This inspection took place on 15 January 2018. At our previous inspection in February 2015 and rated the service as good. At this inspection we found that the provider was still delivering a good service with caring being outstanding.

49 Victor St provides accommodation and personal care for up to five people with a learning disability. 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. Registering the Right Support CQC policy. At the time of this inspection five people were using the service.

There was a registered manager in post who supported us throughout the inspection. 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 received an outstandingly caring service and were treated with dignity and respect. People were encouraged to be as independent as they were able. People's right to privacy was upheld and their relationships respected.

People were involved and able to express their view on how their service was run.

People were safeguarded from the risk of abuse and action was taken to report or investigate incidents of abuse.

There were sufficient numbers of staff available to support people who had been employed through safe recruitment procedures.

Risks of harm were assessed and people were supported to remain safe and independent through the effective use of risk assessments. Lessons were learned following incidents that had put people at risk of harm.

People were protected from the risk of infection as infection control procedures were being followed.

People's needs were assessed and they received care and support from other agencies to ensure a holistic approach.

Staff received regular support and training to be able to fulfil their roles effectively.

The principles of the Mental Capacity Act 2005 were followed to ensure people's capacity to consent to their care was assessed. When people lacked the capacity they were supported to consent by their legal representatives.

People were supported to eat and drink sufficient amounts of food and drink of their liking. When people became unwell or their health needs changed, health care advice and support was gained.

The design and decoration of the building met people's individual needs and preferences.

People who used the service received a personalised service that met their individual needs and preferences. People were at the centre of how their service was run and were fully involved in the planning and developing of the service. Staff used innovative ideas and actions to improve people's quality of life and to give them opportunities in daily life.

People were cared for at the end of their life's wishes on how they wished to be cared for at the end of their life were sought.

There was a clear and visible strategy to deliver high quality care and support and there were systems in place to ensure that responsibilities are clear and performance is managed.

People who used the service, staff and the public were actively engaged and involved in the care delivery.

The registered manager and staff were continuously striving to improve the quality of service for people and staff worked with other agencies to ensure a holistic, open approach to people's care and support

This inspection took place on the 15 February 2016 and was unannounced. At our previous inspection in 2013 we found no concerns in the areas we looked at.

49 Victor Street provided accommodation and personal care for up to five people with a learning disability. Five people were using the service at the time of the inspection.

There was a registered manager in post, they were not available on the day of this inspection. 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 protected from abuse as staff knew what constituted abuse and who to report it to if they suspected it had taken place. There were sufficient staff to keep people safe and to support people to follow their hobbies and interests.

Risks to people were minimised to encourage and promote people's independence. Staff were clear how to support people to maintain their safety when they put themselves at risk.

People's medicines were stored, administered and managed safely.

Staff were supported to fulfil their role effectively. There was a regular programme of applicable training.

The Mental Capacity Act 2005 (MCA) is designed to protect people who cannot make decisions for themselves or lack the mental capacity to do so. The Deprivation of Liberty Safeguards (DoLS) are part of the MCA. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. The provider followed the principles of the MCA by ensuring that people consented to their care or were supported by representatives to make decisions in their best interests.

People were supported to eat and drink sufficient to maintain a healthy lifestyle and their individual nutritional needs were met.

People were supported to access a range of health care services. When people became unwell staff responded and sought the appropriate support.

Staff were observed to be kind and caring and they told us that were well supported by the registered manager.

Care was personalised and met people's individual needs and preferences. The provider had a complaints procedure and people knew how to use it.

The provider had systems in place to monitor the quality of the service. When improvements were required these were made in a timely manner.

Our visit to 49 Victor Street was an unannounced, scheduled inspection. This meant that the home were not aware that we were going to visit. We met with the registered manager, four members of staff and five people who lived at the home.

A safeguarding matter was under investigation at the time of our visit. Systems had been put in place to protect people until the outcome of the investigation is available.

Care plans contained detailed information to enable staff to provide care and support to people living at the home. A varied activities programme helped to ensure people's social and leisure needs were met.

We spoke with staff about the care and support they provided each day. They gave a detailed account of the specific individual needs of people. We saw staff supported people in a caring, compassionate and supportive way.

We looked to see if people's medication was being managed properly. We found the service had systems in place to ensure medication was handled safely and securely.

We saw that arrangements had been made to ensure people were supported by well trained and experienced staff.

We found that 49 Victor Street was compliant in the four outcome areas we looked at.

People said they liked living at the service and regarded it as their home. Some people had lived there for 15 years. People said they made decisions about the support they received and how they lived their lives. People said they got on well with the staff.

Staff saw themselves as people’s support and empowered the people that lived there. People took control of running the service with staff support. For example people said they chose what to eat, went shopping and helped to cook the meals. People said they also chose the furniture and furnishings, how to spend their leisure time and where and with whom to go on holiday. People that lived there answered the door to visitors and answered the telephone spontaneously.

People had their independence promoted. They told us they had support to do their own laundry, clean their bedrooms and one person said they looked after their own medicines. Bedrooms had locks and people kept their own key.

Comments from people included:

‘ I chose where I went on holiday’

‘I make my own sandwiches’

‘The staff are excellent. They are my friends’.

People said they went to the doctor for check ups and went to see specialist health staff. They had routine dental, optician and chiropody treatment.

We found that the provider assesses the needs of the people who use the service through a person centred approach. This means that the people who use the service have autonomy over their lives and how they would like to receive support. The staff at the service are trained in all the essential areas to provide the correct level of support. They are also well supported by the manager of the service. The manager and the provider frequently assess the quality of the service through regular auditing and obtaining the views from the people who use the service. We saw how this information is collated to improve service provision.