We inspected this service on 7 March 2018. St Lukes provides care and support for five people living in a 'supported living' setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The people who live at St Lukes have learning disabilities and 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. At the time of the inspection, there were two people living there.

At our last inspection on 2 March 2016, we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People continued to receive safe care. Staff had a good understanding of what constituted abuse and knew what actions to take if they had any concerns about people’s safety? Risks associated with people’s care were assessed and managed. Incidents and accidents were investigated thoroughly to ensure lessons were learnt and improvements made to minimise the risk of reoccurrence. There were systems in place to ensure people were protected by the prevention and control of infection. People received their medicines when needed and there were suitable arrangements in place in relation to the safe administration, recording and storage of medicines. There were sufficient, suitably recruited staff to meet people’s needs.

People continued to be cared for effectively. People were supported to enjoy their meals and their dietary needs and preferences were met. Staff were supported and trained to ensure people received care and support in line with best practice. People were supported to access healthcare professionals to help maintain their day to day health needs. The home was adapted and decorated to meet people’s individual needs and preferences. 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 the service supported this practice.

The care people received remained good. Staff had formed positive, caring relationships with people. People’s privacy and dignity was promoted at all times.

The service remained responsive. People received personalised care that met their individual needs. Staff understood people’s diverse needs and supported people to follow their interests and engage in activities they enjoyed. People and their relatives were able to raise any concerns or complaints and were confident these would be acted on.

The service remained well led. Staff felt supported and valued by the management team. There were suitable systems in place to continuously assess, monitor and improve the quality and safety of the service. The provider encouraged people, their relatives and staff to give feedback on how the service could be improved to make improvements where needed.

Further information is in the detailed findings below.

We inspected this service on 2 March 2016. This was an announced inspection and we telephoned 48 hours’ prior to our inspection in order to arrange to meet with people who use the service. At our last inspection in November 2014, the service was rated as good overall. However, we asked the provider to make improvements to ensure people were involved in reviewing their care and support. We also asked the provider to improve the systems they used to gather feedback on the quality of the service, including the recording of complaints.

St Luke’s Court is a supported living scheme that providers care and support to five people with a learning disability. On the day of the inspection, there were five people living at the service.

There was a registered manager at the service. 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.

Staff understood their responsibilities to keep people safe from the risk of abuse. There were systems and processes in place to protect people from the risk of harm. Staff received the training and support they needed to meet people’s individual needs and an induction programme was in place to support new staff to understand their role. There were enough staff to meet people’s needs and checks were made to confirm staff were suitable to work in a care environment. People received their medicines as prescribed.

Staff had caring relationships with people and respected their privacy and dignity. Staff welcomed people’s visitors to ensure their important relationships were maintained. People’s dietary needs and preferences were met and they were supported to access other health professionals to maintain good health.

People were supported to make their own decisions as much as possible, but where they lacked the capacity to do so, decisions were made in their best interests. People were supported to take part in activities both inside and outside of the home.

There was an open and inclusive atmosphere at the service. People and their relatives were supported to raise concerns and complaints. Arrangements were in place to gather people’s feedback to make improvements to the service where needed. The registered manager carried out checks to ensure people received a good service. Staff felt valued and supported by the registered manager and provider.

This inspection took place on the 27 November 2014 and was unannounced.

St Lukes Court is a supported living scheme that provides care and support to five people with a learning disability.

The service requires a registered manager. 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 time of our inspection the manager was in the process of registering with us (CQC).

At our previous inspection we found that there were insufficient staff to keep people safe. We found that people’s care plans were not always followed and this meant that people did not always receive the care they required. We had found the provider did not have effective quality monitoring systems in place. At this inspection we found staffing numbers had been increased, care was being delivered which met people’s assessed needs and the provider’s quality monitoring systems had been effective.

People who used the service were unable to tell us if the care they received was good. The relatives we spoke with had a mixture of views about the care their relative received.

The provider had systems in place to keep people safe. The manager and staff knew what constituted abuse and reported any incidents of suspected abuse appropriately.

Staff were assessed as competent before administering any medication. Records showed that people had their medication at the prescribed times.

Staff were well trained and supported to fulfil their role. The provider had robust recruitment process in place. Arrangements were in place to ensure that newly employed staff received an induction and opportunities for training. Records also showed that staff received regular supervision.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLs) and to report on what we find. The Deprivation of Liberty Safeguards are for people who cannot make a decision about the way they are being treated or cared for and where other people are having to make this decision for them. The manager told us that they had raised several DoLS referrals with the local authority.

People’s health care needs were met through close monitoring and with support from external agencies. When people’s needs changed this was quickly noticed and the relevant support was gained.

When people had specific nutritional needs these were met by competently trained staff.

The provider supported people to be as independent as they were able and to maintain and make friendships.

Care was planned and personalised. Records, observations and discussions with staff demonstrated that people using the service were at the centre of the care being delivered. Regular reviews took place to ensure that where people’s preferences had changed this was identified, however we could not see how the person themselves or their representative had been involved.

The provider told us that they had responded to people’s complaints and concerns in line with the complaints procedure, however there was no clear audit trail of complaints raised and the outcome.

Staff told us that the new manager was approachable and supportive. Quality monitoring systems were in place to ensure continuous improvements were identified and made.