Mill Lane Macclesfield is a residential care home for eight people with learning disabilities. The building has three self contained flats with one person living in each and five en-suite bedrooms where people use the communal areas.

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

The care service had not 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.” Registering the Right Support CQC policy

Registering the Right Support gives guidance surrounding the maximum amount of people a home providing support to people with learning disabilities should have. Guidance states this should be six however Mill Lane Macclesfield had been registered to provide support to eight people since 2011. We saw that the home itself was situated in a residential area and that people with learning disabilities who were using the service were able to live as ordinary a life as any citizen.

The home has a registered manager who was supported by a residential 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.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive ways possible; the policies and systems in the service supported this practice. Medications were safely managed.

People who lived in the home and relatives we spoke with all gave positive feedback about the home and the staff who worked in it. The service had a relaxed feel and people could move freely around the service as they chose. People were able to have control over their lives and participate in activities they enjoyed.

Care plans and risk assessments were person centred and detailed how people wished and needed to be supported. They were regularly reviewed and updated as required with input from people and their families. Care plans showed that people's GPs and other healthcare professionals were contacted for advice about people's health needs whenever necessary. We saw the service had responded promptly when people had experienced health problems.

The provider employed their own specialist nurses for epilepsy and behaviour, who were very involved in the support of the people living in the home.

The registered manager and residential manager used different methods to assess and monitor the quality of the service. These included regular audits of the service and staff meetings to seek the views of staff about the service. The staff team were consistent and the providers were also heavily involved in the running of the service.

Staff were recruited safely, received a robust induction and suitable training to do their job role effectively. All staff had been supervised in their role.

Further information is in the detailed findings below.

The inspection was unannounced and took place on the 11 February 2016. Following this an announced visit to the home to look at the new system of computerised support plans took place on the 16 February.

Mill Lane is part of the David Lewis Centre’s ‘Community Programme’ and is registered to provide accommodation for eight people who require support and care with their daily living. The home is located close to Macclesfield town centre. The two storey domestic property made up of three self contained flats and five bedrooms is close to local amenities. Staff members are available twenty four hours a day. At the time of our visit there were eight people living in the house.

Mill Lane had 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.

The registered manager, (their job title within the organisation was service manager), did not work in the home on a daily basis. Day to day management was provided by a residential manager who had responsibility for a total of four services operated by David Lewis and the team leaders who managed each shift.

We were able to ask all of the people living at Mill Lane what they thought about the home and the staff members supporting them.

The service had a range of policies and procedures which helped staff refer to good practice and included guidance on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This meant that the staff members were aware of people's rights to make their own decisions. They were also aware of the need to protect people's rights if they had difficulty in making decisions for themselves.

We asked staff members about training and they confirmed that they received regular training throughout the year, they described this as their mandatory training and that it was up to date.

The care plans, which within the David Lewis Centre were called common care files had been transferred on to the organisations new computerised system called ‘I Care’. We looked at these on the second day of the inspection and could see that they were being reviewed regularly so staff knew what changes, if any, had been made. The files each had a ‘one page profile’ which explained what was important to the individual and how best to support them. This helped to ensure that people’s needs continued to be met.

Staff members we spoke with were positive about how the home was being managed. Throughout the inspection we observed them interacting with each other in a professional manner. The staff members we spoke with were positive about the service and the quality of the support being provided.

The relationships we saw were warm, respectful, dignified and with plenty of smiles. Everyone in the service looked relaxed and comfortable with the staff.

We found that the provider and the home used a variety of methods in order to assess the quality of the service they were providing to people. These included regular audits on areas such as the care files, including risk assessments, medication, individual finances and staff training. The records were being maintained properly.

During our announced inspection on the 8 January 2014 we spoke to the registered manager, the residential manager, the human resources advisor, two members of staff, one of the eight people who lived at the house and two of the relatives of people who lived at the house.

We were told by the registered manager that all staff had received training in the Mental Capacity Act 2005 and its application.

When we spoke to two relatives of the people who lived at the house, they were very complimentary about the standard of care provided. One said; “I think the care is excellent and the house is so nice.”

We were able to confirm that the provider had a recruitment process in place which complied with employment legislation and the Human Rights Act.

The relatives that we spoke to told us that the staff were good at listening to people. One relative said; “When I ring to speak to my son, the carers always make time for a chat, update me on what has been happening and listen to anything I have to say.”

We looked at policies, risk assessments, capacity assessments, staff files and training information. Documentation was clear, detailed and consistent with the provider’s other locations.

We found that people who used the service were given information in a suitable format and helped to express their views about their care and treatment. People who use the service were involved in Person Centred plans and making choices about care and treatment.

People were supported in promoting their independence and community involvement. One family member said that their relative had, "Come on leaps and bounds since moving to Mill Lane."

We found that people’s diversity, values and human rights were respected.

We found that people’s needs were assessed and care and treatment was planned and delivered in line with peoples individual care plan in a way that was intended to ensure their safety and welfare. One family member said, "I am really happy with the care my relative receives. The staff are very informative and they always let us know about any incidents."

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening, through regular staff training and a clear policy.

There were enough qualified, skilled and experienced staff to meet people’s needs.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. One person who uses the service said, "The staff listen to what I say."

During our inspection the people we spoke with who use the service were able to tell us why they were living in Mill Lane. They said they could talk to staff if they are not happy about things and that staff will ‘sort things out for them’. One person said they like doing things for themselves but that staff were always there if they needed help.

People told us they felt safe living in Mill Lane. One person told us that they liked having their own flat where they ‘could do as they want’. Other people told us they liked returning there when they finished work. Another person told us they liked having a shop and chippie close to the home.

People also told us they knew what to do if they had any concerns or worries and were confident that staff would listen to them. One person told us they would tell the staff if anyone upset them. Another person told us that staff had sorted out problems they were having and things were better now.

People told us they had residents meetings where they would talk about things that concerned them. We were also told there was a resident’s forum within the David Lewis Centre where people could meet with the chief executive and share any concerns or worries with him.

People were very positive about the staff and the manner in which they were supported with their daily lives. They told us how much they enjoyed living in the home and how staff supported them to be as independent as possible.

All the people we spoke during out visit told us staff asked them if they were all right and if they had any problems.

The relative we spoke with told us that staff were kind, caring and made them feel welcome when they visited the home. They also told us that because of the support and help offered by staff their family member was very relaxed and happy. The relative confirmed that they attended reviews and spoke with staff on a regular basis. They told us they knew who to speak with if they had any concerns or worries.

The relative we spoke with told us that they had no concerns or worries about the safety and well-being of people who use the service.