Trafalgar Street is a care home providing personal care and accommodation for four adults with learning disabilities and Autistic Spectrum Disorders. It is a four-bedroom house with single bedrooms. The home is in the village of Carcroft, close to community facilities. The village is five miles from Doncaster town centre. At the time of our inspection there were four people using the service.

At the last inspection in August 2015, the service was rated ‘Good’. This inspection took place on 1 August 2017 and was unannounced. This meant the registered provider did not know we were going to carry out this inspection. At this inspection we found the service remained ‘Good’.

The home had a registered manager. 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 who lived at the home felt the service was safe. People were protected from abuse and the risks of abuse by staff who had good knowledge of safeguarding. Staff knew how to spot signs of potential abuse and how to report any concerns they may have had. Risk assessments were comprehensive and regularly reviewed to ensure they remained relevant. There were adequate and effective safeguarding procedures in place.

There were enough staff to meet people’s needs. Where additional staff were required due to people’s changing needs, the registered manager ensured staffing levels were increased to meet this.

People were administered their medicines safely and in a way they liked. Medicines were stored, recorded and administered correctly and staff carried out daily checks to ensure any discrepancies were identified quickly and action was taken to address any issues.

Staff were supported well by senior members of staff and the registered manager. They received regular supervisions and annual appraisals. Staff received regular training updates when required.

The home worked in line with the Mental Capacity code of practice, the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People had maximum choice and control over their lives and staff supported them in the least restrictive way possible. Best interest meetings were held where people did not have capacity to make decisions for themselves and policies and systems in place supported this.

People had their privacy and dignity maintained and staff respected the need for private time and space. End of life documentation was clear and comprehensive, containing relevant information that had been sought from people who lived at the home and their loved ones.

The home responded to people’s changing needs and referrals were made to healthcare professionals in a timely manner. People attended regular appointments with professionals including dentists and chiropodists, where needed.

Activities that took place were well received and people enjoyed taking part. People who lived at the home were encouraged and supported to access the wider community and maintain their health with trips to the gym and swimming baths. Staff and people who used the service were regularly asked for their thoughts and opinions of the home and any improvements that could be made.

Quality monitoring systems were in place and audits carried out frequently. When actions were identified, they were addressed and signed off when complete.

Further information is in the detailed findings below.

There were three people living at Trafalgar Street at the time of our inspection. We met all three people who lived there. We spoke with two people in more depth, to gain their views about the service. The people we spoke with told us they were well looked after and liked living at Trafalgar Street. They told us they were involved in making decisions about their lives.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

People were protected from the risks of inadequate nutrition and dehydration. People told us they chose what they wanted to eat.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

We found that there were appropriate recruitment and selection practices in the home to ensure there were enough qualified, skilled and experienced staff to meet people's needs.

There was an effective complaints system available and people were clear how to make a complaint.

We spoke with all four of the people who used the service. They said that they were happy with the care and support they received and felt the home was a safe place to live. They said that they were offered choices and staff respected their privacy and dignity. Staff encouraged them to be as independent as possible. They told us that there was a wide range of activities for people to take part in and that they got out and about in the community, as well as being involved in the everyday tasks like shopping, cleaning and preparing meals. One person said that the people living in the home and the staff are more like a family than a residential home.

The inspection took place on 13 and 18 August 2015 and was unannounced on the first day. Our last inspection of this service took place in August 2013 when no breaches of legal requirements were identified.

Trafalgar Street is a care home providing personal care and accommodation for four adults with learning disabilities and Autistic Spectrum Disorders. The home is in the village of Carcroft. The village is five miles from Doncaster town centre. At the time of the inspection three men were living in the home.

There was not a registered manager at the service at the time of the 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 and associated Regulations about how the service is run.

The registered manager had retired in early 2015. There was a new manager in post, who had worked for the provider for several years, and was familiar with the people who used the service. They told us they intended to apply for registration with CQC.

People said they felt safe and the staff we spoke with had a clear understanding of safeguarding people from abuse, and of what action they would take if they suspected abuse.

Care and support was planned and delivered in a way that ensured people were safe. The individual plans we looked at included risk assessments which identified any risk associated with people’s care. We saw risk assessments had been devised to help minimise and monitor the risk, while encouraging people to be independent.

We found there were enough staff with the right skills, knowledge and experience to meet people’s needs. We saw the staff training record for the service. This showed that staff were provided with appropriate training to help them meet people’s needs.

We found the service to be meeting the requirements of the mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) and the staff we spoke with were aware of the Act. However, there was a need to develop assessments, records, training and practice in area.

People were supported to maintain a balanced diet and snacks were available. Staff and people who used the service placed a lot of emphasis on eating a healthy diet. The two people we spoke with told us they liked the food.

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

People’s needs were assessed and care and support was planned and delivered in line with their individual support plan. We saw staff were aware of people’s needs and the best ways to support them, whilst maintaining their independence.

We saw that people took part in some activities, of their choice, on a weekly basis and the manager encouraged people to tell him of other activities they wished to engage in.

People’s individual plans included information about their family and friends and who was important to them. We saw that people took part in lots of activities and events on a weekly basis.

The service had a complaints procedure and people knew how to raise concerns. The procedure was also available in an ‘easy read’ version. The registered manager told us the company sent out satisfaction surveys to people for them to comment on their experience of the service provided and the outcome was very positive.