Cleveland House is a care home, providing accommodation and support for up to 11 people with a learning disability and people with autism. At the time of our inspection 11 people were living in the service.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. This service provides personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the 'Registering the Right Support' and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had 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.

At our last inspection on 23 and 28 October 2015 the service was rated ‘Good’ overall. At this inspection, we have rated the service 'Good' overall.

Safeguarding procedures were in place and staff demonstrated a clear understanding of what abuse was and how they would know if people were at risk of harm through changes in their behaviour. The service had detailed risk assessments in place to guide staff. People were supported to take positive risks whilst being kept safe from harm. The overall health and safety of the service was overseen by staff and people to encourage a sense of independence and people truly felt this was their home. The service provided information relating to infection control in an accessible format. Staff were recruited safely to ensure they were suitable to support people with learning disabilities and staffing levels were sufficient. People’s medicines were managed safely by staff who had received appropriate training and people were supported to understand their medicines where possible.

Staff received a detailed induction and completed ongoing training to allow them to provide high quality support. The service worked well with health and social care professionals and promoted healthy living through encouraging people to exercise and have a healthy diet. Staff understood the Mental Capacity Act 2005 (MCA). MCA is law protecting people who are unable to make decisions for themselves. As people were not able to provide consent to the care and treatment they received, the appropriate authorisation procedures had been completed. These are referred to as the Deprivation of Liberty Safeguards (DoLS). The service had been designed with the needs of people in mind and people had choice around how they wanted their home to look. This is in line with the values that underpin the 'Registering the Right Support' and other best practice guidance.

Observations and records confirmed the service worked in a person-centred way and people’s individual preferences and support needs were understood by staff. People were observed to be able to approach staff at any time for support and staff were seen to be caring in their responses. People had a great deal of independence and were supported to build their confidence by engaging in a variety of activities and doing things they had never done before. The service aimed to protect people from discrimination by encouraging a culture of learning and celebration around different cultural backgrounds. People were empowered to make their own choices and improve their quality of life by being involved in making decisions about the care and support they received. Advocacy services were made available to help people have their views and wishes heard. The service promoted people’s privacy and dignity and tr

People’s care and welfare needs were being met. They and their relatives told us they were happy with the quality of care that was provided. A person who used the service said “I am happy here. I want to stay here.” One relative told us “it’s absolutely fantastic, I thank my lucky stars that she went to live there.” Another said “everybody is looked after very well. I can tell that he is happy.”

We found that people were treated with respect and their health needs were met. A relative said “they are very good with health needs and always follow things up.” Another told us “they all get choice and are asked what they want.” There were systems in place to ensure that people received their prescribed medication safely and appropriately.

We found that there were sufficient staff on duty to meet people’s needs. Both staff and relatives confirmed this. One relative told us “there are enough staff and they know what they are doing.” Another said "the staff are superb and know what they are doing.”

People were protected from the risks of unsafe or inappropriate care because accurate and appropriate records were maintained.

During the course of our inspection we met and spent time with six of the people who used the service. Three people talked to us about what they did, what they liked and about Cleveland House. For the other three people, who were not able to give us verbal feedback, we were able to observe what they were doing and how they interacted with the staff. We also spoke with the relatives of four people who used the service. All those we spoke with were happy with the care and support provided by the service. We saw that people who used the service and staff spent time together doing different things and chatting to each other. People were treated with respect by staff and appeared relaxed in their company.

A person who used the service said, “I like it at Cleveland House because they help me. I like going out and having lunch, I like going to college and I like my job.” A relative said, “He is very well looked after and safe and we are happy with the care that he gets.” Another commented, “She is very happy there and has got on fantastically since she's been there. Can't speak too highly of the place. They are given options and are encouraged all the time to make choices.”

This unannounced inspection took place on 23 and 28 October 2015 and was unannounced on 23 October 2015.

Cleveland House is an 11 bed service providing support and accommodation to people with a learning disability. At the time of the inspection 10 people were living there. It is a large house in a residential area close to public transport and other services. In addition to the main house, a self-contained flat had been built in the garden to enable the person living in it to become more independent .The house did not have any special adaptations and people who used the service did not need any. People lived in a clean and safe environment that is suitable for their needs.

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 and associated Regulations about how the service is run.

The service provided outstanding care and support. The registered manager and staff were highly motivated and committed to ensuring that people had meaningful and fulfilling lives. They were proud of the work they did and of people’s achievements.

The staff were highly committed and provided people with positive care experiences. They ensured people’s care preferences were met and gave them opportunities to try new experiences. People were supported to be involved in activities of their choice in the community and in the service. They had full, varied and personalised activity programmes.

People received a strongly person centred service. They were supported to make choices and to have as much control as possible about what they did. People and their family members were consulted and involved in assessments and reviews.

Staff were clear about their roles and responsibilities. They received effective training and excellent guidance and support from the registered manager. This provided them with the knowledge, skills and confidence to meet people’s needs in an outstanding and individualised manner. The registered manager and staff team were committed to continuous improvement of the service and to improving people’s quality of life.

People’s views were sought and valued. They were involved in developing and shaping the service provided. People and their relatives were encouraged to be involved in the planning of care.

The service was robustly monitored by the registered manager and the provider to ensure that people were receiving a safe and effective service that reflected their needs and wishes.

People were safe at the service. They were supported by kind, caring staff who treated them with respect. Strategies to minimise risk were robust and enabled staff to support people as safely as possible both in the community and in the service.

The staff team worked closely with other professionals to ensure that people were supported to receive the healthcare that they needed.

Staff had completed Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) training. Deprivation of Liberty Safeguards is where a person can be deprived of their liberties where it is deemed to be in their best interests or for their own safety. Staff were aware that on occasions this was necessary. We saw that this was thought to be necessary for some people living at the service to keep them safe.

People were supported to eat and drink enough to meet their needs. They told us that they liked the food.

Systems were in place to ensure that people received their prescribed medicines safely and appropriately.

The provider’s recruitment process was robust and ensured that staff were suitable to work with people who needed support.