About the service:

Outreach Community & Residential Services – 17 York Avenue is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both premises and the care provided, and both were looked at during this inspection. The home provides care and accommodation for up to four people who have learning disabilities or who have autistic spectrum conditions. At the time of the inspection there were four people living at the home.

People’s experience of using this service:

At this inspection we found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

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. The outcomes for people using the service reflected the principles and values of registering the right support. This was because peoples support focused on them having choice and control and as many opportunities as possible for them to gain new skills and become more independent.

People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible. People felt safe and risks to people were managed well, ensuring peoples choices were respected.

Staff received the training and support they needed to carry out their roles effectively. Staff members had been safely recruited and there were sufficient numbers of staff to provide people with the person-centred support they needed.

Medicines were managed safely. Staff helped people to stay healthy and promoted their wellbeing.

People told us their individual beliefs, as well as their Jewish religion and culture, were respected.

Staff and managers knew people really well and showed genuine compassion and understanding for the people who lived at the home. People were respected as individuals.

Managers and staff were committed to promoting and maintaining people’s independence, it was at the heart of the service.

The home was well led. The registered manager had a clear vision of what the service should be. They were committed to ensuring people were respected as individuals, had opportunity for ordinary life experiences and that their independence was encouraged. Staff we spoke with shared this passion and commitment for providing a good quality person centred service.

Audits of the service, company policies and procedures and staff practice all helped to evidence how the service was meeting the regulations. The quality assurance records that we saw demonstrated how the registered manager maintained oversight of the service.

Rating at last inspection:

At our last inspection, published in August 2016, we rated the service as good.

Why we inspected:

This was a planned inspection based on the last inspection rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This was an announced inspection, which took place on 19 July 2016. We had previously carried out an inspection on 23 July 2014 when we found the service to be compliant with all the regulations that were in force at the time.

17 York Avenue is a care home registered to provide accommodation and personal care for up to four people who have a learning disability or mental health needs. At the time of this inspection, four people were using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 for this service was also the registered manager for four other residential services run by the provider.

People who lived at the home who were able to speak with us told us they felt safe at the home. They said they could approach the registered manager, the staff or a relative if they had any worries or concerns. They were confident they would be listened to and that any problems would be sorted out.

Recruitment processes were sufficiently robust and should help protect people who used the service from the risk of staff who were unsuitable to work with vulnerable adults.

There were sufficient staff available to meet people’s needs. No outside agency staff were used by the service. This meant that people who used the service received consistent support from a staff team who knew them well.

There were systems in place to ensure the safe administration of medicines and effective infection control practices. Staff had received the training they needed to support people safely and effectively.

People had the access they needed to health and social care professionals.

People we spoke with told us that their Jewish faith and culture was observed, for example, attending Shule, celebrating Shabbos and buying kosher food.

The atmosphere in the service was relaxed and friendly and there was a good rapport between people who used the service and the staff supporting them.

We saw that those who used the service had person centred care records, which included easy read formats and photographs that helped people to be involved in decisions about their care and support.

People had access to a range of activities that met their individual needs and were encouraged to be as an independent as possible.

Wherever possible people who lived at the home were encouraged to maintain contact with their family and friends.

We saw records that showed that the registered manager carried out regular audits of the home’s records and health and safety checks.

All the people we spoke with told us the registered manager and the project manager were approachable and would always listen and respond if they raised any concerns.

During this inspection, we contacted the commissioner and safeguarding teams at the local authority. They raised no concerns about the service with us.

We saw that people were asked for feedback about the quality of the service they received.

People were supported in promoting their independence and community involvement. Some people attended a Jewish group called the Friendship Circle or Contact which enabled them to attend social activities with others. One person had plans to meet a friend for lunch. Another was planning to go our shopping for new furniture for their bedroom.

There were systems in place to reduce the risk and spread of infection. People’s food and drink met their religious or cultural needs. We were told that the kitchen followed kosher practices and two sinks were used for different food types such as meat and milk.

People told us they helped to keep the house clean and tidy. They took responsibility to clean their rooms and some communal areas with the support of staff.

Appropriate checks were undertaken before staff began work. There were effective recruitment and selection processes in place. We talked with a support worker who confirmed they had received a six week induction shadowing established support workers at a number of different services. They told us the training they had received was “very good” and their line manager was “very approachable and supportive” and the organisation had encouraged them to raise any issues or concerns they had.

Prior to our visit we contacted the commissioning team about the service. They informed us that they were not aware of any concerns about 17 York Avenue.

When we arrived at the home one person had just returned from a trip out to the shops as well as to pay their rent and pick up a prescription. The person told us all about what they had done whilst out that day and what plans they had for the coming week. From what we were told this was a busy week but they had put sometime aside to relax and have a rest.

People confirmed that their cultural and religious needs were met and that staff followed kosher practices when shopping and in the kitchen. People said that sometimes they visited relatives and friends at Shabbos but if they were at home it was their choice about how they observed cultural and religious practices.

We saw that a person was involved in a review of the support they received with relatives and the manager.

Before our visit we contacted the local commissioning team and the safeguarding team. They confirmed that they had no concerns about the home.

People who use this service lead active lives, therefore we talked to the manager the day before the visit. This was to make sure there would be somebody available at the house in order to carry out the site inspection.

When we arrived at the service there was one service user and one member of staff available to assist us in the inspection process. We also spoke to a relative of a service user following the inspection of the home.

In addition to gaining the views and comments of people experiencing the service, we asked other external agencies including social services contracts team. They reported the service was compliant to their standards and regulations.

A staff member told us three service users were at college and working in the community so were unavailable to speak to during the site inspection. The member of staff told us there are always enough staff on duty to assist people in their choice of daily lives. Comments included, “People living here are very independent, and they do a lot of things for themselves.” A person living at the service told us they felt supported, “I keep very busy, I do lots of things every day.”

A person we spoke to told us they were happy with the care their relative receives. “I think they do a great job, my relative gets all the care they need.” Also, “My relative does things they like to do”.

We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask: Is the service safe? Is the service caring? Is the service effective? Is the service responsive to people’s needs? Is the service well led?

Below is a summary of what we found. The summary is based on speaking with two people who used the service and a staff member who supported them, observation and looking at records.

Is the service safe?

People who lived at the home who we spoke with told us they felt safe at the home. They said they could approach a staff member if they had any worries or concerns. They were confident they would be listened to and that the problem would be sorted out.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Is the service effective?

People told us that their individual needs, choices and preferences were acted upon and were respected by the staff supporting them.

People were involved in a range of community based activities to ensure social inclusion.

Is the service caring?

People had lived at the home for a long time. Interactions between people and the staff member supporting them were seen to be frequent, friendly and the atmosphere was calm and relaxed.

Is the service responsive to people’s needs?

Wherever possible people who lived at the home were encouraged to maintain contact with their family and friends.

We were told by people we spoke with that their Jewish faith and culture was observed, for example, celebrating Shabbos and buying kosher food.

In the ‘dreams and aspirations’ section of a person’s records it stated that they wanted to make new friends, to be healthy and continue to work at the charity shop. The person thought all their goals had been achieved.

Is the service well-led?

The manager of the home was registered with the Care Quality Commission (CQC). We saw records that showed that the registered manager carried out regular audits of the home’s records and health and safety checks.

People said that they felt comfortable to raise any concerns that they had with the registered manager, support staff or a relative. They were confident that people would listen and sort the problem out.