The inspection visit took place on 8th January 2019 and was unannounced. A further announced visit took place on 10th January 2019.

Catherine Care Limited is a residential service that is registered to provide support to people who have learning disabilities. The service is registered with the CQC to provide accommodation for up to five adults. At the time of our inspection five people were using the service. People lived in individual rooms with access to the communal kitchen and garden.

There were two registered managers at this location. One registered manager works part time and the other is also a director. The provider informed us that both of the registered managers intended to deregister in due course and an acting manager was currently in place who would register with the CQC once the existing registered managers had trained them. 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.

Both registered managers, the acting manager and an area manager were at the home when we visited.

At our last inspection we rated the service Good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Mental capacity assessments were undertaken but were not always documented and this was not picked up by audits. Training was undertaken in Equality, Diversity and Human Rights but there was no documentation in place to indicate that this was considered in care planning for people.

People were kept safe from the risk of harm. Staff knew how to recognise signs of abuse and were aware of safeguarding procedures. There were a sufficient number of appropriately trained staff to maintain people’s safety. People were not at risk of medicine administration errors as medicines was stored and administered safely.

People’s needs and choices were assessed and reviewed when their needs changed. Staff were appropriately skilled and trained to deliver effective support. They were encouraged to undertake further qualifications and training certificates. People had access to healthcare services and staff knew when to make referrals. The home was adapted to meet people’s needs and their rooms were decorated to their personal preferences. 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 were supported by kind and caring staff who displayed empathy and compassion. Staff considered communication needs and supported people to express their views. People were supported to maintain their privacy and dignity and their independence was promoted.

People and their relatives were involved in care planning and their views were respected. People were encouraged to participate in activities of their choice with the support of care workers and through accessing a local Community Hub. Staff and relatives told us they are confident they will be listened to and any complaints and concerns will be addressed.

Staff and relatives told us that they find the management team open and approachable. The managers were aware of their legal responsibilities and submit timely notifications to CQC when required. Audit processes were in place.

Further information is in the detailed findings below.

The service was registered to provide accomodation for up to five adults with a learning disability. At the time of our inspection four people were using the service. The service was also registered to provide personal care in people’s homes, at the time of the inspection one person was receiving this service.

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 told us they felt safe at the service and staff knew how to recognised and report any concerns. Staff told us they had received training and an induction that had helped them to understand and support people better. The provider was implementing the care certificate as part of people’s inductions. We found risks to people were managed in a way to keep people safe. There were enough staff to support people and they worked flexibly to meet people’s needs. People received their medicines safely and they were stored so people were protected from the risks associated with them. At mealtimes there were choices for people and they told us they enjoyed the food.

The principles of the Mental Capacity Act 2005 were followed. There were capacity assessments and best interest decisions in place for people who needed them. The provider had considered if people were being restricted unlawfully.

Staff had developed positive relationships with people and they knew about their life and daily choices. People were encouraged to be independent and their privacy and dignity was respected. People made choices about their day and had support from advocates when needed. When people needed support from professionals referrals were made and the actions were implemented within the service.

Checks were completed by the provider and the service to bring about improvements. Staff felt they were listened to and were given the opportunity to raise concerns. We found there was a complaints procedure in place and people and relatives knew how to complain.

On the day of our inspection five people were living at the home. We spoke with people who used the service. People told us they were happy at the home. One person said, “I like it here, I feel safe and the staff are nice”. Another person said, “Staff listen if I’m confused”.

During the inspection we sampled people’s care records and spoke with staff. They helped us to answer the five questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

People were treated with respect and dignity by the staff. Care plans identified people’s needs and were reviewed. Staff demonstrated a good understanding of people’s needs. People were given choices and supported to make decisions themselves. Risk assessments were in place and control measures identified. This meant that people’s needs were met and people were kept safe.

Staff received ongoing training in the Mental Capacity Act and Deprivation of Liberty safeguards. This meant that systems were in place to safeguard people as required.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. Only staff that had been trained administered medication.

