About the service.

Prince Bishop Court is a care home for up to 15 people who are living with learning disabilities.

The service is provided from two adjacent properties. The larger of the properties was separated into two smaller homes, the second property was a smaller, separate terraced house. Both properties are within proximity of each other and situated in a residential area.

The service is registered for the support of up to 15 people. At the time of the inspection 12 people were using the service. The larger property is bigger than most domestic style properties and provided support for ten people within the two separate homes.

The size of the service having a negative impact on people was mitigated by the building design promoting current best practice guidance promoting people living in small domestic style properties to enable them to have the opportunity of living life to the full.

The design of the properties fitted into the residential area where there were other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service.

People were observed to be happy and told us they liked the care and support they received from the provider.

The registered manager ensured people received a safe service with systems and processes in place which helped to minimise risks. Staff effectively reported any safeguarding matters. All incidents were critically analysed, lessons were learnt and used to improve practice.

Medicines systems were organised and people were receiving their medicines when they should. The provider was following national guidance for the receipt, storage, administration and disposal of medicines.

The principles and values of Registering the Right Support and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied.

The outcomes for people using the service reflected the principles and values of Registering the Right Support. For example, people’s support focused on them having choice and control over the care and support they received and as many opportunities as possible to become more independent.

Staff treated people as individuals and respected their privacy and lifestyle choices.

Staff were skilled and knowledgeable in the care and support people required. They provided flexible care and support in line with people's needs and wishes. The staff team was consistent with some staff working at the service for many years.

People, their relatives and health and social care professionals were actively involved in decisions being made about the care people received.

The provider and registered manager monitored quality, acted quickly when change was required, sought people's views and planned ongoing improvements to the services. Relatives told us if they were worried about anything they would be comfortable to talk with a member of staff.

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

Rating at last inspection and update.

At the last inspection the service was rated requires improvement (published 14 June 2018).

Previous breaches.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider is no longer in breach of regulations.

Why we inspected.

This was a planned inspection based on the previous rating.

Follow up.

We will continue to monitor intelligence we receive about the service until we return to vi

This inspection took place on 17 and 18 April 2018. The first day of the inspection was unannounced, which meant that the staff and provider did not know we would be visiting. The second day was announced. This was the first inspection of the service since it was registered with CQC on 27 January 2017.

Prince Bishop Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service provides support and accommodation for up to 15 people with learning disabilities. It is provided from two properties separated into three houses. The properties are set together in a residential area of Chester Le Street near to public transport routes, local shops and community facilities. At the time of our inspection there were 12 people using the service.

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.

The service had a registered manager. A registered manager is a person who has registered with the 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.

Records showed that whilst some maintenance and equipment checks were undertaken not all required checks took place. Legionella checks and hot water temperature checks were not carried out regularly. Medicines were not always managed safely.

We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, namely Regulation 12, Safe Care and Treatment.

You can see what action we have asked the provider to take at the back of the full version of this report.

Provider and management audits covered areas such as premises, complaints, and recordings however the issues we found during this inspection in regards to health and safety checks and medicine management were not identified through these processes. We have made a recommendation about a review of the quality assurance systems used to ensure they are more robust.

Emergency contingency plans were in place but were not comprehensive.

Policies and procedures were in place to protect people from harm such as safeguarding and whistleblowing polices. Staff knew how to identify and report suspected abuse. People and their relatives felt the service was safe.

People and relatives said there were suitable numbers of staff on duty to ensure people’s needs were met. Safe recruitment practices were in place. Pre-employment checks were made to reduce the likelihood of employing staff who were unsuitable to work with vulnerable people.

People’s risk assessments and care plans were in place and had been reviewed regularly.

Staff received training to be able to carry out their roles in areas including health and safety, food safety and people movement. They had regular supervision and annual appraisals and told us they were well supported by the registered manager.

People had access to a range of healthcare such as GPs, hospital departments and dentists. People’s nutritional needs were met. Infection control practices were followed.

Learning took place following reviews of accidents and incidents where themes and trends were addressed.

Independence was actively promoted. People were supported to have maximum 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.

Care was planned and delivered in