Hurst Green Road is registered to provide personal care for up to four people with a diagnosis of a learning disability or autistic spectrum disorder. At the time of our visit there were three people living at Hurst Green Road.

At the last inspection on 11 June 2015 Hurst Green Road was rated Good. At this inspection we found the service remained Good.

A requirement of the provider's registration is that they have 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. At the time of our inspection there was a registered manager at the service.

A person and a relative told us they felt people were safe at Hurst Green Road. The registered manager and staff understood how to protect people they supported from abuse, and knew what procedures to follow to report any concerns.

Staff had a good understanding of risks associated with people's care needs and how to support them.

There were enough staff at Hurst Green Road to support people safely and at the times they preferred. Recruitment procedures made sure staff were of a suitable character to care for people at the home.

Medicines were stored and administered safely, and people received their medicines as prescribed. Regular audits were carried out of medicines to ensure they were managed in line with good practice guidelines.

People were supported to attend health care appointments to maintain their health and well-being and received support with a varied diet that took account of their preferences and dietary needs.

Staff were kind and supportive and ensured people's privacy and dignity needs were met.

The management and staff team understood the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People were supported to make everyday decisions themselves, which helped them to maintain their independence. Where people were not able to make decisions, relatives and healthcare professionals were consulted for their advice and input.

People were supported to pursue their hobbies and interests both within and outside the home. Activities were arranged according to people's individual preferences, needs and abilities. People who lived at Hurst Green Road were encouraged to maintain links with friends and family.

Relatives knew how to make a formal complaint and told us they felt comfortable raising any concerns they had with the staff. At the time of our inspection no complaints had been received, however, the provider had systems in place to monitor complaints across all of their services. This was so they could identify any areas where improvements could be made to benefit all people including those at Hurst Green Road.

Staff felt the management team were supportive and promoted an open culture within the home. Staff were able to discuss their own development and best practice during one to one supervision and team meetings.

A programme of training and induction provided staff with the skills and knowledge they needed to meet people's needs.

The provider carried out audits to check the support and care people received to continually monitor and improve the quality of the service.

This inspection took place on the 2 June 2015 and was unannounced.

Hurst Green Road provides care and accommodation for up to four people with a diagnosis of a learning disability or autistic spectrum disorder. At the time of our visit there were four men living in the home.

There was a registered manager at the time of our inspection. 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 was a friendly, relaxed atmosphere in the home and both people and staff were very welcoming. People showed interest and concern for each other and responded positively to staff. People approached staff as they wished and there were lots of friendly exchanges which demonstrated that people trusted staff. Staff knew how to recognise changes in people’s emotional behaviour that might be an indication they were worried or did not feel safe.

Some people could occasionally display behaviour that could compromise their own health and safety, or that of other people. The service had worked with healthcare professionals in psychology to produce guidelines to manage those risks. ‘Personal handling plans’ ensured staff used the least restrictive way to maintain people’s safety so they could develop and maintain positive relationships with the people they supported.

Medicines were managed safely and where people were prescribed medicines for anxiety or agitation, there were detailed guidelines in place to ensure they were given them safely and consistently.

There were sufficient numbers of staff to provide the levels of supervision each person required. Staff received training and support so they could meet the individual needs of people effectively.

The provider and registered manager understood their obligations under the Mental Capacity Act and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not inappropriately restrict their freedom. The provider had made applications to the local authority in accordance with the DoLS.

Staff understood the importance of enabling people to do as much for themselves as possible to maintain their skills and promote their independence. People helped with domestic tasks which gave them a sense of value and involvement in the day to day running of the home.

People’s care plans contained information about their personal preferences and focussed on individual needs. People and those closest to them were involved in regular reviews to ensure the support provided continued to meet their needs.

People were involved in making decisions about what they had to eat and drink. Staff liaised with external healthcare professionals when there were any changes in people’s mental or physical wellbeing.

There was a strong and stable management team in place who took time to know and understand the needs of the people who lived at the home. The management team spent time with people and staff on a day to day basis which helped ensure the quality of care was maintained.

There were four people living at Hurst Green Road at the time of our visit. We chatted to people as they moved around their home. We also spoke with three members of staff and the registered manager.

We looked at the care files for two people who lived at the home. The care plans were comprehensive and contained information about people’s individual support needs.

We saw people were provided with opportunities to undertake activities as a group but also benefited from one to one time with staff members. We observed relaxed and comfortable interactions between the people who lived in the home and with the staff who supported them. There was lots of laughter and people approached staff as they wanted throughout our visit.

We were satisfied people were receiving their medicines when needed and in a safe way.

All staff were working towards further qualifications in health and social care. Staff told us they received training which helped them meet the needs of the people in the home. One staff member told us, “It is brilliant. If I think I need anything I tell them and they book me on the training.”

Records we looked at showed the home had systems in place to monitor the care provided to people.

We visited Hurst Green Road on 26 October 2012. Nobody knew we would be visiting. There were three people living in the home at the time of this visit. We spent time with them and observed their interactions with staff.

There was a pleasant and relaxed atmosphere. The people living there were happy to talk to us as they moved around their home. They told us they liked living there. One person said, " It would upset me if I left Hurst Green." People were encouraged to be involved in making decisions and choices as to how they spent their day. They were also supported to be involved in domestic tasks that promoted their independence.

Staff spoken with were knowledgeable about people's needs and how to support individuals on a daily basis. There were guidelines in place to assist staff to manage people's behaviours and keep them and others safe.

Information about how to raise concerns was provided in a format that was accessible to the people who lived at Hurst Green. Individual care plans provided staff with details that would enable them to identify when people were unhappy.

People participated in a range of activities that provided them with an interesting life and supported their connections with the community.

When we visited the service on 15 December 2011 we saw that good use was made of large laminated coloured photographs around the home and there was a library of large clear coloured photographs in bound folders. The manager told us that these had been put together by support workers to help people to understand and make choices. They supported a 'total communication' system for people and helped to give them some control over their lives.

We spent an hour in the communal rooms watching and listening to how people were supported and cared for. We saw that there was constant interaction between workers and people who used the service. Workers treated people with kindness and as individuals.

Records showed us that workers had the qualifications and up dated training in specific skills necessary to support the needs of people. This included accredited training in safe administration of their medication.

People had care plans that were individual to them. They included directions for workers in supporting people with health and person care needs and education and leisure. Risks to people posed by their condition were assessed and managed to balance safety with rights and choices.

People had sufficient space to be away from each other if they chose. We saw that people made use of entertainment in their bedrooms as well as mixing with others in the lounge and kitchen.

The service was short of four full time workers at that time and this reduced the freedom of some people at some times to go out. The service relied heavily on bank staff. Some agency workers were used but to keep continuity of care the provider tried to make sure that these were regulars workers who had got to know the people who used the service.