There were enough qualified, skilled and experienced staff to meet people’s needs. This meant that people received care and support from staff who were competent and of good integrity.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

People experienced care and support that met their needs. People were encouraged to remain as independent as possible and to participate in a range of activities and outings. Records showed people, their relatives and professionals were involved in care reviews. Hospital passports were in place in case people were admitted to hospital. This meant that people’s needs were met.

People were able to move around the home freely and safely. Signage using symbols and pictures were available throughout the home to identify areas and contents of cupboards. Regular audits and checks took place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people’s needs.

Is the service caring?

People were supported by kind and attentive staff. We saw that support workers showed patience and gave encouragement when supporting people. We saw people responded positively to staff. One person said, “Yes, I get good care and support”.

People’s preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. People were involved in their day to day care and were supported to maintain relationships that were important to them. We saw that people were supported to do things they wanted to do. Their diversity and individuality were promoted and respected.

Is the service responsive?

We saw staff that responded quickly to meet people’s needs and ensured people’s safety was maintained. For example, one person was supported with personal care. We saw that people were supported to express their views and these were acted on. People had the opportunity to engage in activities both in the home and within the community.

People were aware of how they could make a complaint. Although no formal complaints had been received we saw records of a concern raised by a family member. We saw that action had been taken to address the concern.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. Staff felt supported in their roles and felt their views were listened too. Staff we spoke with told us it was a good staff team and that the registered manager and directors were very involved in the home.

The service had a quality assurance system. A new quality audit had been developed and was in the process of being used. This meant the quality of the service was continually improving.

We carried out this inspection as part of our schedule of inspections to check on the care and welfare of people who used this service.

We spoke with the registered manager, the acting manager and two members of staff.

We were told that the service supported four people at the time of our inspection.

During the inspection, we spoke with three people who used the service and two people who were visiting someone who used the service.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

One person told us: “I am happy here. The staff are good, they are special”.

Another person told us: “I am happy. I do arts and crafts at college, drama and I see my friends”.

We found that the provider met the care and welfare needs of people who used the service.

We found there were recruitment checks in place to ensure people were cared for, or supported by, suitably qualified, skilled and experienced staff.

We saw that the provider had an effective system to regularly assess and monitor the quality of service that people received.

We found that records were accurate, fit for purpose and met the needs of people who used the service.

During our visit we spoke with the registered manager, the staff and people living at the service.

One person living at the service told us, “I like it here. I went to Blackpool and went on buses and trams. I like the staff”.

A relative told us, "The staff are so lovely. [My relative] is so well looked after. I can't praise them highly enough!".

Two people living at the service were not available to talk to us as they were doing activities in the community on the day of our inspection.

Staff told us they felt supported by the manager and had completed all training to undertake their care role.

Staff we spoke with told us they had completed safeguarding training and understood how to identify abuse and what to do if an incident occurred.

We found that there was a system in place to obtain people's views about the service and we saw evidence that people's views were acted on.

We found that there were effective systems in place to manage risks to the health, safety and welfare of people living in the service.

We looked at five outcomes to assess whether people were involved and participated in the service they received; whether care was provided appropriately; whether the home could adequately ensure people's safety; whether carers were adequately supported in role and whether there was a system for ensuring ongoing quality assurance within the home.

We found that Catherine Care Limited was compliant in all five outcome areas.

We carried out the visit as we had not received any information about the service since it had registered with us in 2010. We concentrated on finding out how the care was carried out and looked at the quality of service people received.

We saw that staff were kind, respectful and unhurried and gave support in ways that respected people's dignity and privacy. Staff had developed good relationships with people and spent time talking and taking an interest in their lives. People told us they liked living in the home and the staff knew how to provide support.

People dressed in their own style and if they needed support, staff helped individuals to continue to take a pride in their appearance.

People could choose how to spend their day and were able to go into the community and be involved in local social events. People were supported to participate in their hobbies and interests including drama, theatre and playing music.

Relatives were able to continue to play an active role and support people and provide care. People told us family members visited, shared meals and were including in social activities. Family and friends had been on holiday with people who used the service.

There were procedures in place to make sure that complaints were listened to and acted upon, and to protect the well being and safety of people who lived in the home. People told us they were able to speak freely and were confident any concerns identified would be dealt with.