About the service: Grant Thorold Library provides personal care and support to people with autism or a learning disability who live in their own homes. At the time of the inspection, they were providing personal care and support to 19 people. 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.

People’s experience of using this service: -

The way staff responded to people’s individual needs had been very good. The support staff had provided had been flexible and tireless, which had enhanced the quality of specific people’s lives. This had enabled people to live more independently, access community facilities, to be more included in society and to be prepared for nursing interventions. There was a strong sense of staff empowering people to make their own decisions and including them when important decisions were made such as staff recruitment. Staff supported people to develop coping mechanisms to manage their mental health needs, had taught people cooking skills in order to be independent and liaised with professionals on the use of assistive technology. In discussions, staff described the ethos of using all means possible to support and reassure people when they had anxious or distressed behaviours to avoid the use of medicines to calm people. The care plans had comprehensive information for staff in how to meet people’s needs.

People were protected from abuse and avoidable harm. Staff had completed training in how to safeguard people and risk assessments were completed to identify potential hazards. These measures provided staff with knowledge about what constituted abuse and the action to take should they have concerns. The risk assessments helped staff to minimise risk whilst ensuring people still made their own decisions and risk-taking was manageable and as safe as possible.

Staff supported people to access a range of health care professionals when required and ensured they received their medicines as prescribed. Staff liaised with health professionals as part of planning and delivering care and support.

People had support to meet their nutritional needs when this was part of their support plan. Staff assisted people to plan menus, shop for ingredients and prepare meals of their choice.

Staff had developed good relationships with people and treated them with dignity and respect; they encouraged people to be as independent as possible. Information was made accessible to people in different formats, for example easy read versions, symbol cards and staff training in sign language.

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. Staff had received training in mental capacity legislation and understood their responsibilities. They knew how to gain consent before delivering care tasks and ensured people could make their own decisions and choices.

Staff were recruited safely and there were sufficient numbers to support people safely. Those people who required one to one support had this planned and provided; this was confirmed in discussions with staff.

Staff had access to training, induction, supervision and support. All staff spoken with described management support as accessible and training as relevant to their role. Staff were provided with personal protective equipment to help minimise the spread of infection; staff had completed training in infection prevention and control.

There was a quality monitoring system which ensured checks and audits were carried out, people’s views were obtained and listened to and shortfalls were addressed. Accidents and incidents were analysed so that lessons

Grant Thorold Library is a supported living service that provides personal care and assistance to people who live in a supported living project. The aim of the service is to provide people with the support they need to live as independently as possible. Grant Thorold Library is situated in a residential area of Grimsby and has accessible entrances and car parking facilities. Currently personal care is provided on a 24 hour basis to three people who live at the same address and to one other person as part of a large package of care with other people involved.

The service had a registered manager in post as required by a condition of registration. 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 registered provider is reviewing the registered manager post so the person may change in the near future.

We undertook this inspection on the 3 June 2016. We gave the service 24 hours’ notice as we wanted to be sure there was someone available at the main office to speak with us.

We found the service was well-managed and had good systems in place to recruit staff safely and to ensure there was sufficient available to meet people’s needs. Employment checks had been carried out so people could be sure those staff supporting them were suitable to work in care settings.

Staff knew how to safeguard people from the risk of abuse and harm. We saw staff had policies and procedures to guide them and undertook safeguarding training so they could recognise abuse and know how to report it. Staff completed risk assessments to enable them to identify any areas of concern and plan interventions to minimise risk whilst at the same time supporting people to make choices about aspects of their lives.

We found the registered provider and staff team acted within the law in relation to supporting people who lacked capacity to make major decisions for themselves. They consulted with people and took advice from health and social care professionals about best interest decisions. We saw staff provided information to people who used the service which helped them to make choices about aspects of their lives.

We found staff supported people to maintain their health by monitoring their needs and assisting them to access community health professionals when required.

Staff supported people to prepare meals and to have a well-balanced diet and fluid intake. They helped people to shop and plan the weekly menu so choices were varied. Staff monitored people’s nutritional intake and weight and took action when there were any concerns.

The support staff provided helped to maintain people’s independent living skills which included personal support, housekeeping and their tenancy requirements. We observed positive interactions between staff and the people they supported; staff were kind and patient and gave people time to respond to questions and requests. Relatives had very positive comments about the staff team and felt they supported their family members to have a good quality of life.

We saw staff supported people to access community facilities so they could feel included in society. They also assisted people to participate in activities within the service to help them pursue individual interests and to interact with other tenants. Staff supported people to maintain relationships with their relatives.

We saw staff completed training so they had the skills required to support people. Staff were supervised and had appraisal to help with their development. New staff completed an induction and were supported by more experienced staff until they felt ready to assist people alone.

The service had a quality monitoring system in place. This consisted of audits, observations of pra