The inspection took place on the 15 June 2017 and was announced.

Care Management Group – 100 Goldstone Crescent provides personal care and accommodation for three younger adults who have learning disabilities. The support provided is tailored to meet people’s individual needs and enables the person to be as autonomous and independent as possible. There were three people living at the service at the time of our inspection.

At the last inspection on 12 August 2014, the service was rated Good overall. At this inspection we found the service remained Good overall.

People and their relatives told us they felt people continued to be safe in the service. They knew who they could talk with if they had any concerns. They felt it was somewhere where they could raise concerns and they would be listened to. Systems in place to assess and manage risks had been maintained to provide safe and effective care. People continued to be supported by staff who had been through robust recruitment procedures.

Sufficient numbers of suitable staff had been maintained to keep people safe and meet their care and support needs. Staff on the day shifts usually covered any gaps in day staff. One member of staff told us, “There is a minimum of two staff on the shift. That’s more than enough. It’s a lovely team. Two team members have been here for many years, so know the people well.” Staff told us they received supervision and they were well supported. They had received training to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively.

Care and support provided was personalised and based on the identified needs of each individual. People’s care and support plans and risk assessments had been maintained and reviewed regularly. Where people were unable to make decisions for themselves this had been considered under the Mental Capacity Act 2005.

People continued to live in a service with a relaxed and homely feel. People were supported by kind and caring staff who treated them with respect and dignity. One member of staff told us, “It’s like a family here.” They were spoken with and supported in a sensitive, respectful and professional manner.

People told us they liked the food provided. Staff told us that an individual’s dietary requirements had been considered and people were regularly consulted about their food preferences.

Relatives told us communication with the service was good. People had regular opportunities to comment on the care they received. They were aware who to speak with if they had any concerns.

Staff told us that communication throughout the service continued to be good and included comprehensive handovers at the beginning of each shift and staff meetings. They confirmed that they felt valued and supported by the manager, who they described as very approachable. The registered manager told us that senior staff had maintained a range of internal audits, and records confirmed this. They operated an 'open door policy' so people living in the service, staff and visitors could discuss any issues they may have.

Further information is in the detailed findings below.

On this inspection we spoke with all three people who used the service and a family member of one person. We also spoke with the registered manager and three care workers. We looked at care documentation, records, audits and minutes of meetings.

People who used the service had an active voice in their support programme and where appropriate, indicated their agreement.

We found that people’s needs were assessed and support was planned and delivered to meet identified needs. We saw and heard from people who told us that they felt safe and happy living at the service. One person who lives at 100 Goldstone Crescent told us “I like it here. I can bake cakes on my day off.” We saw people were supported sensitively and respectfully in a manner which valued them. A relative told us “The staff and facilities are excellent.”

We found that appropriate standards of hygiene had been maintained and people were supported in a clean, hygienic environment.

We saw there were enough qualified, skilled and experienced staff to meet people's needs.

Records relevant to the management of the services were accurate and fit for purpose.

During our inspection we found that care workers had formed close professional relationships with people living in the home. The premises were clean and generally well maintained and the atmosphere was relaxed and homely.

As far as practicable and in accordance with their individual care plans, people were enabled and supported to make choices about their daily lives. They had input into how the home was run and were able to influence decision making processes. Care workers had developed awareness and a sound understanding of each individual's care and support needs. This was evident from direct observation of individuals being supported in a professional, sensitive and respectful manner.

Communication and consultation with people's family members was effective and ongoing. Relatives felt well informed and had the opportunity to partake in individual assessment, care planning and reviewing processes.

Positive comments received from people living in the home and their relatives indicated a high level of satisfaction with the home and the services provided:

“I like living here. The staff know me very well and I have everything I need”.

“The care provided is very good and staff are excellent. It gives us peace of mind knowing that she is being so well looked after and her needs are being met.

During our visit, we found that people living in the home were settled and well cared for. This was reinforced by positive comments received and also evident from direct observation of effective interaction and of individuals being supported in a professional, sensitive and respectful manner.

We were told that, in accordance with their identified wishes and individual support plans, people are encouraged and enabled, as far as practicable, to make choices about their daily lives.

Positive comments from relatives of people living in the home indicated a high level of satisfaction with the care and support provided:

‘The manager is approachable and the staff are all very kind and helpful. I am totally satisfied with the care provided and I have absolutely no complaints’.

The inspection was carried out on 14 November 2014. 100 Goldstone Crescent provides personal care and accommodation for three adults with mild to moderate learning disabilities. The provider, Care Management Group (CMG) is a national provider of support to over 600 people with a learning disability. They offer a wide range of services to help all types of people, such as supported living services, outreach and home support, residential adult services and day skills/resource centres.

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 were positive about the support they received and the staff at the home, one person said, “I feel safe here. I like living here.” Their relatives said that they were very happy with the care and support provided. One person told us, “My family member is so happy there that he does not wish to come home sometimes”. Staff were available to meet people’s support needs in a timely manner. So, for example, we saw that staff had time to spend supporting people in a meaningful way that respected individual needs.

The provider acted in accordance with the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS). The provisions of the MCA are used to protect people who might not be able to make informed decisions on their own about the support they receive. There was a commitment to apply for DOLs where a mental capacity assessment has been completed for people who lacked capacity to take decisions.

People living at 100 Goldstone Crescent received effective support. The manager told us, “We are a small stable team, and one or two have known some of the people for a lot of their adult lives.” We found people’s preferences were met wherever possible, for example, people talked to us about their holidays and we heard that they took active decisions on the location and type of holiday they wanted.

During our inspection we spent time in the lounge, kitchen and dining areas and we took time to observe how people and staff interacted. We saw frequent friendly engagement between people and staff. Staff responded positively and warmly to people, they responded to people’s needs appropriately and with confidence.

People’s health care needs were assessed and support planned and delivered to meet those needs. People received their medicines as prescribed and at the correct time. People had access to other healthcare professionals such as GP’s. People told us they could talk with staff if they had a concern about their health and that staff then took the appropriate action. Staff told us that they felt people received the support they needed to maintain their health and that they were good at responding to people’s changing needs.

People were supported to eat and drink enough to keep them healthy and were encouraged to consider making healthy choices. People were supported to use their kitchen to access a range of snacks and drinks and had choices at mealtimes.

Support plans were reviewed monthly by staff and annually with people’s relatives or representatives. These were updated to reflect people’s changes of needs to ensure continuity of their support. People accessed a wide range of activities and were encouraged to maintain their wide circles of support networks. The manager told us, “We are always open to finding and using educational and social activities that people enjoy”.

Staff told us that they would raise concerns with the manager or others within the Care Management Group and were confident that any concerns would be dealt with. One person’s response was typical, “It’s a nice place to work. There is a good staff team who are supportive of each other and led by a very approachable manager”.