Talbot Street is a residential care home for up to three vulnerable adults who require residential support. The home is situated in a residential area of Southport, close to local amenities. The home has three separate bedrooms, a shower room and bathroom, two lounge areas, dining area, kitchen area and rear and front garden. The service is part of the organisation Autism Initiatives.

At the last inspection, in March 2015 the service was rated Good.

At this inspection we found the service remained Good.

The home operated within the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We were provided with information in relation to capacity assessments and processes which needed to be in place to make decisions in a person’s best interest. 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.

Medication was administered safely by staff who had received the appropriate training. Medication records were accurate and systems were in place to order repeat medication, dispose of medication and record any medication discrepancies. An audit of the administration of medicines was completed each week.

All care files contained individual care plans and risk assessments which were regularly reviewed and updated in order to minimise risk. Care plans were person centred and contained relevant information in relation to a person’s wishes, choices and preferences.

Risk assessments were in place for the three people who lived at the home. The assessments offered key information about significant areas of risk and how such situations would need to be managed for the safety of everyone living at the home.

Staff expressed how they were supported in their roles as support workers; they had completed specific training in order to fulfil their roles effectively and explained that there was an open door policy where they could seek support, advice and guidance whenever they needed to.

A formal complaints process was available at the home but relatives explained that any complaints or concerns could be openly discussed with the staff and managers as and when they needed to be.

Further information is in the detailed findings below.

We conducted our inspection of Talbot Street late in the afternoon, so we could see people who were returning from day centres, talk with them, and observe them in their home environment.

We spoke to two people who lived at Talbot Street. One person showed us round the house, and drew our attention to the new wet room. Another told us they were visiting relatives over the weekend and they were looking forward to making their journey by public transport, with their support worker. When talking to both these people, they referred to Talbot Street as their home, and their relatives houses as a place they visited.

A support worker who assisted us with our inspection, explained that the three people living at Talbot Street, had done so for quite a number of years, and that their relationships could be compared to those of brother and sister, or house mates. They explained " I have quite a close bond with [name of person] as I've been their support worker for so long. I thoroughly enjoy my work and could never think of leaving." This staff member described the good relationships they had with families of people living at Talbot Street.

During our inspection, we observed that people were relaxed and happy in their home. They enjoyed the company of their support worker, and were included in every day tasks that made the house run smoothly. The house was well maintained, and we saw evidence of recent improvements made by the provider.

Due to the nature of people's disabilities we were able to communicate in a limited way with the people living at the home present on the day of our inspection. To help us understand we spent time with people, saw the type of support they got and whether they had positive experiences.

We also had the opportunity to speak with some relatives of people receiving care, who told us they were happy with the care and support received. Relatives we spoke with told us “the staff are very good, [my relative] is well looked after and safe." "[My relative] is treated as a person and an individual."

Most of the people living at 72 Talbot Street chose not to meet with us to talk about the support they received. However they agreed that we could contact their relatives to obtain their views of the support provided at the home. We therefore spoke with relatives of two of the people who live there.

In meeting the people living at 72 Talbot Street and reading their records it was evident that they received the support they needed to live a lifestyle of their choosing. People were supported to communicate in ways they could understand, including the use of verbal, written and picture methods. Staff provided people with the support they needed and chose with all areas of their lives, including their health, daily living skills and to get out and about and pursue their hobbies.

Relatives we spoke with told us that they are happy with the service provided at the home. They said that they were confident in the staff team and that they were satisfied their relatives enjoyed living there.

The inspection took place on 10, 11 and 12 March 2015 and was announced.

72 Talbot Street provides accommodation and support for up to three adults who have autism. The service is provided by Autism Initiatives UK. The house is a large detached property situated near the centre of Southport, with access to local shops, transport links and other services.

There is a registered manager for the service. They were on long term absence from work. Autism Initiatives had appointed a temporary manager who had applied to be registered with the Commission. 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.

During our inspection we used a number of different methods to help us understand the experiences of people who lived at Talbot Street. This was because the people who lived at Talbot Street communicated in different ways and we were not always able to directly ask them their views about their experiences. Our observations showed people appeared relaxed and at ease with the staff. People were kept safe because there were arrangements in place to protect them from the risk of abuse. Staff understood what abuse was and the action to take should they report concerns or actual abuse.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). The manager informed us people who lived at Talbot Street were supported to make key decisions regarding their care. We found the area manager, the home manager and staff knowledgeable regarding acting in people’s best interests. We saw this followed good practice in line with the Mental Capacity Act (MCA) (2005) Code of Practice. Applications had been made for standard DoLS authorisations for the three people who lived In the home.

Each person who lived at the home had a plan of care. The care plans we looked at contained relevant and detailed information. This helped to ensure staff had the information they needed to support people in the correct way and respect their wishes, likes and dislikes. A range of risk assessments had been undertaken depending on people’s individual needs to reduce the risk of harm. Risk assessments and behavioural management plans were in place for people who presented with behaviour that challenges. These gave staff guidance to keep themselves and people who lived in the home safe in the home and when out in the community.

Medication was stored safely and securely. Staff had completed training in medication administration. The manager told us they carried out practical competency assessments with staff to ensure they were administering medication safely. The systems we saw ensured people received their medications safely

We looked around the building. We found it was clean and well maintained. Staff had a rota in place to ensure cleaning was completed daily. We found audits/checks were made regularly to monitor the quality of care provided and ensure it was safe and standards of cleanliness and décor were maintained.

