15 School Street

There was 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.’

At the last inspection on 3 August 2016 we asked the provider to take action to make improvements to capacity assessments and quality improvement systems. This action has been completed. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice. When decisions were made because people did not have capacity to do so they were made in their best interest.

Quality monitoring systems were effective in highlighting errors and implementing actions to ensure that they were addressed.

Staff received training and support to enable them to fulfil their role effectively and were encouraged to develop their skills. They understood their responsibilities to identify and report abuse. There were enough staff to meet their needs and to ensure that they could go out to their organised activities and socially.

People were supported to maintain good health and had regular access to healthcare professionals. Their care plans were regularly reviewed to correspond with changing support needs and they were personalised and accessible. Risk was assessed, actions were put in place to reduce it and their effectiveness was reviewed. Medicines were administered as prescribed and they were stored safely.

Staff had caring relationships with the people they supported which were respectful. They understood how people communicated and supported them to make choices about their care. They knew people well and provided care that met their preferences. People’s privacy and dignity were maintained at all times. They were supported to maintain and develop important family relationships.

There was a procedure in place for people to complain, although no complaints had been received. People had up to date care plans which were regularly reviewed.

Staff felt supported by the registered manager and they understood the responsibilities of their registration.

The service provides personal care on a 24 hour basis to two people living in their own home. There was a registered manager at the service. 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 manager and provider had a system to monitor the safety and quality of the service but improvements were needed to ensure people’s medicines were recorded in accordance with good practice and that people’s care records were accurate and up to date. Staff demonstrated that they understood their responsibilities to support people with making decisions about their care but the provider needed to improve their record keeping to demonstrate that people’s rights were being upheld.

Staff understood their responsibilities to keep people safe from the risk of abuse. There were systems and processes in place to protect people from the risk of harm. Staff received the training and support they needed to meet people’s needs and an induction programme was in place to prepare staff for their role. There were enough staff to meet people’s needs and checks were made to confirm staff were suitable to work in a care environment. People were supported to take their medicines when they needed them.

People were supported with their dietary needs and had a choice of food and drinks that met their preferences. Staff monitored people’s health to ensure they had access to other health professionals when needed.

Staff had caring relationships with people, supported their privacy and dignity and encouraged them to maximise their independence. People had opportunities to engage in activities that met their individual needs and were supported to follow their interests both at home and in the local community. People were supported to maintain relationships with people that mattered to them.

There were processes in place for people and their relatives to raise any complaints and express their views and opinions about the service provided.

People who used the service were not able to tell us what they felt about the service and if they were happy with it. In order to make our judgements we spoke with staff and relevant professionals or other people who had involvement in their lives and care. We looked at records and observed how people were supported.

At the last inspection the service operated as a registered care home. Since then the service has successfully re registered as a domiciliary/ supported living service. This meant that people who used the service had legal tenancy of their own home.

We saw that people's needs were assessed and care plans were in place detailing how people's needs should be met. Records were reviewed regularly to ensure they were up to date.

Medication was managed, stored and administered safely. Records we looked at showed staff followed the prescriber's administration advice and also monitored the stock levels of medication kept on behalf of people.

Staffing arrangements varied dependent on people's needs and staff were deployed flexibly to ensure people's needs could be met.

We saw that care was provided as the records said it should be and people were supported to be independent.

The majority of staff had received the training they needed to provide people with the support they required or had the training planned. People that used the service were protected from the risk of abuse.

Records were up to date, regularly reviewed and accessible if necessary. Storage arrangements were secure which meant that people's personal information was protected.