This inspection took place on 27 January 2017 and was announced. We informed the registered provider at short notice (the day before) that we would be visiting to inspect. We did this because the location is a small service for people who are often out during the day and we wanted to make sure the people who lived there would be in when we visited.

Walsingham - 6 Greenford Walk provides care and support for up to six adults with a learning disability. It is a detached house situated on a housing estate in Middlesbrough and is close to local amenities. The home has two communal lounges and a dining room and all bedrooms are single occupancy. At the time of our inspection six people were using the service.

At the last inspection on 23 January 2015 the service was rated Good. At this inspection we found the service remained Good.

People and relatives we spoke with told us they felt the service was safe. Risks to people using the service were assessed and plans put in place to reduce the chances of them occurring. Safeguarding and whistleblowing procedures were in place to protect people from the types of abuse that can occur in care settings. People’s medicines were managed safely. There were enough staff deployed to keep people safe. The registered provider’s recruitment processes minimised the risk of unsuitable staff being employed.

Staff received mandatory training in a number of areas, which assisted them to support people effectively and they were supported with regular supervisions and appraisals. People’s rights under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) were protected. People were supported to maintain a healthy diet and to access external professionals to monitor and promote their health.

People and their relatives spoke positively about the staff at the service, describing them as kind and caring. Staff treated people with dignity and respect. Staff knew the people they were supporting well, and throughout our inspection we saw staff having friendly and meaningful conversations with people. People were supported to be as independent as possible. People were supported to access advocacy services where needed and to discuss end of life care.

People and their relatives told us staff at the service provided personalised care. Care plans were person centred and regularly reviewed to ensure they reflected people’s current needs and preferences. People were supported to access activities they enjoyed. Procedures were in place to investigate and respond to complaints.

People and staff spoke positively about the service and people said they were proud of where they lived. People and staff spoke positively about the registered manager, saying she supported them and included them in the running of the service. The registered manager and registered provider carried out a number of quality assurance checks to monitor and improve standards at the service. The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.

We inspected Walsingham 6 Greenford Walk on 6 November 2014.  This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting. 

The service provides care and support for up to six adults with a learning disability.  It is a detached house situated on a housing estate in Middlesbrough and is close to local amenities.

The service had a registered manager in place.   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 told us they felt safe in the service and we saw there were systems and processes in place to protect people from the risk of harm.  Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

We found that people were encouraged and supported to take responsible risks.  Those people who were able were encouraged and supported to go out independently.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for.  People and staff told us that there were enough staff on duty to meet people’s needs.  They understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

Appropriate systems were in place for the management of medicines so that people received their medicines safely. 

There were positive interactions between people and staff.  We saw that staff were kind and respectful.  Staff were aware of how to respect people’s privacy and dignity.  People told us that they were able to make their own choices and decisions and that staff respected these.

People told us they were provided with a choice of healthy food and drinks which helped to ensure that their nutritional needs were met. 

People were supported to maintain good health and had access to healthcare professionals and services.  People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments. 

Assessments were undertaken to identify people’s health and support needs as well as any risks to people who used the service and others.  Plans were in place to reduce the risks identified.  Support plans were developed with people who used the service to identify how they wished to be supported.

People’s independence was encouraged and their hobbies and leisure interests were individually assessed. Staff encouraged and supported people to access activities within the community.

The provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take action to support them.  People we spoke with did not raise any complaints or concerns about the service.

There were effective systems in place to monitor and improve the quality of the service provided.  Staff told us that the home had an open, inclusive and positive culture.

We spoke with three people who used the service. They told us they were treated well and the staff were good. One person said, “I like living here.” Another person told us, “I am treated well” and “I like the staff.”

We found that people were treated with dignity and respect. We saw there was a friendly and relaxed atmosphere between people living and working at the home. We observed staff interacting well with people and supporting them which had a positive impact on their wellbeing.

We found the premises that people, staff and visitors used were safe and suitable and that people were cared for and supported by suitably qualified, skilled and experienced staff.

We found there was an effective complaints system in place at the home.

We spoke to two people living at the service who told us, “It’s nice here, better than where I used to be”, “I choose when I get up and have a shower”, “I cooked dinner last night, we take turns cooking” and “I help around the house”. People told us about the variety of activities they undertook “I’m going to play bingo this afternoon, I go every Wednesday”, “I enjoy going line dancing”, “I’m saving to get a TV for my birthday and a trip to Newcastle” and “I love Take That and have been to see them at Wembley”. Also they discussed how they were able to make choices about what they did and how the home was run “I’m looking forward to Christmas, I’m going to stay with my brother” and “we have house meetings for everyone once a month”.

During the inspection we spoke with three people who used the service. We also spoke with a senior carer and four care staff. One person we spoke with told us, “I am going to Scarborough on Saturday on a trip.” They also said, “I have been to Liverpool and Manchester on a trip.” Another person told us, "The staff are nice, they always help me with things when I need it.”

We found that people had their needs assessed and that care plans were in place. People we spoke with told us they liked living at the home and that they were like a family. All the people we spoke with were satisfied with the service they received.

People were provided with a choice of suitable and nutritious food and drink.

People who used the service were protected from the risk of abuse and told us they felt comfortable and safe with staff.

Staff had received appropriate training and had regular supervision and appraisals.

The quality of the service was monitored and reviewed on a regular basis.