Girling Street is a residential care home that provides accommodation and personal care for up to five people who have a learning disability. There were four people living in the service when we inspected on 17 January 2018. We gave the provider just under 24 hours’ notice that we would be inspecting the service because it is a small service and we needed to be sure that there would be someone at home.

At the last inspection in April 2015 the service was rated as ‘Good’ in four of the key questions we ask and overall. The key question of Responsive was rated as ‘Outstanding.’ At this inspection we found that the provider had sustained these ratings.

Girling 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. Girling Street accommodates up to five people in a mid terrace house situated centrally within the town of Sudbury. The service was situated within close proximity of the shopping town centre.

The registered manager at Girling Street was also the registered manager at another of the providers locations, which was situated a third of a mile from Girling Street. The two services share the same staff team and many of the non service user specific records we looked at, such as team meeting minutes were the same across both services. Therefore there are similarities in the inspection reports for both locations. We inspected the other service the day after the inspection at Girling Street.

The care service had 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 lived as ordinary a life as any citizen.

People continued to be provided with regular opportunities to express their wishes, aspirations and preferences regarding how they lived their daily lives. People were supported to make their own decisions about the care and support they received. Regular meetings continued to be held between people and their keyworker to ascertain their individual thoughts and choices. People continued to be supported to access a wide range of personalised activities and social opportunities. Staff supported people to access the local community and encouraged activities which promoted their independence.

Staff continued to demonstrate a good understanding of safeguarding and how to report concerns. Sufficient numbers of staff continued to be in post and rotas were written around the needs of the people who lived at the service. Recruitment procedures continued to be effective and thorough. This included pre-employment checks to ensure new staff were suitable to work at the home. Staff had a good understanding of risks associated with people's care needs and how to support them.

Medicines continued to be stored and administered safely, and people received their medicines as prescribed. Weekly and monthly audits were carried out of medicines to ensure they were managed in line with good practice guidelines. Infection control practice was good and helped to reduce the risks associated with poor cleanliness systems.

Good leadership continued to be in place that provided staff with the necessary support and training to make sure people received good quality care. The service had good links with external healthcare professionals. People received necessary support from these services when they needed help. Appropriate records were kept of any appointments people attended.

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 received a service that was caring. Staff knew peopl

This inspection took place on 15 July 2015 and was unannounced.

Girling Street provides care and support for up to a maximum of five people who have either learning disabilities or who have an autistic spectrum disorder. On the day of our inspection there were five people living at the service.

The service has a manager registered with the Care Quality Commission (CQC). 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.

There were suitable arrangements in place for the safe storage, receipt and administration of people’s medicines. Medication profiles had been produced which provided staff with guidance as to people’s medical conditions, medicines that had been prescribed and for what reason, such as allergies and how people chose to take their medicines.

Staff were skilled in communicating with people. They showed warmth, kindness and used innovative communication methods to gain people’s views.

People were provided with regular opportunities to express their needs, wishes and preferences regarding how they lived their daily lives. For example, meetings with their keyworker and as a group with the manager.

People were supported to access and attend a range of personalised social, educational and occupational activities. Staff supported people to access the local community and encouraged activities which promoted their independence.

People’s needs were comprehensively assessed and support plans gave clear guidance to staff on how people were to be supported. Support in planning people’s care, treatment and support was personalised to reflect people’s preferences and personalities.

The manager and staff demonstrated a good knowledge of their roles and responsibilities with regards to the Mental Capacity Act 2005 and the steps to take to enable people’s best interest to be assessed if they lacked capacity to consent to their care and treatment.

Staff demonstrated a thorough knowledge of the needs of people and had been trained in a range of relevant subjects to support them to provide safe, effective and responsive care to people.

There were sufficient numbers of staff to meet people’s needs. Staffing levels were flexible to provide for people’s changing needs and provide support for them with their social and leisure interests where one to one support was required. Rapport between staff and people was supportive, warm, kind and respectful. People were comfortable in the company of staff and demonstrated their enjoyment of being with staff with lots of laughter expressed.

The service was well led with systems in place to assess people’s views about the care they received and to check that the care of people was the primary focus. The views of people were sought and the manager empowered people to be involved in making decisions about how the service was run and how their care was provided. The manager and the provider had quality and safety monitoring systems in place. Where shortfalls were identified, produced action plans with timescales. This showed that the provider responded to protect and ensure the health, welfare and safety needs of people were met.

We undertook a scheduled inspection of Girling Street on 5 June 2014. During our inspection we spoke with two people who used the service. We also spoke with two staff.

Some people who used the service were not able to tell us verbally about their views and experiences so we used observation and interaction to gain an understanding of their care and support.

We looked at the care and support records for two people who used the service, records relating to consent and the safeguarding of vulnerable adults from abuse, staff training and support and quality assurance checks.

We considered our inspection findings to answer 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?

Staff had received a range of training to protect people who used the service from harm. They were aware of the action they needed to take if they suspected abuse had taken place.

We found that the service had suitable arrangements in place to assess people's mental capacity to make decisions for themselves.

The service had policies, procedures and quality monitoring in place to ensure systems were working well. People were provided with care and support that ensured their welfare and safety.

Is the service effective?

People's assessments showed that their care and support was planned and delivered in a way that ensured that their needs were being met.

Individualised care meant that people were fully involved, where possible, in choices and decisions about their lives. This made their care and support more effective as it enhanced their wellbeing and independence.

Is the service caring?

We saw positive interaction between staff and people who used the service. Staff spoke with people in a caring, respectful, considerate and encouraging way.

Staff had a good knowledge of people's likes and dislikes, their everyday needs and their personalities. People's preferences and diverse needs had been recorded in their support files and care and protection was provided in accordance with their wishes.

Is the service responsive?

Regular checks on the needs of people who used the service were undertaken to ensure there were sufficient staff on duty with the rights skills to respond to people's needs appropriately.

The service offered a range of activities for people to enjoy. These had been developed from listening to the views of people who used the service and information from people who knew them well.

The service worked well with other agencies. A range of health and social care professionals from the community were involved in people's care. This showed that people received their care in a joined up way.

Is the service well-led?

A comprehensive quality monitoring process and on-going improvement plan was in place. Regular care reviews showed that the service put people's needs first and staff training and supervision ensured that staff were able to support them appropriately.

The service was well-led as it was continually improving in its care provision and in the environment to make Girling Street a good place to live and work.

We spoke with four people who used the service and two members of staff as part of this inspection. People who used the service told us they were very happy with the care they received and that they felt safe. They told us they enjoyed the range of activities provided.

One person told us, “I like living here and the staff help me and are kind to me.” Another person told us, "I am looking forward to my holiday at Centre parcs.”

We saw several examples where staff supported and cared for people in a dignified and respectful way. We found that the service was meeting the personal, emotional and healthcare needs of people who used the service. We found that medication was being administered safely to people and managed effectively.

We found that staff were appropriately recruited and inducted into the service and there was an appropriate and effective system in place to manage complaints.

When we inspected the service on 12 October 2012 we found concerns with regard to inadequate staff training. We re-inspected the service on 1 February 2013 where we saw records that confirmed all staff had now received the mandatory training required.

We spoke with one member of staff and one person who used the service during our inspection in February 2013. We were told that the staff training had “Greatly improved and that they had lost count of the courses they had attended recently”.

We spoke with three people during our inspection. We were told by three people that staff are kind and caring. One person told us that if they had a problem they knew who to talk to and that they felt safe living at the home.

We were told that people were supported to go out on the bus and that staff also took people on holiday. All three people spoken with told us that they were happy living at St Faiths and Girling Street.

People told us they were happy living in the home.