.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Throughout our inspection we observed good interactions and found people who used the service were relaxed and happy in the care of the staff.

People said that Cantley House was set in a quiet and friendly neighbourhood. The remarks about the service have been included in the relevant sections of this report.

This inspection took place on 14 and 15 October 2014.

Cantley House was last inspected in August 2013 and we found they were meeting the regulations we looked at.

Cantley House provides accommodation and personal care for up to three people with learning disabilities and autistic spectrum disorders. On the day of the inspection three people were living at the home. The home 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.

People were relaxed and happy on the day of the inspection. We saw staff talking with people in a friendly manner. We saw staff assisted people as they needed whilst encouraging people to be as independent as possible.

We saw care records were of a high standard and contained detailed information to guide staff who were supporting people. Risk assessments were completed and regularly reviewed. We found people were supported to live full and active lives and access to the local community.

People were able and encouraged to take part in activities which reflected their individual hobbies and interests. Staff demonstrated a caring attitude towards the people living at Cantley House. People were supported to maintain strong relationships with their families.

Staff were well supported through a system of induction, training, supervision, appraisal and professional development. There was a positive culture within the service which was demonstrated by the attitudes of staff when we spoke with them and their approach to supporting people to develop their independence. We saw the service was organised to suit the needs of the people who lived there.

People were supported by sufficient numbers of staff on duty. The manager and staff told us that staff numbers were always one to one but could be increased to address changes in risk or changing support needs.

We looked at the arrangements in place for the administration of medicines and found these to be safe. Medicines were stored securely in a locked cabinet. Medicines stored tallied with the number recorded on the Medication Administration Records (MARS). Arrangements were in place for the storage of controlled drugs if required. We saw from training records, all staff had received medicines training.

The service was not consistently well-led. Some policies held outdated or incorrect information. Annual training for staff in mandatory areas was not up to date. You can see what action we told the provider to take at the back of the full version of the report.