What life is like for people using this service:

• People continued to receive safe care. People were safe and staff knew how to keep them safe from harm. The provider had a recruitment process to ensure they had enough staff to support people safely. People received their medicines as prescribed. People were protected from the risk of infection because staff followed infection control guidance and had access to personal protective equipment. Accidents and incidents were recorded and appropriate action taken to reduce people's risks.

• People continued to receive effective care. Staff had the skills and knowledge to meet people's needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People's nutritional needs were met and they received enough to eat and drink to ensure they had a healthy diet. People accessed health care when needed.

• People continued to receive care from staff who were kind and caring and knew them well. Staff were patient, compassionate and empathetic and had built good relationships with people. People's privacy, dignity and independence were respected by staff.

• People continued to receive responsive care. People's support needs were assessed regularly and planned to ensure they received the assistance they needed. People's support was individualised. People were supported to take part in activities of interest and their preferences, likes and dislikes were known to staff. The provider had a complaint process which people were aware of to share any concerns.

• The service continued to be well managed. The environment was friendly, warm, and clean. The registered manager was known and made themselves available. People's relatives shared their views by completing provider feedback forms about the service. Spot checks and audits were carried out to ensure the quality of the service was maintained.

More information is in the Detailed Findings below.

Rating at last inspection:

Rated Good overall (report published 14/09/2016)

About the service:

Lonsdale Midlands Limited is a residential care home that was providing personal care to four people with a range of needs including learning disabilities and behaviours that may challenge at the time of the inspection.

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.

Why we inspected:

• This was a planned inspection based on the rating at the last inspection. The service remained Good overall.

Follow up:

• We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This unannounced inspection took place on 8 August 2016. At our last inspection on 30 December 2013, we found the provider was meeting the requirements of the regulations we inspected. 164 Walker Road provides accommodation and personal care for up to four people with learning disabilities or autistic spectrum disorder. At the time of our inspection there were four people living at the home.

There was a registered manager in post. 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 told us they felt safe. Staff knew how to protect people from the risk of harm or abuse, and of their responsibilities to report any concerns of potential abuse. Risks to be people had been assessed and staff were aware of how to support people safely. There were enough staff to meet and respond to people’s needs. Recruitment processes were in place to ensure staff had appropriate checks before they began working at the home. People received their medicine as prescribed and these were managed safely.

Staff had the skills and knowledge to meet people’s needs. Staff received regular one to one meetings and felt supported by the registered manager. People were supported to make their own decisions about their care and support needs. Staff obtained consent from people before they were provided with care. Assessments of people’s capacity to consent had been completed and where required decisions made in people’s best interest. People were offered a choice of what they would like to eat and drink. People’s care needs were assessed and care was planned and delivered to meet those needs. People had access to healthcare professionals to ensure that their health needs were met.

People told us staff were kind. People felt comfortable to approach staff for support. Staff understood people’s choices and respected their dignity and privacy when providing care and support. People were encouraged to be as independent as possible. People were supported to maintain relationships and relatives were welcomed at the home. People were supported to take part in a variety of different interests and hobbies. The provider had a system in place to respond to people’s complaints and concerns.

Staff said the home was well managed and the registered manager approachable. The provider had effective quality audits systems in place to monitor the quality of care people received. This included gathering feedback from people, relatives and staff.

On the day we visited Walker Road we met two of the four people who lived there. The people did not have verbal communication skills which enabled them to talk with us so we spent time observing the care and support they received. We observed that the staff provided care in a friendly and caring manner. The staff and the people were relaxed and confident in each other’s company. The staff we spoke with demonstrated that they understood the importance of respecting people’s views and involving them in their care.

We were shown around the building by the registered manager. All areas of the building were furnished and maintained to a high standard. The people were happy to show us their bedrooms which were well-furnished with their own belongings.

We saw how people were involved in planning their daily living and community activities. We saw the use of a story book which showed how the people had been involved in the development of the garden.

We saw that the people’s care plans and the home’s policies and procedures were all up to date. All the records we looked at were clearly written and ensured the welfare and safety of the people was addressed.

The staff we spoke with said the training they received was very comprehensive and good. They said that if they identified areas of interest or additional training needs, this was supported. We saw that the people who lived at Walker Road received care from staff that had the appropriate levels of support and training.

From discussions with the acting manager, a member of care staff and from observations it was evident that people were given a choice in activities of daily life. Records demonstrated that mental capacity assessments were undertaken when necessary and best interests decisions made as appropriate.

We saw detailed documentation to show that people's needs had been assessed and appropriate plans of care put in place to meet these needs. Risk assessments were in place and recorded the action to take, to reduce the risk of harm. We spoke with one person who lived at the home, this person was independent in choosing activities that they wished to undertake and was confident in telling staff what they wanted to do.

Medication storage was safe and records had all been fully completed. Safeguards had been put in place to try to eliminate the risk of medication errors from occurring. The home had medication policies and regular audits took place.

We saw that there were sufficient staff on duty on the day of our inspection to be able to meet people's needs. People were engaged in activities of their choice and staff provided support people needed. We noted that various in house and external activities took place on a regular basis as well as holidays away from home. Staff had in depth knowledge of the likes and dislikes of the people under their care.

Systems were in place to monitor the quality of the service provided and people were asked for their views.