118-120 Dudley Street is registered to accommodate and deliver nursing and personal care to up to eight people who have a learning disability, physical disability and or autistic spectrum disorder. At the time of inspection six people lived there.

At the last inspection in August 2015 the service was rated Good.

At this inspection we judged the service provided remained Good.

Why the service is rated Good.

People told us they felt safe at the home and relatives confirmed they were happy with people’s safety. Staff understood their role to keep people safe from harm and knew how to escalate any concerns. There were enough staff to support people and new staff were recruited safely. People were supported with their medicines and we saw the arrangements in place for the management of medicines were safe.

Staff had been trained and had the necessary skills to support people’s complex needs effectively and felt fully supported in their role. People were supported to have 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 told us they enjoyed the meals and the quality of the food offered. People were supported with their nutritional needs so that they could eat and drink safely. People's health needs were known and planned for so that they had the support they needed to remain healthy.

Everyone described the staff as kind and caring and we saw they had a caring approach and were attentive to people. People’s privacy and dignity was protected and their independence promoted.

People had been fully involved in planning their care and lifestyle and had been supported to participate in and pursue their interests. People had access to a complaints process and other platforms to raise any concerns they might have.

Good leadership was in place and the staff team continued to feel supported by the management team. We received consistent feedback that the home was well run, and that the registered manager was supportive and approachable. The registered manager had continued to monitor the quality and safety of the service and to seek people’s feedback with a view to making continued improvements.

Our inspection was unannounced and took place on 24 August 2015. The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

The provider is registered to accommodate and deliver nursing and personal care to eight people. People who lived there had a range of conditions which included learning disability or associated needs and some people had symptoms of dementia. Eight people lived there at the time of our inspection.

The service provided support to a mixed age range of adults who may have wished to go out into the community. We started our inspection early in the morning so that we could meet and speak with the people who lived there and staff before they went out.

At our last inspections of 2012 and 2013 the provider was meeting all of the regulations that we assessed.

The manager was registered with us as is required by law. 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 received support from staff with taking prescribed medicines. Generally this was done in a way that people preferred and that minimised any risk to them.

Staff knew the procedures that they should follow to ensure the risk of harm or abuse to people was reduced.

Staff were available to meet peoples individual needs. Staff received induction training and the day to day support they needed to ensure they did their job safely.

Staff had received training and they understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This ensured that people received care in line with their best interests and would not be unlawfully restricted.

Staff supported people with their nutrition and health care needs. We found that people were enabled and encouraged to make decisions about their care and they or their relatives were involved in how their care was planned and delivered.

People were encouraged and were supported to engage in recreational activities that they enjoyed.

People were cared for and supported by kind and caring staff to be independent and attend to their own needs when they could.

All people received assessment and treatment when needed from a range of health care professionals including their GP, specialist consultants and specialist nurses which helped to promote their health and well-being.

Systems were in place for people and their relatives to raise their concerns or complaints.

People and their relatives communicated to us that the quality of service was good. The management of the service was stable. The registered manager and provider undertook regular audits and took action where changes or improvements were needed.

There were eight people living there on the day of our inspection. We met all the people living there and spoke with three people. Some people were not able to tell us their experiences of living there because of their complex needs. So we spent time observing how staff interacted with people. During our inspection we also spoke with five members of staff and the registered manager.

We saw good interactions between people who lived there and staff. We observed that people were at ease in the company of staff. One person told us, " I like it here, the staff help me."

We saw that people's needs had been assessed by a range of health professionals and people's healthcare needs had been monitored and met.

Systems were in place to safely manage people's medicines to help meet their health needs.

Several areas of the home had been redecorated and refurbished to make it more safe and comfortable for people to live in.

We saw that checks were made on staff before they started working there to ensure people's safety. Staff had the skills and knowledge to know how to safely support people to meet their needs.

People were asked for their views about the home and these were listened to. One person said, " I am happy here, I have the food and drink that I like." We saw that audits were completed and action was taken to make improvements where needed.

Our inspection was unannounced, which meant that no one knew that we would be visiting. There were seven people living there when we visited. We spoke with five people living there, five members of staff and the deputy manager. We looked at two people's records.

The people living there told us and we saw that they could make choices about their lives. People told us they liked living at the home. One person said, “I’m happy living here.”

We saw that people were encouraged to do things for themselves so promoting their independence skills and self esteem.

We saw that people were supported to have regular health checks to ensure their well being. Staff supported people when needed to attend health appointments and followed health professionals advice to ensure that people's needs were met.

Systems were in place to ensure that people were safeguarded from harm. We saw that people were comfortable in the company of staff and they spent time talking with and listening to people. One person told us, “I feel safe here and would not want to leave here.”

Staff received the training they needed so they knew how to support the people living there. Staff told us they were supported in their role.

People were asked for their views about the home and these were listened to. Where risks to people's safety and welfare were identified, action was taken to make improvements.

We carried out this review to check on the care and welfare of people using this service.

We spoke with four people who used the service and three members of staff. People told us they were happy at Dudley Street and that staff helped them with their care and support needs. People told us and we saw that staff supported them with making choices for what they wished to do. One person showed us their life story book; this was written like a diary and had all the activities, holidays and celebrations they had enjoyed, supported with photographs. The person told us that they had chosen their holidays and trips. One person said “The staff here are really nice, they are good to me, I love going on holiday”. Another person said “I like having my nails painted, staff do them for me”, and we saw that this was the case. A third person told us “I’ve been bowling and I like singing, I had my own special singer for an hour to celebrate my birthday, they sang all my favourite songs, it was lovely”. We saw that a daily programme of activities for each person was displayed in the office and within their care plans.

We saw that written plans were in place to show how the service supports people with their care and health needs. Care plans were comprehensive with likes and dislikes included. Plans had been written in an “easy read” large print style that included pictures which helped people to access information about them.

We saw the way the staff checked the quality of the service. People are asked for their opinion of the standard of the service, with any suggestions for improvement being acted upon. People told us of their satisfaction of life within the home, “I love it here, I know all the staff, they are good staff, take us out, and look after us”. Another person wished to be involved in a Bangladeshi group and we saw that staff had sourced community contacts for this.

Some people were not able to tell us their experiences due to their medical conditions. We saw that information was available to show how people had been supported to express their views about things that affected them and make their decisions known.