This announced comprehensive inspection took place on 7 February 2018. At the last comprehensive inspection carried out in April 2015, we found a breach of Regulation 19 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. A focussed inspection was carried out in February 2017 where the provider was found to have fully met their legal requirements.

At this inspection, we found the service remained good in all areas, with an overall rating of good.

St Helens Down registered with the Care Quality Commission (CQC) as a ‘care home’ for younger adults in March 2014. People living here may have a learning disability or autistic spectrum disorder, a mental health illness, a physical disability or a sensory impairment. People in care homes receive accommodation and nursing or personal care as a 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 the inspection.

St Helens Down accommodated six people in one 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.

There was registered manager in post. 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.

People’s care and support was well planned, with comprehensive plans in place to guide staff. Care was personalised and individual to meet people’s differing needs. Risks were clearly identified and as least restrictive as possible. All the necessary actions were taken to reduce risks while maintaining people’s independence.

People were protected by a safe and effective recruitment process in place. Staff were trained, supervised and supported in their roles. Staff were motivated, enjoyed their jobs and felt valued. There were staff vacancies which were being covered by regular agency staff. Staff had a good understanding of what constituted abuse and what they needed to do to raise concerns.

Positive relationships had developed staff who knew how to meet people’s needs fully. Care staff were kind and respected people’s choices. People were supported to have their healthcare and wellbeing met. The service had a homely and calm atmosphere, with enough space for people to enjoy time on their own or with other people.

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. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed and infection control procedures were in place. People were supported to choose what they wanted to eat and drink and were involved in menu planning.

People lived in a home which was kept in good order and had any adaptations, design and decoration of the premises carried out. All the necessary safety checks on the building, systems and equipment were undertaken.

The service regularly sought the views of people who used the service. People knew how to raise any concerns. There were robust quality assurance systems in place which enabled the provider to monitor and improve practice.

We carried out a comprehensive inspection of St Helens Down on 23 April 2015. A breach of legal requirements was found in relation to records and quality assurance systems. After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach and told us this would be completed by the end of September 2015.

We undertook this focused inspection on 27 February 2017 to check that they had followed their plan and to confirm they now met legal requirements. We found improvements had been made and the provider was now meeting all legal requirements.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for St Helens Down on our website at www.cqc.org.uk.

St Helens Down provides accommodation and personal care for up to six people with learning disabilities. At the time of our inspection there were six older people living at the home. People had a range of needs and all required some assistance. This included, personal care, mobility, communication and going out.

There is a registered manager at the home. 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 regularly asked for their feedback about the service and what they would like from it. People were listened to and improvements were made based on the feedback they gave. People’s care plans reflected their individual needs and choices and other records demonstrated the support people had received.

The registered manager had developed an open and positive culture which focussed on improving the experience for people and staff. There was an effective quality assurance system in place. Audits were analysed to identify where improvements could be made, and these were implemented. There was an on-going action plan for the service to ensure it continued to develop and improve.

This inspection took place on 23 April 2015. The inspection was unannounced. This meant the provider did not know we were completing an inspection.

St Helens Down is registered to provide accommodation and personal care for a maximum of six people with learning disabilities. At the time of our inspection five older people lived at the service.

People had different communication needs. Some people were able to understand and verbally respond to simple sentences and some people used words and gestures to answer questions. People had different levels of verbal reasoning skills. We talked directly with people and used observations to better understand people's needs.

The service had 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.

We found one breach of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 17: Good Governance. You can see what action we told the provider to take at the back of the full version of this report.

People were encouraged to comment on the service provided to influence how the service was developed. There were audit processes in place intended to drive service improvements. It was not always clearly recorded what actions had been taken to address shortfalls or feedback identified by the provider’s quality assurance systems.

The registered manager had ensured that people were safe. People said they felt safe with the care staff and there were sufficient staff to meet people’s needs.

Staff had the required competency to meet people’s needs. Staff received on-going supervision and appraisals to monitor their performance and development needs.

Staff were kind, caring and respectful to people when providing support and in their daily interactions with them. People spoke positively about the care staff and told us they liked the staff.

People received care that was responsive to their care needs. People felt confident they could make a complaint and that the provider would address their concerns.

Staff had received training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). This legislation sets out how to proceed when people do not have capacity and what guidelines must be followed to ensure people’s freedoms are not restricted.

Records showed that the Care Quality Commission (CQC) had been notified, as required by law, of all the incidents in the home that could affect the health, safety and welfare of people.