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Inspection carried out on 10 May 2018

During a routine inspection

Gladstone Road is a residential care home for two people with a diagnosis of autism and learning disabilities. The home is situated in the residential area of Seaforth. The home is located close to public transport links and leisure and shopping facilities.

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 on-going 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 service met all relevant fundamental standards.

Relatives we spoke with told us that they felt their family members were safe at the home and that staff took care of their needs. We saw through people's body language that people were comfortable with the staff.

There were robust measures in place to ensure people were safe. Risk assessments were in place specific to their individual needs and any behaviour they may present. They included detailed guidance for staff so people could be supported appropriately. Staff had received training in safeguarding adults from abuse and knew what to do if they saw or suspected abuse.

There was sufficient staff on duty to meet people's needs. People required individualised staff support to access the community and take part in activities. Staff were consistently provided to enable them to do this. Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults.

We found that staff had the skills, knowledge and experience to support people effectively and safely. Staff were supported by the manager and senior support workers through regular supervisions, annual appraisal and regular training. Staff meetings were held regularly.

Medicines were managed safely and people received their medicines as prescribed. Staff had been trained to administer medicines in order to ensure errors were kept to a minimum.

We found the home clean with no odours. The home was well maintained and in good decorative order. People's bedrooms were personalised. Regular checks and tests, such as gas, electricity, water safety, fire drills, weekly fire alarm tests and external checks of fire fighting equipment, were completed to maintain safety in the home.

People's needs were assessed and reviewed regularly to reflect people's current health and support needs. We saw that people were supported to achieve their outcomes. Appointments were made regularly for the GP, dentist and optician to help to maintain good health.

People were supported to eat and drink enough to maintain a balanced diet. We saw that people were encouraged to eat healthily and adopt an active lifestyle.

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 made decisions and choices in relation to their care, support received and daily activities. Staff knew the people well and how they communicated their needs and choices, including their preferred daily routine.

The relatives we spoke with told us they felt that the staff were caring. People were supported to be as independent as possible. Staff spoke positively and with compassion about people’s independence and their achievements.

Clear records of people’s daily routines helped to ensure staff supported people according to their preference. The use of a ‘visual planner’ showed people’s routines to provided reassurance and as a memory aide for what was planned for the day.

Visitors were free to come to the home and see their family member when they wanted, and there was space in the home for people to visit in comfort either in the person's room, or in the communal areas.

People received personalised care that was responsive to their needs. Care plans were written for the individual and informed staff of their preferences and wishes. We found they contained detailed information that enabled staff to meet people’s needs. Support plans were completed to show the goals people wanted to achieve.

People in the home enjoyed a range of activities, with staff support. People accessed the community to enjoy amenities such as pub lunches, walks in the countryside, swimming and gardening.

There was a complaints policy in place but no complaints had been received since the last inspection in 2016. The policy was displayed in the home.

The registered provider had appointed a new manager to the home. They had submitted an application to the Commission to be the registered manager for Gladstone Road.

There was a person-centred and open culture in the home. Staff showed a commitment to provide support which achieved good outcomes for the people living in the home.

Quality assurance audits were completed by support staff and senior care staff which included, medication and health and safety.

There was a process completed annually where relatives had the opportunity to voice their opinions about the service. Staff and relatives were in regular contact by telephone, email and instant messaging to keep them updated.

The manager and registered provider met their legal requirements with the Care Quality Commission (CQC). They had submitted notifications and the ratings from the last inspection were clearly displayed in the home.

Further information is in the detailed findings below.

Inspection carried out on 28 October 2015

During a routine inspection

This unannounced inspection of Gladstone Road took place on 28 October 2015.

Gladstone Road is situated in the residential area of Seaforth. The service is operated by Autism Initiatives and provides care and support for three people with a diagnosis of autism and learning disabilities. The home is located close to public transport links and leisure and shopping facilities.

There was a registered manager in post; however they were not present at 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 2008 and associated Regulations about how the service is run.

The relatives of the people who lived at the home and staff told us people were safe. There were systems and processes in place to protect people from the risk of harm. These included thorough staff recruitment, staff training and systems for protecting people against the risks of abuse.

Relatives told us staff were respectful towards them and their family members and we observed that staff were caring and supportive to people throughout our inspection.

We observed there were enough suitably trained staff to meet people’s individual care needs. We saw that staff spent time with people and provided assistance to people who needed it. Staff were available to support people to go on trips or visits within the local and wider community.

Staff understood the need for them to respect people’s choice and decisions. Assessments had been made and reviewed regarding people’s individual capacity to make specific care decisions. Where people did not have capacity, decisions were taken in ‘their best interest’ with the involvement of family members where appropriate and relevant health care professionals. This showed the provider was adhering to the Mental Capacity Act 2005. This is legislation to protect and empower people who may not be able to make their own decisions.

The provider was meeting their requirements set out in the Deprivation of Liberty Safeguards (DoLS). DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests. At the time of this inspection, there were two applications which had been authorised under DoLS for people’s freedoms and liberties to be restricted. We checked records as saw the process had been carried out effectively.

People’s health and social care needs had been appropriately assessed. Care plans provided detailed information for staff to help them provide the individual care people required. Identified risks associated with people’s care had been assessed and plans were in place to minimise the potential risks to people. There was a procedure in place for managing medicines safely.

There were effective systems in place to monitor and improve the quality of service through feedback from people who used the service and their families, staff meetings and a programme of audits and checks.

Inspection carried out on 8 October 2013

During a routine inspection

The people who used the service could not tell us about their experiences of using it or comment about the care and support they received, due to a variety of complex needs. On the day of our inspection one person was at home. The other two people were attending day time activities.

We observed some interaction between support staff and one person receiving a service to be positive, with staff being supportive, sensitive and encouraging in a non-patronising manner.

We spoke to their relatives to gather their views and experiences of the service. One person told us "The staff understand my relative's needs.” Another person said, "I am informed of everything."

We spoke with the manager and support staff on duty at the time of our visit.

We looked at the care records and found they contained all of the relevant documents to support a person safely. We looked at the policies and procedures kept at the home.

On checking medication management we found that people received their medicines as prescribed. Records regarding medication were completed correctly.

We carried out a tour of the home to assess if it was safe, hygienic and comfortable for the people living there and for the members of staff working there.

Inspection carried out on 19 February 2013

During a routine inspection

The people who use the service could not tell us about their experiences of using it or comment about the care and support they received, due to a variety of complex needs. However we spent time observing the interaction between two of the people who lived at the home and the staff. We spoke with three staff and two relatives to gather their views about the service provided.

We saw that people where encouraged to be independent around the home and in the activities they took part in. We saw care and support being provided that was appropriate to the people's needs.

We looked at the care records and found they contained relevant documents to support people safely.

We looked at staff files, training and supervision records to check if staff received appropriate training and support to carry out their job. We found staff had an individual training plan and had received training this year to assist them in their work. They had received regular support and supervision.

Some of the comments from the people's relatives were:

"The staff are well trained."

“I have nothing but praise and admiration for the staff at Gladstone Road.”

"They always keep in touch with me about my relative.”

“My relative gets the right support for their needs.”

“I have no cause for concern about my relative. “

Reports under our old system of regulation (including those from before CQC was created)