The inspection was unannounced and took place on 1 May 2018.

St Chads is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

St Chads accommodates four people one adapted building.

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

There was a registered manager in post. 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.

At the last inspection in January 2016 the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated good

People were supported by competent, caring staff who had been recruited safely. People’s relatives were positive about the service and felt their relatives were well supported, safe and cared for.

People were relaxed and confident with staff. Staff spoke warmly to people and treated them with respect and affection. We observed staff knew people well and understood people’s individual communication styles and preferences.

Staff followed best practice guidelines and were supported to do this by the provider. There were clear plans and guidelines in place to help staff support people if they demonstrated any behaviour that may challenge.

People were supported to access the community and follow any interests they had.

There was strong effective leadership at both the service and provider level.

This inspection took place on 15 January 2016 and was unannounced. When St Chads House was last inspected in April 2014 there were no breaches of the legal requirements identified.

St. Chads House is a care home service without nursing for four people with learning disabilities or autistic spectrum disorder. On the day of our inspection there were four people living at the service.

The service has 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 staff had received training regarding how to keep people safe and they were aware of the service safeguarding and whistle-blowing policy and procedures.

Staffing was arranged in a flexible way to respond to people’s individual needs.

There were suitable arrangements in place for the safe storage, receipt and administration of people’s medicines.

People were provided with regular opportunities to express their needs, wishes and preferences regarding how they lived their daily lives. This included meetings with a designated member of staff who was their keyworker.

Each person was supported to access and attend a range of working, educational and social activities. People were supported by the staff to use the local community facilities and had been supported to develop skills which promoted their independence.

People’s needs were regularly assessed and resulting support plans provided guidance to staff on how people were to be supported. Support in planning people’s care, treatment and support was personalised to reflect people’s preferences and personalities.

The staff had a clear knowledge of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. These safeguards can only be used when a person lacks the mental capacity to make certain decisions and there is no other way of supporting the person safely.

Meetings had been arranged in order to enable people’s best interest to be assessed when it had been identified that they lacked the capacity to consent to their care and treatment.

There was a robust staff recruitment process in operation designed to employ staff that would have or be able to develop the skills to keep people safe and support individuals to meet their needs.

Staff demonstrated a detailed knowledge of people’s needs and had received training to support people to be safe and respond to their support needs.

The service maintained daily records of how peoples support needs were meet and this included information about medical appointments with GP’s and Dentists for example.

Staff respected people’s privacy and we saw staff working with people in a kind and compassionate way responding to their needs.

There was a complaints procedure for people, families and friends to use and compliments could also be recorded.

We saw that the service took time to work with and understand people’s individual way of communicating in order that the service staff could respond appropriately to people.

The provider had quality monitoring systems in place which were used to bring about improvements to the service.

We found that there were opportunities for people to be involved in decisions about the care they received and their daily lives. People were supported to set personal goals and maximise their independence. People were treated with respect and their privacy was respected.

People were enabled to give informed consent about their care and welfare. Mental capacity assessments were undertaken to evidence where people were not able to give informed consent. Where this was the case best interest decisions had been made with professionals and people's representatives.

There were risk assessments in place which provided guidance to staff. These enabled staff to support people where they undertook activities which may have presented a risk to their health and welfare. Behaviour plans showed how the service supported people with their behaviours in a positive and supportive way. Support plans were person centred and reflected the care needs of individuals. One person told us they liked the staff and got the help they needed. A representative told us they felt their relative was living in a safe environment and saw the service as their home.

Staff received support through one to one meetings and training to undertake their role and responsibilities effectively.

There were audits in place so that the service could make a judgement about the quality and safety of the service they provided.

We looked at each persons care plans, observed people being supported by staff and spoke to people. We saw that people had been involved in drawing up their support plans. We found people were being supported in promoting independence and community involvement. However, we found that people's views and experiences on their care, treatment and support were not sought.

People had annual reviews and health action plans, behaviour support plans and support plans in place. However, we found individual needs assessments and comprehensive risk assessments were not in place. We were told of one incident where one person was not supported in accordance with their care plan. This meant that people's needs were not assessed and care, treatment and support was not delivered in line with individual care plans.

Safeguarding policies and procedures were in place and staff training in safeguarding was delivered. We found the provider had responded appropriately to allegations of abuse.

We looked at staffing arrangements and discussed these with people supported, staff and the provider. We found that the provider was taking appropriate steps to ensure there were sufficient numbers of suitably qualified, skilled and experienced staff.

We found there was no formal system for assessing and monitoring the quality of service provided. There was no evidence of learning taking place as a result of complaints or comments or accidents and investigations.

We considered our inspection findings to answer questions we always ask; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who lived in the home, the staff who supported them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by staff. People told us that staff treated them well. People were cared for by staff who were aware of the risks to people's safety and health and staff knew how to support them in a safe way.

People were protected from the risks associated with medicines. There were systems in place to ensure the safe storage and administration of medicines.

The service was safe, clean and hygienic. The home was well maintained and equipment was serviced regularly therefore not putting people at unnecessary risk.

Recruitment practice was safe and thorough. People were cared for by suitable staff.

Systems were in place to make sure that staff learned from events such as accidents and incidents, complaints, concerns and investigations. This reduced the risks to people and helped the service to continually improve.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Although no applications had needed to be submitted staff had been trained to understand when an application should be made, and in how to submit one. This meant that people would be safeguarded as required.

Is the service effective?

People told us that they were happy with the care they received and that their care needs were met. It was clear from observations and from speaking with staff that they had an excellent understanding of people's care and support needs. One person told us “I’m very happy living here; I like it. The staff are nice.”

Staff had received training which enabled them to meet the needs of the people who lived at the home.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people.

People who lived in the home, their relatives, friends and other professionals involved with the service were encouraged to share their views of the service. Where shortfalls or concerns were raised these were addressed.

People’s preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People's needs were reviewed regularly and in response to any changing needs. We read information in people's records which indicated they had been consulted about the care they received.

People's preferences were gathered and used to plan care to meet their specific needs. People had access to a wide range of activities and were supported to maintain relationships with people that were important to them.

The service worked well with health and social care professionals and services to make sure people received their care in a joined up way.

Is the service well-led?

The service had an effective quality assurance system. This was in the process of being reviewed and improved where possible when we inspected.

Staff told us they were clear about their roles and responsibilities. Staff had a very good understanding of the ethos of the home and quality assurance processes which were in place. People who lived in the home and their representatives were asked for their views about the care provided and they were acted on. This helped to ensure that people received a good quality service at all times.