This inspection took place on 11 April 2018 and was unannounced. The service was last inspection in November 2015 and was rated as ‘Good’ in all questions asked.

5 Trinity 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. 5 Trinity Street accommodates three people in one adapted building.

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. We saw that the service conformed to these standards.

There was a registered manager, but they were not present during the 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.

People were supported by a group of staff who had received training in how to recognise signs of abuse. Staff were aware of the risks to people and what actions they should take if they suspected a person was a risk of harm. Where safeguarding concerns arose, they were responded to appropriately. Behaviour management plans in place provided staff with information on how to support people safely and in line with their specific needs.

People were supported by sufficient numbers of staff who benefitted from an induction and training which would provide them with the skills to care for people effectively and safely. People received their medicines as prescribed by their GP but medication audits had failed to identify some medication records were inconsistently recorded.

Systems were in place to protect people from the spread of infection. Accidents and incidents were reported, investigated and recorded and where appropriate individual lessons were learnt and practice changed.

Staff were provided with the information required to support people’s care, health and social well-being. People were supported to visit their GP and other healthcare professionals in order to maintain good health. People were encouraged to make choices regarding their daily living, including planning and preparing their meals.

Staff routinely obtained people’s consent prior to offering support. 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 support from staff who treated them with dignity and respect. Staff were described as kind and caring and supported people to maintain their independence. People were provided with information in a format they understood.

People were routinely involved in the planning of their care and supported to take part in activities they enjoyed.

Where complaints were raised, they were investigated and responded to appropriately. People were confident that if they did raise concerns they would be listened to and action would be taken.

People spoke positively of the new staff who had been bought into the service and the management team who were supporting them. Staff felt supported in their role and were equipped with the information required to meet people’s needs.

Systems were in place to provide people with the opportunity to give feedback on the service. A variety of audits were in place to assess the quality of the service provided, but not all audits had identified the concerns raised during the inspection.

Our inspection was unannounced and took place on 6 October 2015.

The provider is registered to accommodate and deliver personal care to a maximum of three people who had a learning disability or associated need. On the day of our inspection three people lived there.

The manager was registered with us. 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.

Although we found that medicine recording and administration was managed safely. However, the storage of medicines had not been formally risk assessed to confirm its safety.

We saw that there were systems in place to protect people from the risk of abuse. People had not experienced anything that hurt them or that they were afraid of.

The provider had systems in place to recruit new staff. Staff received an induction which gave them the initial knowledge and support they required to meet people’s needs. Staff numbers and experience ensured that people would be safe and their needs were met in the way that they wanted them to be.

Staff had training and one to one supervision to equip them with the knowledge they needed to provide appropriate support to the people who lived there. Staff felt that they understood their job role and responsibilities.

Staff had received most of the training that they required. However, not all staff had received first aid training. The deputy manager told us that this would be arranged.

People felt that the staff were nice and kind and we saw that they were. We observed that interactions between staff and the people who lived there were positive in that staff were kind, polite and helpful to people.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). We found that the provider was meeting the requirements set out in the MCA and DoLS to ensure that people received care in line with their best interests and were not unlawfully restricted.

People liked the food and drink that they were offered. Records confirmed that the people who lived there were supported to have a varied diet in sufficient quantities.

An easy read complaints system was available so that people and their relatives could state any concerns and dissatisfaction.

People and their relatives felt that the service was generally well led. We saw that the provider had monitoring and auditing systems in place to ensure that the service met people’s individual needs and preferences.

There were three people with learning disability living at the home on the day of our visit; no one knew we would be visiting. We spoke to three people who lived at the home, three staff, two relatives, and the deputy manager.

Staff spoken to was able to tell us about people's needs so that they received care in a way that they preferred. One staff told us, ‘’People always choose and we help them.’’ Both relatives told us they were consulted about their relative's care and kept informed about their relative's health so they felt involved in their care. One person told us, “I can cook my own food and staff help me.’’

All staff spoken to were able to tell us about people's needs and records seen confirmed that staff were knowledgeable about the people they cared for. We saw positive interactions between staff and people that lived at the home. One person said, “I like it here staff care about me.’’

Medicines were prescribed and given appropriately to the people who used the services.

The needs of people living at the home are met through the provision of sufficient and appropriately skilled staff. One person told us, ''The staff are great, they look after us.''

There were systems in place to monitor how the home was run, to ensure people received a quality service.

There were three people with learning disability and challenging behaviour living at the home on the day of our visit; no one knew we would be visiting. We spoke to three people who lived at the home, three staff, two relatives and the manager.

People with learning disability are not always able to tell us about their experiences so we looked at records relating to their care and observed staff caring for them. Throughout the day we saw staff communicating with each person in the way that they could understand.

We saw that choices were offered and that people's views were sought and acted upon. Staff spoken with were able to tell us about people's needs and how they ensured that people received care in a way that they preferred. One staff told us ‘’We support people to do the things they want to do.’’

We saw that people were relaxed in their environment and that systems were in place to keep people safe from harm. A relative told us ‘’ X is very safe there.’ A range of training was provided to staff so that they had up to date knowledge and skills in order to support the people who lived in the home. There were systems in place to monitor how the home was run, to ensure people received a quality service.

We were able to speak directly with all three people who use this service. They told us that they have enjoyed living at Trinity Street for a long time and that they are happy there. They said they like the staff that look after them, and get on well with them. They said that staff are kind and friendly, and treat them with respect. All of them said they felt safe in their home, and said they had someone they could talk to if they were worried or upset about anything. They also told us that they were able to go to places they liked and do things they valued and enjoyed.