Mayo House provides care and accommodation for up to seven people with learning disabilities and complex needs. People live in their own self-contained flats within the home.

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.

At our last inspection we rated the service Outstanding. At this inspection we found the evidence continued to support the rating of Outstanding 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.

Why the service is rated Outstanding

There was a strong person centred culture at the service and people were empowered to achieve their goals. The service was very well led, by managers who valued the staff team and people being supported. There was a culture of learning from previous experiences.

The principles of the MCA were embedded in to practice and staff actively sought the least restrictive options in all aspects of people’s care and support. Staff received good training and support to enable them to carry out their roles effectively.

The service was outstanding in its responsiveness to individual needs. We heard of examples of where staff went above the expectations of their role to ensure that people were well supported.

People were supported to be independent where possible and they were treated with dignity and respect. People were able to maintain contact with families.

People using the service were safe. Staff understood their responsibility to safeguard people from abuse. There was a culture of positive risk taking, so people were able to lead busy and fulfilling lives.

Further information is in the detailed findings below

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Mayo House is registered to provide accommodation for seven people who require personal care. Each person has their own self-contained flat within the building. Five flats are on the ground floor and two on the first floor. At the time of our inspection seven people were using the service. Each person had complex needs and required individual support to help them manage their behaviours.

This inspection was unannounced and took place on 10 and 11 August 2016.

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.

In addition to the registered manager, a deputy manager was employed at the service, along with six team leaders, community support workers and ‘assigned bank workers’. A total of 32 staff were employed at the service.

People using the service had varied and complex needs. Some people required intensive support to assist them to manage their behaviours. Not every person was able to make their views known verbally. As a result staff were required to develop a range of skills and abilities to provide the care and support people needed. We found staff had been supported to develop these and people received a service that was planned and delivered around their individual needs. During our inspection we were also struck by the calm atmosphere in the service in addition to the caring and skilled approach of staff.

People were safe. Staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Medicines were well managed and people received their medicines as prescribed. Emergency systems had been put in place to keep people, visitors and staff safe.

The service was effective. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see their GP and other healthcare professionals when required. People’s healthcare needs were met and staff worked with health and social care professionals to access relevant services. The service was compliant with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People’s views were actively sought and they were involved in making decisions about their care and support. Information was provided in ways that was easy to understand. People were supported to maintain relationships with family and friends.

The service was exceptionally responsive to people’s needs. People received person centred care and support. They were offered a range of individual activities both at the service and in the local community, based upon their hobbies and interests. People, relatives and staff were encouraged to make their views known and the service responded by making changes. Transitions for people moving to the service were very well planned. Staff had worked to ensure people had fair and equal access to healthcare services.

People benefitted from a service that was exceptionally well led. The registered manager and senior staff were well respected and demonstrated good leadership and management. They had an open, honest and transparent management style. The management team were experienced and had received appropriate leadership and management training and advanced training in positive behavioural support. The provider had sophisticated systems in place to check on the quality of service people received and any shortfalls identified were acted upon. The vision and values of the service

We spoke with one person using the service and four staff on duty. The person we spoke with said their needs were met, they explained that staff helped them to be independent and maintain their hobby. They said there were times when it was a bit noisy for them. As a result the staff had supported them to contact their social worker about alternative accommodation.

The interactions we saw between people and staff were friendly, respectful and activities were completed at a relaxed pace. Our observations and conversations with the staff showed that they genuinely cared for the people they supported.

Staff said, "It's a good place to work as it enables people to do what they want", "People go on holidays each year and we are planning a holiday to Disneyland Paris with someone", "Support and back up from the manager is brilliant", "All my training needs are met".

People were treated with respect and central to the decisions taken about their care. Where they were unable to give consent the appropriate actions were taken. People's needs were assessed and person centred care plans and risk assessments gave an overview of how people should be supported.

The provider took appropriate steps to ensure that people were not at unnecessary risk of abuse.

Staff were employed in sufficient numbers and with the appropriate skills to meet people's needs.

Systems were in place that enabled people to give their opinions and enable the quality of the service to be monitored.

Four people were out at the time of our visit. Two people were at home and we were able to gain the views and experiences from one of these people. This person told us that they ‘had a good relationship with the staff’ and that they were, ‘supported to live the life that they wanted too’.

Staff were confident and knowledgeable about people and their needs. Staff were trained to equip them with the knowledge, skills and understanding so that they were able to effectively meet people's needs.

We saw that people were supported to live independently and this was evidenced in the information contained within their care plans.