York Road provides accommodation and personal care for people with learning disabilities. At the time of our inspection, four people were living at the service.

At the last inspection on 23 March 2015, the service was rated ‘Good’.

We carried out this unannounced comprehensive inspection of the service on 5 October 2017. At this inspection, we found the service remained ‘Good’.

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 supported this practice.

People were happy at the service. People received care from staff who knew how to identify and report potential abuse. The registered manager assessed risks to people’s health and well-being and developed support plans that provided guidance to staff about how to deliver safe care.

The provider ensured there were sufficient numbers of suitably skilled staff deployed to meet people’s needs. New staff underwent appropriate recruitment procedures to protect people from receiving care from care workers who were not suitable for the role.

People continued to receive their prescribed medicines from staff who were trained and assessed as competent to do so. Staff followed the provider’s procedures and best practice to administer, store, record and dispose of people’s medicines at the service.

People consistently received care from trained and skilled staff. Staff continually received training, supervision, appraisal and the support they required to develop in their roles.

People continued to receive the support they required to access healthcare services when needed. People enjoyed the meals provided at the service and received sufficient amounts to eat and drink.

People had their care delivered in a kind and caring manner. Staff maintained people’s privacy and dignity and treated them with respect. People were involved in making day-to-day decisions about their care. People received care that was in line with the requirements of the Mental Capacity Act 2005 (MCA) and the restrictions placed on their freedom under the Deprivation of Liberty Safeguards (DoLS). People consented to their care and treatment.

Staff encouraged people to take part in activities at the service and in the community. People had opportunities to develop their daily living skills and received the support to be as independent as possible.

People received care that met their individual needs. The registered manager assessed and reviewed people’s care and support plans. Staff understood people’s needs and provided care in line with their changing needs and support plans.

People knew how to make a complaint if they were unhappy with the service. The registered manager investigated and resolved concerns and complaints in line with the provider’s procedures. People were asked their views about the service and their feedback was used to improve the quality of care.

People and staff were happy with the management and leadership of the service. The quality of service remained under check to ensure staff delivered high standards of care. The registered manager maintained a close partnership with external agencies to drive the quality of care at the service.

This inspection took place on 23 March 2015 and was unannounced.

At the last inspection, which we carried out on 20 January 2014, we found the service was meeting all the regulations that were looked at.

14a York Road is a home that provides accommodation for up to four people with personal care and support needs. The home specialises in supporting adults living with learning disabilities, autistic spectrum disorders and down syndrome. There were four people using the service when we visited.

There was a registered manager in post, although they had not been in day-to-day charge of the service for over a year. In the interim two acting managers supported by an area manager had been in day-to-day charge of the service on two separate occasions. The homes current acting manager, who had been running the home since December 2014, is in the process of applying to the Care Quality Commission (CQC) to become the service’s new registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 14a York Road was a comfortable place to live and that they felt safe there. They also told us staff looked after them in a kind, caring and respectful manner. Our observations and discussions with people using the service and their relatives supported this.

People’s rights to privacy and dignity were respected by staff. People were encouraged to pursue meaningful social, educational and vocational community based activities that interested them. People were also supported to maintain social relationships with people who were important to them, including relatives and advocates.

People had a choice of meals, snacks and drinks throughout the day and staff actively encouraged people to eat healthily. Staff routinely monitored the health and welfare of people using the service. Where any issues had been found appropriate medical advice and care was promptly sought from the relevant healthcare professionals. People received their medicines as prescribed and staff knew how to manage medicines safely.

Staff knew what action to take to ensure people were protected if they suspected they were at risk of abuse or harm. The provider assessed, monitored and mitigated the risks relating to the health, safety and welfare of people using the service. Staff were given appropriate guidance to mitigate these identified risks and keep people safe. The service also managed accidents and incidents appropriately and suitable arrangements were in place to deal with foreseeable emergencies, such as fire. We saw the premises were well maintained and safe.

Sufficient numbers of suitably competent staff were deployed in the home to meet the needs of the people who lived there. Staff received appropriate training and support and the registered manager ensured their skills and knowledge were kept up to date.

People’s consent to care was sought by the service prior to any support being provided. People agreed to the level of support they needed and how they wished to be supported. Where people's needs changed, the provider responded and reviewed the care provided.

The acting manager understood when a Deprivation of Liberty Safeguards (DoLS) application should be made and how to submit one. This helped to ensure people were safeguarded as required by the legislation. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.

The acting manager encouraged an open and transparent culture. People and their relatives felt able to share their views and experiences of the service and how it could be improved. People and their relatives also felt comfortable raising any issues they might have about the home with staff. The service had arrangements in place to deal with people’s concerns and complaints appropriately.

There were effective systems in place to monitor the safety and quality of the service and the registered provider/manager took action if any shortfalls or issues with this were identified through routine checks and audits. Where improvements were needed, action was taken.

People's need and risks were assessed and a personalised support plan was developed so that care was delivered in line with needs. Support plans were reviewed and updated regularly. People's individual goals and objectives were considered and monitored and communication difficulties were managed within the care planning process. Activity, well-being and progress were monitored on a continuous basis by an assigned key worker.

There were suitable procedures to manage foreseeable emergencies, including the training of staff.

Staff took steps to ensure that people consented to the care and support they received and used different communication tools to enable people to convey their wishes.

The provider had systems to ensure that people were cared for in a clean and hygienic environment and that procedures were monitored regularly. Staff received regular training and updates on infection prevention control.

There were adequate numbers of staff to provide care and support for people using the service and arrangements for staff absences.

The provider had measures to assess and monitor the quality of the service. There were regular health and safety checks at the premises and the parent organisation also conducted monthly quality assessments. There was a suitable complaints procedure and people supported to give their views and comments on the service. One person living at the home told us, "I'm happy here. The staff are nice, the food is good and it's healthy."

Some of the people using the service could not communicate verbally however each person had a profile indicating their communication methods that they and members of staff understood.

One person using the service told us they regularly went to watch the Arsenal Ladies football team. They had been to concerts to see The Wanted, Olly Murs and Westlife’s final tour. They had been to the West end to watch the musical ‘Wicked’. They told us “I like it here, its okay, I like my room and the food is good”.

We observed positive interactions between staff and people using the service. We saw that staff treated people using the service with dignity and respect during the course of our visit.

Some of the people who use the service cannot communicate verbally however each person has a communication profile indicating their method of communicating that they and members of staff understand.

One person who uses the service told us, “I am alright here, I have no problems, I get to go out when I want. I went to see Westlife on Saturday at the O2”. They also told us if they had to complain they would speak to the team leader and they would sort it out.

A care manager told us that the service worked according to peoples care plans and risk assessments. People who use the service were well looked after in terms of personal care, their care plans were regularly reviewed and if there were any issues the service contacted them to discuss them. The service was managed properly and they had no concerns about the care and support provided to the people who use the service.