225 London Road provides personal care and accommodation for up to six people in a small domestic care home setting. The home was presented as an ordinary detached house over two floors with access to the first floor via stairs. People had single rooms. Communal space consisted of a lounge area and dining room. There was a private garden at the rear of the property.

225 London Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of inspection there were five people living in the home.

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.

The care service was provided 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 our last inspection in June 2016 we rated the service Good. At this inspection, we found the service had remained Good.

The home was well decorated and adapted to meet people’s needs. The home had a homely feel and reflected the interests and lives of the people who lived there, with photos of people and staff on display.

None of the people who lived at the home were able to communicate using ordinary verbal conversation. However, most people could respond to direct questions with a “yes” or “no” answer and used other forms of communication such as basic sign language or sounds which the staff knew how to interpret.

People gave us positive feedback about the home and their satisfaction with care staff and did this through their interaction with staff and the ease with which they moved about the home and exercised choice throughout the inspection.

There were sufficient numbers of staff to meet the needs and preferences of the people that lived there. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff ensured that people were involved in decisions by speaking with people and making sure care plans were personalised and easy to read.

People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff. Staff supported people in a way which was kind, caring, and respectful.

Staff told us they received the support and training they needed to help them do their jobs well. The managers were proactive in ensuring staff completed training relevant to the needs of people living at the service. This included specialist training to enable staff to care for people with particular needs.

Staff helped people to keep healthy and well, they supported people to attend appointments with GP’s and other healthcare professionals when they needed to. Medicines were stored safely and people received their medicines as prescribed, with accurate records available to show which medicines people had received. People were involved in their food and drink choices and meals were prepared taking account of people’s health, cultural and religious needs.

People were supported to have maximum choice and control of their lives and staff

225 London Road provides accommodation and personal care for up to six adults with a learning disability and/ or autistic spectrum disorder. At the time of our inspection six people were living in the home. The inspection took place on 29 June 2016 and was unannounced. At the previous inspection, held in September 2013 and followed up in December 2013, we found that the service was meeting the required standards.

The home was presented as an ordinary detached house over two floors with access to the first floor via stairs. People had single rooms. Communal space consisted of a lounge area and dining room. There was a private garden at the rear of the property.

There was a registered manager in post, and they were at the home 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 home was well decorated and adapted to meet people’s needs. The home had a homely feel and reflected the interests and lives of the people who lived there, with photos of people and staff.

People who were able to communicate with us gave us positive feedback about the home and the caring nature of staff. Other people were able to demonstrate in other ways that they felt safe and cared for at the home, for example through their interaction with staff.

There were sufficient numbers of staff to meet the needs and preferences of the people that lived there. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police. Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff ensured that people were involved in these decisions by speaking with people and making sure care plans were personalised and easy to read.

People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff. Staff supported people in a way which was kind, caring, and respectful.

Staff helped people to keep healthy and well, they supported people to attend appointments with GP’s and other healthcare professionals when they needed to. Medicines were stored safely, and people received their medicines as prescribed. People were involved in their food and drink choices and meals were prepared taking account of people’s health, cultural and religious needs.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Where people’s liberty may have been restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

The provider regularly sought people’s and staff’s views about how the care and support they received could be improved. There were systems in place to monitor the safety and quality of the service that people experienced.

We met with five people living at the home and spoke with one person. We haven't been able to speak with all people using the service because some people using the service had a number of complex needs meaning that it was difficult for some to tell us about their experiences. We spoke with the relatives of three people from London Road. One relative told us "Staff have worked with people at the home for a long time, they understand people's responses".

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 not always protected against the risks associated with medicines because the arrangements the provider had in place were not always being followed. Some practices were unsafe and some medication was stored loose and could not be clearly identified.

We spoke with three staff who gave details about the training they had completed within the last year and this included moving and handling, first aid, fire safety and medication management, which meant that staff were addressing their on-going learning needs.

Three staff we spoke with told us about how they would support someone who made a complaint or raised matters of concern. They each described the main features of the complaints policy including listening to and acknowledging people's concerns.

We spoke with two people living at 225 London Road and two relatives of people living at the home. People told us that they enjoyed being with staff and spending time on their activities like horse-riding, going on holiday and shopping for clothes and food.

People spoke with us about the care that their relatives received and felt that staff were caring and supportive of people living at the home. They felt that people were safe and well cared for and the service was “as good as one can get” where staff took a genuine interest in the needs of people at the home.

The provider may wish to note that relatives commented on how they would value being kept informed of staff changes, in particular when there are new or relief staff covering for long term absence or new staff commencing employment, as and when these changes occurs.

We spoke with four of six staff who gave detailed accounts of their work roles and responsibilities and described how they support people living at the home to achieve their goals and participate in their daily activities like attending college.

People told us that they really like living at the home. They told us about all the activities they like to do, and how they are supported by the staff. Some people told us about support they had to be more independent in their life and how much they enjoyed this.

People said that they get involved in housework, which they don’t mind, and that they help the staff to prepare the meals.

People showed us their care files. They said that they were involved in putting all the information together and how they enjoyed posing for the photo’s. They said that the information showed exactly what they like to do.

The people told us that they enjoy the different holidays and outings that are arranged by the service throughout the year, as they like going out and about and filling their time.