The inspection took place on 26 November 2018 and was unannounced.

Hayling Road is one of the services run by Stockdales of Sale, Altrincham and District Limited, a registered charity providing person centred care and support to people with complex care needs. Hayling Road is registered with the Care Quality Commission (CQC) to provide care and accommodation for up to seven people.

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 ongoing 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 had 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.

Staff received safeguarding training and knew how to keep people safe and raise concerns if they suspected someone was at risk of harm or abuse.

People had comprehensive risk assessments which were reviewed and updated timely to meet people’s changing needs. This ensured staff had access to the relevant information and guidance to mitigate risks.

Staffing levels remained consistent and the service benefited from a stable workforce. Relatives and staff told us there were sufficient numbers of staff to meet people’s needs.

The management of medicines was safe. There were appropriate arrangements in place to ensure that medicines had been ordered, stored, administered and disposed of appropriately.

People who used the service at Hayling Road continued to receive effective care and support from staff that were well trained and competent to carry out their roles. This included training and ongoing development of staff to meet the needs of people living with complex needs.

People were supported in line with the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People were encouraged to make decisions and choices about their care and had their choices respected.

People's consent to care and treatment was sought prior to care being delivered.

People were encouraged to maintain a healthy nutritionally balanced diet and had access to sufficient amounts to eat and drink, at times that suited them.

People's health care needs were monitored and maintained; people had access to health care services as and when needed.

People continued to receive care and support from staff that were kind, caring and compassionate.

People were treated with dignity and respect and had their independence promoted by staff that openly expressed their fondness for the people they cared for and supported.

Support plans were person centred and tailored to meet people's individual needs. People were encouraged to be involved in the development of their care plans, which were updated regularly to reflect people's changing needs.

A variety of activities were provided and staff demonstrated a good understanding of people’s needs and adapted activities to reflect people’s individual interests.

The provider had a complaints procedure in place and people felt confident in raising concerns or complaints to staff and the registered manager.

Staff told us the service was well-led and a good place to work. We were told by staff and relatives of people who used the service that the registered manager and deputy manager were visible, had an open-door policy and were approachable. This meant people, their relatives and staff could meet with members of the management team as and when they needed.

There was an effective system for audit and quality assurance to mo

When we arrived at the home everybody was in the lounge which had a calm relaxed atmosphere. Sensory lights were being used and people looked clean and well cared for. Families we spoke to told us "The ethos of the service is second to none, the needs of the individual are paramount and the service is very inclusive".

We saw the rota demonstrated there was sufficient numbers of staff to meet the needs of the individuals safely. The manager and staff we spoke with said the rota was responsive to people’s changing needs and staff would often stay on to support people with an activity.

During our Short Observational Framework for Inspection (SOFI) we observed people being treated compassionately with their individual needs considered. We saw staff interacting effectively and engaging individuals in conversations and humour.

We spoke to families who said they were confident that any issues and concerns would be reported to them. They were also confident that any concerns they had about their family members would be dealt with effectively. Regular house meetings and team meetings took place which enabled people to feedback and discuss anything they were concerned or unsure about.

Families told us they liked to see the way the staff were encouraged to grow and develop by the senior managers and Hayling should be considered a centre of excellence.

Due to the complex needs of people living at Hayling Road it was difficult for people to express their opinions on the service they received. Although the people we spoke with found it difficult to fully express what they were trying to say, they looked happy and comfortable in their surroundings.

People’s care records contained detailed information to show how people were to be supported and cared for and how their dignity and privacy were to be respected.

We saw that people were given lots of support and encouragement to take part in the many varied activities that took place. Staff told us how important they felt it was for the people using the service to feel part of the community.

We were also told by staff that great importance was attached to ensuring that people using the service were involved in decision making about their daily routines.

Due to the complex needs of people living at Hayling Road it was difficult for people to reliably give their verbal opinions on the service they received. We looked at people's records, how people interacted with the staff, general observations throughout the visit and discussions with staff.