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. Staff were only able to start work at the home when the provider had received satisfactory pre-employment checks.

We saw there were enough staff on duty to support people as needed in the home. This included support with personal care, to attend employment and take part in regular activities when they wished to. We saw the staff rotas which confirmed this.

Staff received an induction and regular mandatory (required) training to update their practice and knowledge. Records showed us that staff were up-to-date with the training. This helped to ensure that they had the skills and knowledge to meet people’s needs. Staff told us they felt supported in their roles and responsibilities.

People who lived in the home were supported to make their own drinks and snacks, with staff support. As well as indicating they wanted a drink or snack we saw staff asking them throughout the day. Staff had good knowledge of people’s likes and dislikes in respect of food and drinks and people’s routines in respect of meal times. We saw that people who lived in the home had plenty to eat and drink during our inspection.

People who lived in the home took part in a variety of activities both in the home and in the community. Some people attended a day centre, a work placement; others enjoyed activities both in the home and in their local community. They completed daily activity planners using pictures as a way of knowing and understanding what they were doing at different times of the day.

During our visit we observed staff supported people in a caring manner and treated people with dignity and respect. Staff knew people’s individual needs and how to meet them. We saw that there were good relationships between people living at the home and staff, with staff taking time to talk and interact with people.

A procedure was in place for managing complaints and family members we spoke with were aware of what to do should they have a concern or complaint. We found that complaints had been managed in accordance with the home’s complaints procedure.

The temporary manager was applying for registration with the Commission. We found they provided an effective lead in the home and was supported by a clear management structure.

Systems were in place to check on the quality of the service and ensure improvements were made. This included carrying out regular audits on areas of practice.

The inspection took place on 10, 11 and 12 March 2015 and was announced.

72 Talbot Street provides accommodation and support for up to three adults who have autism. The service is provided by Autism Initiatives UK. The house is a large detached property situated near the centre of Southport, with access to local shops, transport links and other services.

There is a registered manager for the service. They were on long term absence from work. Autism Initiatives had appointed a temporary manager who had applied to be registered with the Commission. 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.

During our inspection we used a number of different methods to help us understand the experiences of people who lived at Talbot Street. This was because the people who lived at Talbot Street communicated in different ways and we were not always able to directly ask them their views about their experiences. Our observations showed people appeared relaxed and at ease with the staff. People were kept safe because there were arrangements in place to protect them from the risk of abuse. Staff understood what abuse was and the action to take should they report concerns or actual abuse.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). The manager informed us people who lived at Talbot Street were supported to make key decisions regarding their care. We found the area manager, the home manager and staff knowledgeable regarding acting in people’s best interests. We saw this followed good practice in line with the Mental Capacity Act (MCA) (2005) Code of Practice. Applications had been made for standard DoLS authorisations for the three people who lived In the home.

Each person who lived at the home had a plan of care. The care plans we looked at contained relevant and detailed information. This helped to ensure staff had the information they needed to support people in the correct way and respect their wishes, likes and dislikes. A range of risk assessments had been undertaken depending on people’s individual needs to reduce the risk of harm. Risk assessments and behavioural management plans were in place for people who presented with behaviour that challenges. These gave staff guidance to keep themselves and people who lived in the home safe in the home and when out in the community.

Medication was stored safely and securely. Staff had completed training in medication administration. The manager told us they carried out practical competency assessments with staff to ensure they were administering medication safely. The systems we saw ensured people received their medications safely

We looked around the building. We found it was clean and well maintained. Staff had a rota in place to ensure cleaning was completed daily. We found audits/checks were made regularly to monitor the quality of care provided and ensure it was safe and standards of cleanliness and décor were maintained.

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. Staff were only able to start work at the home when the provider had received satisfactory pre-employment checks.

We saw there were enough staff on duty to support people as needed in the home. This included support with personal care, to attend employment and take part in regular activities when they wished to. We saw the staff rotas which confirmed this.

Staff received an induction and regular mandatory (required) training to update their practice and knowledge. Records showed us that staff were up-to-date with the training. This helped to ensure that they had the skills and knowledge to meet people’s needs. Staff told us they felt supported in their roles and responsibilities.

People who lived in the home were supported to make their own drinks and snacks, with staff support. As well as indicating they wanted a drink or snack we saw staff asking them throughout the day. Staff had good knowledge of people’s likes and dislikes in respect of food and drinks and people’s routines in respect of meal times. We saw that people who lived in the home had plenty to eat and drink during our inspection.

People who lived in the home took part in a variety of activities both in the home and in the community. Some people attended a day centre, a work placement; others enjoyed activities both in the home and in their local community. They completed daily activity planners using pictures as a way of knowing and understanding what they were doing at different times of the day.

During our visit we observed staff supported people in a caring manner and treated people with dignity and respect. Staff knew people’s individual needs and how to meet them. We saw that there were good relationships between people living at the home and staff, with staff taking time to talk and interact with people.

A procedure was in place for managing complaints and family members we spoke with were aware of what to do should they have a concern or complaint. We found that complaints had been managed in accordance with the home’s complaints procedure.

The temporary manager was applying for registration with the Commission. We found they provided an effective lead in the home and was supported by a clear management structure.

Systems were in place to check on the quality of the service and ensure improvements were made. This included carrying out regular audits on areas of practice.