Church Street is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Church Street Care Home is in Eastwood, Nottinghamshire and is registered for eight places. It provides care for people with a learning disability and/or autism. There were six people living there at the time of our inspection. Accommodation is provided on two floors and there is access to a small outside space. 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.

At our last inspection in August 2016, 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.

Processes were in place to protect people from abuse and avoidable harm. Staff completed risk assessments and reviewed them regularly to ensure risks to people’s health and safety were identified and managed, while avoiding unnecessary restrictions to people’s freedom. Incidents and accidents were reported, investigated and action was taken to minimise the risk of similar incidents occurring in the future.

Staffing levels were planned to ensure the required care and support could be provided and staff were organised and deployed effectively. Medicines were managed and administered safely.

The premises and environment were well maintained and the required safety checks were completed. Infection prevention and control was effectively managed.

People’s care and support needs were assessed and care was effective; resulting in positive outcomes for people. Staff had good access to training and development, supervision and appraisal. Staff worked well with other professionals to ensure people had access to healthcare support as needed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff gained people’s consent to care and support and when people lacked capacity to make a decision, the principles of the Mental Capacity Act (2005) were followed.

People participated in a range of activities according to their individual choices and preferences within the home and in the community. They were encouraged to develop independent living skills and live life to the full. Staff understood the importance of this for people and provided the structured support people required. This enabled people to achieve positive outcomes and promoted a good quality of life.

Relatives praised staff for their kind and caring approach. Although people were unable to fully express themselves verbally, they showed by their actions they were relaxed and happy with staff. People were treated with dignity and respect by staff, who provided positive support and encouragement.

Staff provided person centred care and had an in-depth knowledge of the people they cared for. They engaged in a wide range of activities based on their personal choices. People were treated equally, without discrimination and information was presented to them in a way they could understand.

The service continued to be well led. The registered manager demonstrated excellent leadership skills and was committed to continuous quality improvement. The service was person centred and focused on providing as many opportunities for people as possible. People were involved in the development of the serv

We inspected the service on 20 and 26 July 2016. The inspection was unannounced. Church Street Care Home provides care and support for up to eight people with a learning disability. On the day of our inspection seven people were using the service.

The service had a registered manager in place 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 2008 and associated Regulations about how the service is run.

People were supported by staff who knew how to recognise and respond to abuse and systems were in place to minimise the risk of harm. Risks associated with people’s care and support were effectively identified and managed.

People received care and support in a timely way and there were sufficient numbers of suitably qualified and experienced staff employed. Medicines were managed safely and people received their medicines as prescribed.

People received effective care from staff who received support to ensure they could meet people’s needs. Staff received a thorough induction when they began working at the service and action had been taken when gaps in training had been identified.

People were supported to make choices and decisions by staff who communicated effectively with them. Where a person lacked capacity to make certain decisions their rights were protected under the Mental Capacity Act 2005.

People were supported to eat and drink enough. People had access to healthcare professionals and people’s health needs were monitored and responded to.

People were supported by staff who were very respectful, kind and supportive. Staff were motivated to find creative ways of communicating with people to ensure that information was understood and people’s wishes were sought.

People’s rights to privacy and dignity were actively promoted within the service and upheld. People and their relatives felt able to raise any concerns or complaints and the management team were in the process of further developing systems for capturing feedback about the service.

People were supported by staff who understood their support needs and ensured they received personalised responsive care. People were able to make choices about their care and partake in activities and pursue their interests as they wished.

There was an open and supportive culture at the service. People, their relatives and staff felt able make suggestions about the running of the service and told us that their views were listened to. Improvements were being made to how views on the running of the service were gathered to ensure this was being done on a regular basis. There were systems in place to monitor and improve the quality of the service which were effective in identifying and responding to issues.

We used a number of different methods to help us understand the experiences of people who used the service, because the people had complex needs which meant they were not able to tell us their experiences.

We spoke to the relatives of four people, who told us they had no concerns regarding the care and support received by their relative. One relative said, "[My relative] is very well supported and looked after.” Another relative said, “[My relative] loves the place. They get the best care. I’m perfectly happy. I’m lucky my [relative] is there.” A third relative said, “It’s absolutely excellent, I have no qualms at all. [My relative] is so happy, after a few hours with me; they want to go back home, to Church Street Care Home.”

We found that people were asked for their consent prior to receiving care and treatment, and support was provided in people’s best interests.

We found staff were attentive to people's needs and their interactions were caring and friendly. We found that care was delivered in line with people’s individual care plans.

We found that staff were recruited safely and appropriately, and there were sufficient staffing numbers to meet people’s identified needs.

We found that people and their relatives were supported to raise concerns and make complaints regarding the service they received.

The people we spoke with told us that they had been involved in the development of their care plans. People had also been involved in choosing activities they would like to take part in, and choosing food for their menu. One person said, “I choose the cottage I go to each year for my holiday.”

One staff member commented on a recent admission to the service and said, “The last gentleman who moved in came for tea, met with other service users and then stayed overnight to make sure he was comfortable being here, before moving into the service.”

People told us they liked living at the home and felt they were well cared for. One person said, “They look after me very well here.”

One relative commented on the effectiveness of staff looking after their family member in the event of any illness. They said, “If he is ill, they have the doctor out straight away and support his needs very well.”

People told us that they felt safe living at the home. One person said, “I feel safe here. If I was unhappy I would speak to my support worker.” People told us that they like the staff and staff were able to meet their needs. They also told us they could speak to the manager or staff and they would be listened to.

We found that people were treated with dignity and respect, people were safe and that staff were supported to provide care that met people’s needs.

We found that the provider took steps to assess the quality of the service being provided.