We saw that people were comfortable in their surroundings and in their interactions with the staff.

Staff told us that people were encouraged to make choices around their day to day lives and individual personal preferences were always respected. One member of staff said “As a staff team we are good at encouraging choices.” Another member of staff said “We get to know people very well, we support people on an individual basis.”

Staff said that people’s privacy and dignity was always respected and that all care needs were met to a high standard. One member of staff said “We treat people as we would like to be treated ourselves.”

Staff told us that the service had a homely, relaxed atmosphere. One person told us “We support people to do individual activities of their choice.” Another staff comment was “We all have good relationships with people and we take everybody on holiday every year.”

As part of this review process we contacted Trafford Commissioners who had recently undertaken a monitoring review of the service. No major concerns were raised.

The inspection took place on 16 and 17 November 2015. The first day of inspection was unannounced. At the previous inspection in December 2013 the service was meeting the legal requirements.

Hayling Road provides care and accommodation for up to six people with learning and physical disabilities.

The service had a registered manager. 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.ale, Altrincham & District Ltd

Hayling Road is one of the services run by Stockdales of Sale, Altringham and District Limited, a registered charity providing person centred care and support to people with complex care needs.

People living at Hayling Road had lived there since childhood. The service had supported their transition into adulthood by changing their registration from a children’s service to an adult service. This meant people living at the home did not have to look for alternative accommodation once they turned 18 years of age and could remain settled within their own home.

Hayling Road accommodated six people in an environment which was decorated to a very high standard. Each person had their own room which reflected their individual taste and preferences. There were two bathrooms and a shared kitchen, lounge and conservatory area. People also had access to a sensory garden which was equipped with a variety of different textures, sounds and smells to enhance people’s outdoor experience.

There was a strong person-centred culture apparent in all aspects of the service. Person-centred means care and support which is specifically tailored to meet the needs, goals and wishes of each individual and includes the individual, as far as is practicable, in decisions about all aspects of their lives.

Staff described working together as a team; they were committed to providing person-centred care and helping and supporting people to achieve their potential. Staff told us that the management of the service, including the senior managers and the trustees, had a very ‘hands on’ approach which made them accessible to all.

The people who used the service had complex needs and were not able to tell us fully about their experiences. We used a Short Observational Framework for Inspection (SOFI) to help us understand the experiences of the people who used the service.

We observed that staff treated people with dignity and respect and it was clear they knew the people they supported well.

We found staff were recruited in a safe way; all checks were in place before they started work and they received an induction. Staff received training and support to equip them with the skills and knowledge required to support people in the way they said they wanted to be supported. Training was based on best practice and guidance which meant staff were provided with the most up to date information to support them in their work. There were sufficient staff on duty to meet people’s needs.

We saw staff monitored people’s health and responded quickly to any concerns or change in need. People’s nutritional needs were met and they had access to a range of professionals in the community for advice, treatment and support when needed.

Systems were in place to protect people from the risk of harm or abuse. Staff had received training in safeguarding and knew how to respond to protect the people they supported.

Medicine was ordered, stored and administered safely. Personalised support plans had been developed to ensure people received their medicine in line with their preferences.

We saw people had regular assessments of their needs and care was planned and delivered in a person centred way.

Throughout the inspection we saw and were told about innovative and creative ways the service had responded to ensure people led fulfilling lives and how they were supported to make choices and have control of their lives.

People were actively supported to be part of the local community and, likewise, people from the community were encouraged to attend social events and parties held by the service. Professionals and and families were also welcome to visit the home and attend organised events to raise funds and the profile of the service. This was done collaboratively with the people who used the service and had been successful in positively promoting the rights of disabled people.

The management culture of the home was open. There was a high level of commitment to providing excellent care to people who needed it and equipping staff with the skills and knowledge to provide excellent care. The environment was nurturing and staff responded well to this.

When speaking with staff it was clear that they genuinely cared for the people they supported.

People using the service, their relatives, friends and other healthcare professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were taken on board and dealt with.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.