This inspection took place on 8 January 2019. The registered manager was given short notice of the inspection because the location provides a respite care service for people who are often out during the day and we needed to be sure that someone would be in.

Sheffield City Council – 136d Warminster Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulated both the premises and the care provided, and both were looked at during this inspection.

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.

There was a registered manager in post. 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.

At the last inspection in July 2016, the service was rated good. At this inspection we found the service remained good.

Medicines were administered safely and in line with safe medicines management procedures.

Staff were clear about the process for reporting accidents and incidents to the safeguarding authority to protect people from the risk of harm.

People who used the service were protected by the registered provider's robust recruitment policies and procedures.

Staff were provided with appropriate support through a programme of regular and on-going supervision and appraisal. Also, appropriate systems were in place to support staff with their training and development needs. Staff told us they felt very well supported by their line managers.

Staff told us they enjoyed working at this service. Regular staff meetings meant staff could make suggestions about how the service could be improved. Staff told us their views were always listened to.

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.

Staff liaised with other healthcare professionals as required if they had concerns about a person's health. People were supported by staff to eat a balanced diet and meet their health care needs.

People who used the service and their relatives made positive comments about the staff and told us they were treated with dignity and respect. The relationships between people who used the service and staff were warm and friendly. The atmosphere in the home was calm and relaxed.

People and their relatives were involved in the planning of their care and support, which included details of people's needs and preferences.

People and their relatives had no concerns but if they had were confident they would be listened to and dealt with.

There was an effective system of quality assurance in place. The registered manager carried out audits to identify where improvements could be made and acted on these to improve the service.

Sheffield City Council -136d Warminster Road provides short stay respite accommodation for up to seven adults with learning disability. The service is on one level and provides a range of single room accommodation. It is situated in a quiet residential area of south west Sheffield close to local amenities.

There was a registered manager in post. 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 last full inspection took place on 18 June 2013; the registered provider was compliant in all areas assessed. We undertook this current unannounced inspection on 20 July 2016.

The CQC had not received all notifications for incidents which affected the safety and wellbeing of people who used the service as required by registration regulations. This had been a misunderstanding by the registered provider and registered manager and they told us they would forward all required notifications in future. We have written to the registered provider to remind them of their responsibilities in this area.

We found people who used the service were protected from the risk of harm and abuse. Staff had received safeguarding training and knew what to do if they witnessed abuse or if it was disclosed to them. Staff knew what to do in cases of emergencies and each person who used the service had a personal evacuation plan.

People had risk assessments in place for specific concerns, such as falls and choking and these contained detailed information to guide staff in how to minimise risk. Some areas of the environment had been risk managed but not all and the registered manager confirmed they would review this. Incidents and accidents had been analysed to help find ways to reduce them.

There had been no recent recruitment of new staff to the service although staff had been transferred to work from other services within the organisation. The staffing levels had recently been reviewed and increased to ensure sufficient numbers were on duty to meet the needs of people who used the service.

Staff supported people to take medicines as prescribed. Staff had received training in medicines management.

We observed kind and caring approaches from the staff team. People’s privacy and dignity were respected and staff provided people with explanations and information so they could make choices about aspects of their lives. Staff were overheard speaking with people in a kind, attentive and caring way. There were positive comments from relatives about the staff team.

Staff received training that enabled them to support people safely and to meet their assessed needs. We found staff received guidance, support, supervision and appraisal. This helped them to be confident when supporting people who used the service.

People who used the service received person-centred care based on their wishes and preferences, although some of the person centred records had been archived. People and their relatives were involved in the formulation of plans of care. Staff were aware of people’s health care needs and the support they provided helped to maintain them. Staff liaised with health professionals for advice and guidance when required.

We found staff supported people to maintain their nutritional needs. They assisted people to make choices about their meals in line with their care plans.

We found people were supported to make their own decisions and to contribute to their planned activities. When people were assessed as lacking the capacity to make their own choices, decisions were made in their best interest but, how the assessments and decisions were recorded could be improved. We have made a recommendation about this.

People who used the service accessed a range of activities

Records checked showed that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

People told us that they were happy living at the home and that they were satisfied with the support they received. People said, "I’m going out to college today. She (member of staff) is my friend. I like coming back. They (staff) keep me company. I like watching TV with them.”

The provider had suitable arrangements in place to ensure that people who used the service were safeguarded against the risk of abuse. People we spoke with said that they felt safe and supported by the staff.

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed.

The service had an effective complaints system available. We found that comments and complaints people made were responded to appropriately.

People told us they were involved and given choices about their care and described examples such as what they wanted to do and where to sit. We saw that people using the service who were able made choices about where to spend their time. One person told us that they “Like to read magazines.”

We saw examples of good communication skills from staff during our observations. This was demonstrated by staff offering reassurance when needed and supporting people at their own pace.

The people who used the service that we spoke with told us that they received their medication on time. One person told us that they knew what medication they were taking and what it was for.

We saw that staff spent one-to-one time with people and observed lots of positive communication and interaction. We also saw that staff were observant and responded quickly when people needed support.