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Inspection carried out on 24 September 2018

During a routine inspection

Park Street is a residential care home providing care, support and accommodation for up to five adults with learning disabilities. At the time of our inspection there were four people living there.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post. 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 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 ongoing 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.

People told us they felt safe. Staff understood their responsibilities to keep people safe from harm. Risk assessments were in place and these promoted people’s independence when at the service and when accessing the community. Medicines were managed safely. Incidents and accidents were reported and lessons learned were shared with staff. Safe recruitment practise was followed and there was enough staff on duty to meet people’s needs.

Staff were trained and supported to carry out their roles. People were supported to have enough to eat and drink. People’s consent for support was sought in line with legislation and guidance.

People using the service said staff were kind and supportive and that staff respected their privacy and dignity. We saw positive interactions between staff and people.

Care and support plans were person centred and detailed people’s personal goals. Staff knew people well and understood their needs. People confirmed that staff supported them as they wanted them to. Complaints were reported, investigated and resolved. Feedback from people and their relatives was sought.

There were robust quality assurance processes in place. Staff spoke highly of the registered manager. The provider’s values were embedded in the day to day support of people. There were strong links with the local community.

Further information is in the detailed findings below.

Inspection carried out on 16 January 2016

During a routine inspection

This inspection took place on 16 January 2016 and was unannounced. The last inspection took place on 15 January 2014. This was a follow up inspection from the 30 September 2013 inspection at which time a breach of legal requirements were found in relation to records. The follow up inspection in January 2014 found the service to be compliant at that time.

82 Park Street provides care and accommodation for up to five people with a learning disability. At the time of our inspection there were four people using the service.

There was a registered manager in place at the home. 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 service was safe in most aspects; however more needed to be done to ensure that the risks associated with medicine stock documentation and auditing were minimised. Safe procedures and a policy was in place to guide staff to manage people’s medicines safely. Staff received training to guide them in best practice procedures.

People told us they felt safe and were well cared for by staff. Comments included “I have been here years. I am very happy and safe”.

On the day of our inspection sufficient numbers of staff were available to support people’s individual needs safely. This was observed throughout the inspection and included the lunchtime meal activity. Some staff told us the service was experiencing staff shortages that sometimes could put pressure on the service and its staff. The staffing issues were confirmed by the registered manager who said they and other senior staff had been working weekends and extra hours to support any shortfalls. We saw people were supported with their nutritional needs in line with their assessed needs.

People’s rights were protected in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People’s capacity was considered in decisions being made about their care and support and best interest decisions were made when necessary.

People’s records demonstrated their involvement in their support planning and decision making processes. People we spoke with confirmed their involvement in the process and how staff respected their wishes. People had choice about their daily activities this was confirmed by documentation that we viewed and one person who was able to tell us of their experience.

People were supported by staff who were kind and caring in their approach and were treated with dignity and respect. This was confirmed by the observations we made during our inspection.

People had support plans and risk assessments in place that were representative of people’s current needs and gave detailed guidance for staff to follow. Staff understood people’s individual needs and preferences which meant that they received care in accordance with their wishes.

The provider had ensured that staff had the knowledge and skills they needed to carry out their roles effectively. Training was provided and staff we spoke with were knowledgeable about people’s needs.

Staff we spoke with felt the service was well led and the registered manager ensured an open and transparent culture within the service. Staff meetings took place on a regular basis. Minutes were taken and any actions required were recorded. A detailed system was in place to monitor the quality of the service that people received. This included a system to manage people’s complaints.

Inspection carried out on 15 January 2014

During an inspection looking at part of the service

At the last inspection in September 2013 we found people were not protected against the risks of unsafe or inappropriate care. This was because the provider had not recorded appropriate information to meet the individual care needs of people. The provider sent us an action plan to show how they planned to address these concerns. This inspection was to follow up on the shortfalls identified and actions subsequently taken by the provider.

Inspection carried out on 30 September 2013

During a routine inspection

There were four people living at the home on the day of our inspection. We met all four people and spoke at length with two people about the care they received. After our visit we talked by telephone with relatives of one person. The relatives told us they had �no worries about care.� We spoke with two of the three staff on duty and two managers. We made observations of how care and support was delivered to people and looked at range of records.

People told us they liked living at the home. One person told us �Staff treat me nicely because they ask me what I want to do.� Another person said �staff are nice and I can talk to them when I want.� We observed staff supporting people appropriately and respectfully. For example, we saw staff asking people what activities they would like to do and knocking on doors and asking permission before entering.

We looked at records to see how the provider had cooperated with other services to ensure the health and social care needs of people were being met. We saw relevant information was shared between services and professionals. This enabled care needs to be appropriately assessed and planned to meet individual needs.

We saw safeguarding information was available to all people living at the home. This information had been adapted with pictures to make it accessible for people. We spoke with staff who demonstrated they knew how to recognise the signs of abuse and the various forms it could take. People told us they felt safe with staff.

We asked staff how they were supported in their roles. Staff said managers were approachable and they felt well supported. The provider had a range of mandatory training which staff told us were helpful to their roles. We spoke with two staff who told us there were opportunities to complete additional work related qualifications. The manager told us improvements were required to the frequency of staff supervision and annual appraisals.

We spoke with two managers and looked at different records to see how the quality of the service was assessed and monitored. We saw the provider had a range of quality monitoring audits and checks in place. These enabled the home to provide safe and appropriate care to people and identify service improvements.

We looked at the care records of all four people living at the home. We saw some care information and care assessments were missing from records. This information would have supported staff to provide appropriate care and support to people. We saw some risk management plans had not been reviewed and updated in line with the provider�s policy. We observed each person had an individual support plan which included the person�s likes and dislikes and goals they would like to achieve.

Inspection carried out on 20 March 2013

During a routine inspection

There were four people living at 82 Park Street when we visited. One person had moved into the home two days prior to our visit. Each person had a learning disability and some had Autism Spectrum Disorder. We were able to talk with three people and asked a range of questions about their care. We talked with one person at length, and briefly with the other two. After our visit we talked by telephone with family members of two of the people who lived at the home. They told us they were happy with the care and support given to their relative. They said: "I think [the person] is doing very well there."

The people who were able to talk with us told us they were happy living at the home. They said or indicated they liked the staff and they were looked after well. We were told staff did not make anyone do anything they did not want to do. People were able to make their own minds up. If a person did not have the capacity to make a decision for themselves, staff would act in the person's best interests. Staff involved people who spoke for the person in any major decisions.

We observed care delivered with patience and compassion. We saw people appeared happy and settled in the home and staff supported them to be as independent as possible. We judged people were given their medicines safely. The service had enough staff with the right skills and experience to support people. People's records and those to run the home were kept confidential and held securely.