About the service: Cumberland Gate is a residential care home. This service supports people with autism; The service is registered to care for three people; there were three people living at the service at the time of the inspection.

People’s experience of using this service:

The service applied the principles of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support in the promotion of choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Cumberland Gate is located in an area that enabled people using the service to participate in their own local community.

Risks that people faced had been assessed and those identified were safely managed. Medicines were managed safely. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm.

Staffing levels were appropriately managed and people received care from consistent, regular staff. Enough staff were employed each day to meet people's needs, keep them safe and give them the opportunity to take part in their chosen activity.

Staff received a range of training appropriate to their role and people's needs and were supported by the acting manager through regular supervision.

People were encouraged and supported to eat and drink well. People with dietary needs were given a choice of suitable meals and snacks. People were supported to access healthcare when needed.

People were offered choice and control and where able, consented to their care and support. Pictures and photographs were used to facilitate effective communication. Staff supported people to be as independent as possible with activities of daily living, such as laundry, cooking, shopping and personal care.

The leadership of the service promoted a positive culture that was person-centred and inclusive. We received positive feedback about the quality of care and support people received and the overall management of the service from their relatives. The interim manager and the staff team showed a desire to improve on the service provided and in turn the quality of life experiences for the people at Cumberland Gate.

Effective systems were in place to check the quality and safety of the service. The environment was safe and in a good state of repair and decoration.

Rating at last inspection: At the last inspection the service was rated Good; (Report published 28 October 2016)

Why we inspected: This was a planned comprehensive inspection to confirm that the service remained good.

Follow up: We will continue to monitor the service through the information we receive. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This unannounced inspection took place on 16 September 2016.

Cumberland Gate is situated in the residential area of Netherton, Liverpool. The service is operated by Autism Initiatives and provides care and support to three adults who have a learning disability. The residential care home is located close to public transport links, leisure and shopping facilities.

There was a registered manager in place. 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.

The service was last inspected on 25 October 2013. At this inspection we identified no concerns and found the service was meeting all standards we assessed.

At this comprehensive inspection visit carried out on 16 September 2016, we received positive feedback from relatives of people who lived at the home. Staff were described as kind, caring and committed. Observations of interactions between staff and people who lived at the home demonstrated people were happy and content.

On the day of the inspection visit, staff responded in a timely manner and people did not have to wait to have their needs met. We observed staff demonstrating patience with people and taking time to sit with them to offer companionship and comfort. People were given time to carry out tasks as a means to promote independence and were not rushed.

The staff turn-over at the home was low and people benefitted from having staff who knew them well. Communication with people was promoted through a total communication approach using photographs and symbols. This promoted autonomy for people who lived at the home.

Detailed person centred care plans were in place for people who lived at the home. Care plans covered support needs and personal wishes. Plans were reviewed and updated at regular intervals and information was sought from appropriate professionals as and when required. Consent was gained wherever appropriate.

People’s healthcare needs were monitored and referrals were made to health professionals in a timely manner when health needs changed. Documentation regarding health needs of each person was comprehensive and concise.

We saw evidence of multidisciplinary working to ensure people’s dietary needs were addressed and managed in a safe way. Staff were knowledgeable of people’s needs and we observed good practice guidelines were consistently followed.

Staffing arrangements were personalised to fit around the needs of the people who lived at the home. People were supported to access community activities of their choosing.

Arrangements were in place to protect people from the risk of abuse. Staff had knowledge of safeguarding procedures and were aware of their responsibilities for reporting any concerns.

Suitable recruitment procedures were in place. Staff were checked before employment was secured.

Suitable arrangements were in place for managing and administering medicines, however these were not always consistently followed. We have made a recommendation about this. Protocols for administering as and when medicines were in place and clearly detailed.

We saw evidence staff had been provided with relevant training to enable them to carry out their role. Staff told us they received supervisions and appraisals as a means for self-development. The registered manager had a training and development plan for all staff.

Staff had received training in The Mental Capacity Act 2005 and the associated Deprivation of Liberty Standards (DoLS.) We saw evidence these principles were put into practice when delivering care.

Systems were in place to monitor and manage risk. Risks were reviewed on a monthly basis and a record was kept to show reviews had taken place.

The service had implemented a range of quali

There were three people living at Cumberland Gate on the inspection. Staff support was in place 24 hours a day. We spoke with two of the three people living at Cumberland Gate. The other person was out during the inspection. Some people had limited verbal communication and we were unable to have in-depth conversations with them.

During the inspection we observed how people were supported by staff. We also spoke with two members of staff. We observed people being treated with respect and dignity. We saw that staff were polite and respectful and communicated with people effectively.

Person centred care records were in place providing information about people. These were updated frequently and showed that people were involved in decisions.

Cumberland Gate was maintained and decorated for the comfort of the people living there. People were able to personalise their bedrooms according to their wishes.

The home was staffed well enough to provide people with individual and group activities.

There were regular checks made of the quality of the service. People knew how to complain if they were unhappy with the support they received.

The people who use the service could not tell us about their experiences of using it or comment about the care and support they received, due to a variety of complex needs. However we spent time observing the interaction between two of the people who lived at the home and the staff and also spoke with two relatives.

We saw that people where encouraged to be independent around the home and in the activities they took part in. One person had their own vehicle and staff supported them to visit their family on a regular basis.

We saw care and support being provided that was appropriate to the person’s needs. One relative told us that the staff team had worked at Cumberland Gate for many years and this helped provide consistent and excellent support.

We looked at the care records and found they contained all of the relevant documents to support a person safely. One relative told us, “I don’t lose any sleep now as I know they care for X (name of person).”

Staff who worked at Cumberland Gate were suitably trained to support the people they worked with. They had an individual training plan and had received training this year to assist them in their work. They had received regular support and supervision. One relative told us, “I have no worries at all as I know this staff team know X (persons name) very well. They are a credit to their organisation.”