This inspection took place on 09 and 14 May 2018 and was unannounced on the first day and announced on the second day.

Ferriby Lane 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. Ferriby Lane accommodates people in a semi-detached house with four bedrooms. In addition, there is another self-contained flat next to the property with one bedroom. At the time of the inspection, the service was providing support to five adults with a learning disability and/ or autism.

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.

There was a registered manager at the service. 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.

This was a comprehensive inspection that looked at whether the service was safe, effective, caring, responsive and well-led.

At our last inspection, we rated the service as Good. At this inspection we found the service Requires Improvement.

People were supported in a clean and accessible environment that was suitable for people’s needs, although there were some repairs that were required to maintain the property. We discussed these with the registered manager who was putting a plan in place to address these. The service identified and responded to risks in the environment, however not all risks had been identified. We found that only one fire extinguisher had a protective case put on following an incident. This was addressed by the registered manager following the inspection, so all fire extinguishers had a protective case.

The service’s electrical safety certificate had urgent recommendations which could have been potentially dangerous, these had not been addressed. Following the inspection the registered manager informed the electrics were planned to be retested and work carried out week commencing 9 July 2018. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of this full version report.

People were supported to receive their medicines as prescribed. Staff were recruited safely and supported in their roles. People were supported by well trained and knowledgeable staff. They knew the people living at the service well and were skilled in delivering effective care and support. Staff were knowledgeable about safeguarding and how to respond to any concerns to keep people safe. Staff worked closely with professionals to ensure they met people's health and well-being needs.

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 to make their own decisions where possible and consent was gained before care or support was provided. For those that lacked capacity to make particular decisions, staff followed the principles of the Mental Capacity Act 2005 and acted in people’s best interest.

People who lack mental capacity to consent to arrangements for necessary care or treatment can only be deprived of their liberty when this is in their best interests and legally authorised under the MCA. The procedures for this in care homes and hospitals are called the Deprivation of L

Ferriby Lane is a large detached property with gardens to the front and rear. It is set on a main bus route in to Grimsby and is close to local shops and other amenities.

The service is registered to provide accommodation and personal care for up to four people with a learning disability and autistic spectrum disorder. There were four people living at the service on the day of our inspection.

Accommodation is provided in a detached two storey building with four large bedrooms, a spacious lounge, a central kitchen dining room, laundry, two offices and self-contained annexe. Three bathrooms are available in the house and the annexe has a bathroom for sole use of the person living there. The service has a large garden with a summer house and some designated off street parking to the front of the building.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. There was a manager registered with the Care Quality Commission (CQC); they had been registered since May 2011.

We undertook this unannounced inspection took place on 15 and 18 January 2016. At the last inspection in January 2014 the registered provider was compliant in all areas assessed.

The people who used the service had complex needs and were not all able to tell us fully their experiences. We used a Short Observational Framework for Inspection (SOFI) to help us understand the experiences of the people who used the service. SOFI is a way of observing care to help us understand people who were unable to speak with us. We observed people being treated with dignity and respect and enjoying the interaction with staff. Staff knew how to communicate with people and involve them in how they were supported and cared for.

We found the service required improvements to one of the five key areas we inspected. We noted some areas that required attention to ensure effective maintenance of the building and these were mentioned to the registered provider, the registered manager and acting manager to address.

Relatives felt every opportunity was provided to safely maximise people’s independence. They also told us communication with the service was very good.

The service developed and maintained strong links with external organisations and within the local community. There was a strong emphasis on key principles of care such as compassion, inclusion, respect, dignity and enablement.

The safety of people who used the service was taken very seriously and managers and staff were well aware of their responsibility to protect people’s health and wellbeing. People we spoke with told us they felt safe living in the home.

We found people’s care plans were written in a way that clearly described their care, treatment and support needs. These were regularly evaluated, reviewed and updated. The care plan format was easy for people to understand by the use of pictures and symbols. We saw evidence to demonstrate that people and their relatives were involved in their care planning.

The staff understood the procedures they needed to follow to ensure people were kept safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

We found staff were recruited safely and there was sufficient staff to support people. Staff received training in how to safeguard people from the risk of harm and abuse. They knew what to do if they had concerns. There were policies and procedures available to guide them.

People who used the service had assessments of their needs undertaken which identified any potential risks to their safety. Staff had read risk assessments and they wer

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

We spoke with two people who were able to communicate with us. They told us they were happy with the service and their views were sought by staff. They also knew how to make a complaint, if they had one.

We saw the complaints procedure was available to people who used and visited the service. Staff told us how they would support people to raise concerns if they could not do so themselves.

People were happy with the care they received and told us they saw a range of health professionals for advice and treatment. We found that staff helped to make sure health and social care was well coordinated and provided by a range of professionals.

We found that the numbers of staff provided was based on people's individual need and regularly reviewed to ensure that there was adequate support available to meet the needs of the people who used the service.

We found people were able to express their views about the service via daily activities of living, surveys and meetings. Audits and checks were completed to monitor quality and where further action was required, this was put in place in order to improve services.

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

During the inspection we spoke to six members of staff, a relative and one person that used the service.

People told us they were happy with the care and support that they received. People's comments included: "I do like it here.” and “They do listen to me."

One person told us about the weekly meetings in place to decide menus, leisure activities and allocation of tasks which promoted independent living skills: "We talk about what we want to do and if anything is upsetting us, so they can help to sort it out.”

Relatives spoke positively about their care and support, comments included: "We are very happy with everything, we are in touch regularly and aware of what is going on. We also have the opportunity to ring and discuss any issues when they are at home and their key worker is always happy to offer advice.”

As part of our inspection we talked with two people who use the service and we asked them questions about the home, the care they received and staff caring for them. Their responses indicated that they felt safe and were happy with the care they received. Some of the comments we received included: "Yes, I feel safe here”, “The staff are fine people”, “The staff are very good” and “I like all of the staff.”

People we spoke with were very positive about the care and support they received. They confirmed they were supported to make choices and decisions about their care. They told us they were assisted to be as independent as possible. One person told us: "Staff help me by talking to me and helping me to do things right."

People told us they were well looked after and they all enjoyed outings and activities. They described some of the activities that they had been involved in. Comments included: "I like youth club and bowling best.”