Stairways is registered with the Care Quality Commission to provide care and support for up to 11 adults with learning disabilities and physical disabilities, which includes some complex needs. The home is comprised of three separate flats that each have their own staff group assigned. People in each flat have their own bedrooms and have access to communal areas such as the kitchen lounge shower and bath rooms.

At our last inspection 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 felt safe living at Stairways, staff had access to good guidance and risk assessments to keep people safe.

Staff received training and appropriate support to carry out their roles effectively.

People`s medicines were managed safely by trained staff who had their competencies assessed. Where people were able they were supported to manage their medicines.

The provider had policies and procedures in place to protect people from the risk of infections and staff adhered to these.

There were enough staff employed through robust procedures to meet people`s needs effectively.

People were involved in planning their care and support, signed their own care plans and consented to the support they received.

People were involved in duties around the home such as cleaning, laundry, cooking meals.

People had opportunities to pursue their hobbies, interest and socialise in house and in the community.

People`s feedback about the service they received was regularly sought and they felt they could voice their opinions in meetings and one to one conversations they had with staff.

People and staff were positive about the management of the service. There were systems in place to ensure the quality of the service was monitored and improved if the need was identified.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Further information is in the detailed findings below.

The inspection took place on 12 January 2016 and was unannounced. At our last inspection on 13 October 2013, the service was found to be meeting the required standards in the areas we looked at. Stairways is registered with the Care Quality Commission to provide care and support for up to 13 adults with learning disabilities and physical disabilities with complex needs. The home is comprised of three separate flats that each have their own staff group assigned. At the time of the inspection there were eleven people who used the service.

There was a manager in post who had registered with the Care Quality Commission (CQC). 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 and associated Regulations about how the service is run.

People told us they felt safe, happy and well looked after at the home. Staff had received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally. Safe and effective recruitment practices were followed to ensure that all staff were suitably qualified and experienced. Arrangements were in place to ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.

Plans and guidance had been drawn up to help staff deal with unforeseen events and emergencies. The environment and equipment used were regularly checked and well maintained to keep people safe. Trained staff helped people to take their medicines safely and at the right time. Identified and potential risks to people’s health and well-being were reviewed and managed effectively.

People and relatives were positive about the skills, experience and abilities of staff who worked at the home. They received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.

Staff made considerable efforts to ascertain people’s wishes and obtain their consent before providing personal care and support, which they did in a kind and compassionate way. Information about local advocacy services was available to help people and their family’s access independent advice or guidance.

Staff had developed positive and caring relationships with the people they cared for and clearly knew them very well. People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained throughout the home.

Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances.

People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community. They felt that staff listened to them and responded to any concerns they had in a positive way. Complaints were recorded and investigated thoroughly with learning outcomes used to make improvements where necessary.

Relatives and staff very were complimentary about the manager, deputy manager and how the home was run and operated. Appropriate steps were taken to monitor the quality of services provided, reduce potential risks and drive improvement.

Stairways is a residential care service that accommodates up to 13 people with a learning disability including profound and complex emotional and physical needs. On the day of inspection there were 12 people in residence across the three houses, although several of these were out at their pre-planned daily activities.

We spoke with several people who lived at the home. Due to their varying communication needs some of our interactions with people consisted of being shown things, quick snapshot conversations and in other cases a conversation in much more detail. People both demonstrated to us and told us that they were happy living at the home and that they were at the forefront of

decision-making about their lives. One person told us that the staff were "very nice" and another said "I like it here".

Support plans were informative, up to date and staff were aware of their contents. People's health needs were assessed and met. Systems for receipt, storage, administration, recording and disposal of medicines were safe. Staff induction and training

systems were robust, ensuring people were well cared for and staff were able to learn and progress with their careers.

When we visited Stairways on 31 January 2013, in addition to speaking with people who used this service, we used a number of different methods to help us understand the experiences of others. This was because some people had complex needs which meant they were not able to tell us their experiences.

There was a relaxed atmosphere in the home and people were at ease in the company of the staff supporting them. Staff who worked at this home had been through robust recruitment checks to ensure they were suitable for this type of work. They were courteous in their approach to people and interacted confidently with them. We observed that people were offered support at a level which encouraged independence and ensured that their individual needs were met. One person said, "I have my own bus pass and can go out by myself."

We noted that people were encouraged to express their views and were involved in planning their care and making decisions about their support and how they spent their time. Some people were out at day centres at the time of our visit, and those who were at home were involved in various one to one activities of their choice. One person had been baking, and another had just returned from the hairdressers.

The provider had systems in place to ensure people were involved in the quality monitoring processes for this service. People were encouraged to share their views and opinions to help improve the standard of care provision.