Harrow Street provides short-term residential respite care for up to five people with learning disabilities. The service also provides day care support to people with learning disabilities, although this activity is not regulated by the Care Quality Commission (CQC). At the time of this inspection there were four people receiving support from the service.

At our last inspection 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 on-going 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.

The service supported people who had varied needs to live a safe and fulfilled life. Assessed risks to people were reduced or eliminated to support the safety of people using the service.

There was a registered manager in post. There were audits and spot checks in place to make certain staff worked correctly and that people received the appropriate support at a good standard. People using the service and their relatives had various ways of sharing their views and this was openly encouraged.

People’s support plans reflected their individual choices and goals and people were supported to have maximum choice and control of their lives. Staff understood and followed the Mental Capacity Act 2005 guidance. Staff asked for people's consent before providing any support.

Support staff and people using the service knew how to make a complaint and had no worries about doing so.

The registered manager regularly asked for the views of people about the quality of the support that was provided at Harrow Street. Staff had completed all required training and this was updated on a regular basis to ensure people's needs were met appropriately.

Systems were in place for the reporting of notifications to CQC and incidents that involved people had been reported to us as required.

Further information is in the detailed findings below.

Harrow Street provides short-term, residential respite care for up to five people with learning disabilities. The service also provides day care support to people with learning disabilities, although this activity is not regulated by the Care Quality Commission (CQC).

We inspected the service on 19 August 2015. The inspection was announced. There were two people using the residential respite service and three people attending for day care on the date of our inspection.

The service had an established registered manager in post at the time of our inspection. A registered manager is a person who has registered with 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.

CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of the inspection one person who used the service regularly had their freedom restricted in order to keep them safe and the provider had acted in accordance with the Mental Capacity Act, 2005 and DoLS.

People were cared for safely and they were treated with dignity and respect. They were able to access appropriate healthcare services and nutritional planning took account of their needs and preferences. Their medicines were managed safely.

People and their relatives were closely involved in planning the care and support provided by the service and staff listened to, and respected, their views about the way they wanted care delivered. People were supported to enjoy a wide range of activities and interests of their choice, both inside the service and in the wider community.

People and their relatives could voice their views and opinions to the registered manager and staff and were able to raise concerns or complaints if they needed to. The registered manager and staff listened to what people had to say and took action to resolve any issues as soon as they were raised with them.

Staff were appropriately recruited to ensure they were suitable to work with vulnerable people. They received training and support to deliver a good quality of care to people. They understood how to identify, report and manage any concerns related to people’s safety and welfare.

Staff delivered the care that had been planned to meet people’s needs and had a high degree of knowledge about their individual choices, decisions and preferences. Staff cared for people in a sensitive, warm and friendly way.

The registered provider maintained systems to regularly assess, monitor and improve the quality of the services provided for people.

During this inspection there were five people who used the service. We spoke directly with one person who used the service and with two relatives. We spoke with three care staff and the registered manager.

We used a number of different ways to help us understand the experiences of people who used the service. This was because some people had complex needs which meant that they were not able to tell us, in detail, about their experiences.

We saw evidence that people were consulted before receiving care. A relative of a person who used the service told us, “We are always involved in reviews; we are always encouraged to be involved.”

People were protected from the risks of inadequate nutrition and dehydration. A relative we spoke with told us, “The food is varied; they (staff) always try to get them to try new things.”

People who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. A relative told us, “The building is lovely and has a big lounge. My family member uses a wheelchair and all parts of the building are accessible to them.”

We saw that records relevant to the management of the service were well maintained and reflected the needs of people who used the service.

We carried out an inspection of Harrow Street to follow up on two areas of non-compliance identified in a previous inspection. We reviewed the evidence that demonstrated the provider's compliance in these two areas.

We reviewed all the information that the provider had sent us, visited the premises and talked with the registered manager and a member of staff.

We saw that the provider had taken the appropriate measures to meet the essential standards of care for people who used the service provided at Harrow Street.

You can see our judgements on the front page of this report.

We used a number of different ways to help us understand the experiences of people who used the service. This was because some people had complex needs which meant that they were not able to tell us about their experiences.

Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with two people who used the service and with the parents of one person who used the service and asked them for their views. We also spoke with three care staff. We also looked at some of the records held in the service including the care files for three people.

People who used the service were supported to make their own decisions where they were able to do so. We saw staff asking people for their views and preferences. One person told us about various community resources they visited on a regular basis, including swimming and grocery shopping.

A relative of a person who used the service said, "(my relative) re-acts to stimuli and we can tell when she is happy, which she is here." They added, "When she's here we have peace of mind."

We observed people contributing towards everyday tasks including being supported in preparing a cooked lunch.

We saw that the building was very clean, well decorated and in good repair.

We identified concerns regarding the arrangements that the provider had in place in the event of a fire or other emergency.

On the day of the visit to the home their was one person staying for respite and two people visiting for day care. One person could not tell us about their experiences due to their inability to verbally communicate.

We spoke with two people who had used the service and asked them if they enjoyed visiting the home. Both agreed that they did. One person said “I like coming here. I went out for a walk and took my camera and took some photos of the snow. I’m going swimming today.”

We spoke with two relatives of people who use the service. They said “We are very glad that we found this service, the staff are lovely.”

Another relative said, “My daughters are really happy when they are there. We chose this service because it was a model of their care at home. If I had to choose I would put it in the top list of services. I can’t fault the place.”