The Quays provides personal care to people living in the community in the Doncaster area. Support packages are flexible and based on people’s assessed needs. At the time of our inspection the service was supporting five people. All of whom were quite young and were living with autism.

The service provides care and support to 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 service was not operating for around 18 months, during which time it was redesigned and was registered to provide support to people living in supported living settings. The supported living service started operating in September 2017.

This comprehensive inspection took place on 14 and 18 June 2018. We gave the service 48 hours’ notice of the inspection visit because the location provides services in people’s home and we needed to be sure that someone would be at the office.

At the last inspection in August 2015 the service was rated good. You can read the report from our last inspections, by selecting the 'all reports' link for ‘The Quays’ on our website at www.cqc.org.uk.

At this inspection we found that evidence continued to support the rating of good with an outstanding rating in the responsive domain (question).

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.

People’s rights and choices were promoted and a positive approach to risk taking meant people could lead fulfilled lives and seek new opportunities.

Staff were trained in safeguarding (protecting people who use care services from abuse) and knew what to do if they were concerned about the welfare of any person who used the service. People were safely supported with their medicines. There were sufficient numbers of staff to meet people’s needs and it was evident that staff had been safely recruited, with people who used the service having a say as to the staff appointed.

The service supported people to maintain a healthy diet and people who required the involvement of health care professionals were assisted to obtain this. Staff told us they enjoyed working at the service and had received support, training and supervision to help them to carry out their support role effectively. 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 support this practice.

People said they were treated with respect and dignity, and staff supported them in a way which met their needs. People’s care and support was exceptionally personalised and this meant that people were at the centre of their care. We found very clear evidence that people’s care and support was planned and reviewed with them and not for them.

It was evident that staff worked hard to provide people with the support they needed to have a good and active lifestyle that suited their individual and cultural needs and aspirations. Staff were very committed to the promotion of people’s rights and supported people to celebrate their diversity. People were supported to use public transport and to travel independently. This had increased their ability to be involved in the local community and gain useful life skills. Other benefits included increased access to their employment, education and leisure activities, as well as the boost in self-esteem, confidence and independence that came with this.

People were supported to follow their hob

At this inspection we set out to answer our five questions; 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, discussions with people using the service, the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People who used the service told us the staff were very kind. One person said, “I feel safe here and I could talk to staff if I was worried about anything.”

We saw there were enough staff available to meet people’s need. We spoke with people who used the service and they told us that they did not have to wait long if they required assistance.

Is the service effective?

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We spoke with people who used the service and they told us the standard of care was very good.

People were provided with a choice of suitable and nutritious food and drink. Care plans contained people’s preferences regarding food, drinks and snacks. We spoke with people who used the service and they told us they were involved in menu planning. Menus included people’s food preferences and people told us that they enjoyed their meals.

Is the service caring?

People who used the service had the opportunity of discussing their care plan and any other issues at a monthly key worker meeting. At this meeting people discussed what they had enjoyed doing that month and what they may like to change for the coming month. They also discussed important dates, for example family birthdays and how they would prepare for them. People who used the service told us they found these meeting valuable.

Is the service responsive?

We saw that care plans were reviewed regularly and any changes were made to ensure people’s needs were met.

We observed staff responding to people who used the service in a timely manner. No one had to wait long before they were attended to. We saw that there were enough staff available to assist people in maintaining their hobbies and interests.

Is the service well-led?

We saw that audits had been completed and where actions had been identified these were addressed.

People who used the service and their representatives were asked for their views about their care and treatment and they were acted on. We spoke with people who used the service and they told us that they were asked their opinion in how the service was run. We spoke with the deputy manager who told us a quality assurance questionnaire was sent out on an annual basis and they shared the outcome with people.

Before people received care and treatment they were asked for their consent and the provider acted in accordance with their wishes. The appropriate procedure was followed where people were not able to give consent. We spoke with two people who used the service and they told us they were always given a choice. One person said, “It’s all about what we want to do and we get choices about everything.”

People who used the service had a care plan which was relevant to their individual needs. We spoke with two people who used the service who spoke positively about the care they received. One person said, “I really enjoy living here and I go on holiday.” Another person said, “I have been involved in staff interviews and gave my opinion.”

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

People were cared for in a clean environment and people who used the service assisted staff in maintaining this.

We found that the provider had an effective recruitment procedure in place. Appropriate checks were undertaken before staff began work.

The provider had an effective system in place to regularly assess and monitor the quality of service that people received.

As part of our inspection we spoke with a number of people who use the service. They spoke positively about the care and support they received. They told us staff treated them with respect and promoted their privacy and dignity. Everyone we spoke with felt they were involved in their care and in making decisions about their treatment.

People told us about the range of activities they were supported to take part in and how staff helped them to develop their daily living skills. One person told us: "I go shopping and help make the dinners"

People living in the home, confirmed they felt safe and said they liked the staff who looked after them. One person told us: "Staff are kind to me, they look after me. I am safe." Another person said: "I talk to my key worker and they sort things out. It is safe and staff are kind."

The inspection took place on 4 August 2015 and was unannounced. Our last scheduled inspection at this service took place in June 2014 when no breaches of legal requirements were identified.

The Quays is a care home without nursing. It provides care for up to six people with learning disabilities, or autistic spectrum disorders. The home is situated close to Doncaster town centre.

The service had a registered manager in post at the time of our inspection. 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 registered manager was supported by a house manager who was responsible for the everyday running of the home. The house manager was supported by team leaders.

The provider had safeguarding policies and procedures in place to guide practice. Safeguarding procedures were designed to protect people from abuse and the risk of abuse.

Care and support was planned and delivered in a way that ensured people were safe. The support plans we looked at included risk assessments which identified any risk associated with people’s care.

We spoke with staff and people who used the service and we found there were enough staff with the right skills, knowledge and experience to meet people’s needs. We saw two care workers were on duty between the hours of 8am and 10pm. The house manager was also based in the home and offered support to staff and people as required and was part of the team.

We found the service to be meeting the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had some knowledge of this and said they would speak to the registered manager for further advice.

Staff we spoke with told us training was effective and done by workbooks. Staff felt this method was more valuable than e-learning. Team leaders felt able to support staff by relating their training to work based practice.

Weekly meetings were held with people to discuss the menu for the coming week. Each person contributed and chose a meal. People were involved in food shopping, preparation and cleaning up afterwards.

People were supported to maintain good health, have access to healthcare services and received ongoing healthcare support. We looked at people’s records and found they had received support from healthcare professionals when required.

People who used the service were supported to maintain friendships. Support plans contained information about their circle of friends and who was important to them. We saw that people had their own interests and hobbies and took part in several activities and events on a weekly basis.

We saw staff were aware of people’s needs and the best ways to support them, whilst maintaining their independence.

People’s needs were assessed and care and support was planned and delivered in line with their individual support plan. The support plans we looked at were person centred and some contained pictures to assist the person in understanding their plan. Support plans included healthcare, communication, personal care, and activities.

The service had a complaints procedure and people knew how to raise concerns. The procedure was also available in an ‘easy read’ version.

Staff we spoke with felt the service was well led and the registered manager was approachable and listened to them. Staff confirmed they knew their role within the organisation and the role of others. They knew what was expected of them and took accountability at their level.