22 De Parys Avenue

The service can accommodate up to seven people living with a learning disability or autistic spectrum disorder. The accommodation is arranged over three floors with accessible outside space. At the time of this inspection there were five men living at the service.

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.

Why the service is still rated good:

People were protected from abuse and avoidable harm. Staff had been trained to recognise signs of potential abuse and knew how to keep people safe. Processes were also in place to ensure risks to people were managed safely.

There were enough staff, with the right training and support, to meet people’s needs and help them to stay safe. The provider carried out checks on new staff to make sure they were suitable and safe to work at the service. Staff provided care and support in a kind and compassionate way.

Systems were in place to ensure people received their medicines in a safe way and people were protected by the prevention and control of infection.

The service responded in an open and transparent way when things went wrong, so that lessons could be learnt and improvements made.

People received care and support that promoted a good quality of life and was delivered in line with current legislation and standards.

People were supported to eat and drink enough. They were actively involved in choosing what they ate and helped to prepare meals for each other.

Staff worked with other external teams and services to ensure people received effective care, support and treatment. People had access to healthcare services, and received appropriate support with their on-going healthcare needs.

The building provided people with sufficient accessible space, including a garden, to meet their needs. The service operated 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.

The service acted in line with legislation and guidance regarding seeking people’s consent. People were enabled 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’s privacy, dignity, and independence was respected and promoted. They received personalised care and were given opportunities to participate in activities, both in and out of the service.

Systems were in place for people to raise any concerns or complaints they might have about the service. Feedback was responded to in a positive way, to improve the quality of service provided.

Arrangements were in place to ensure people at the end of their life had a comfortable, dignified and pain free death, if the need arose.

There was strong leadership at the service which promoted a positive culture that was person centred and open. Since the last inspection a new registered manager had come into post. Everyone spoke very highly of them, and the changes they had made, which had resulted in some positive outcomes for people living at the service.

Arrangements were in place to involve people in developing the service and seek their feedback.

Systems were in place to monitor the quality of service provision and to drive continuous improvement.

Opportunities for the service to learn and improve were welcomed and acted upon, and the service worked in partnership with other agencies for the benefit of the people living there.

Further information is in the detailed findings below.

Is the service safe?

People told us they felt safe. We saw that the provider was making the necessary improvements to ensure that people were cared for in an environment that was safe, clean and hygienic. People's needs had been assessed, and risk assessments described how any identified risks to people were minimised. The recruitment practice was safe and thorough, and the provider took action to ensure staff competence. People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

Is the service effective?

Detailed care plans were in place, and people told us their needs were being met. Staff received training to support people with various care needs. They also sought additional support from other health and social care professionals, to ensure positive care outcomes for people using the service. The service provided people with adequate and nutritious food and drink that ensured they maintained good health.

Is the service caring?

People were supported by kind and attentive staff. It was clear from our observations and from speaking with the staff, that they had a good understanding of the needs of the people they supported. People told us the staff were caring. One person said, "The staff are all friendly."

Is the service responsive to people's needs?

We observed that staff responded promptly to people's needs. We saw that care plans had been updated when people's needs changed, and that referrals had been made to other health and social care professionals when required. The service took account of individual preferences, and people were supported to access a variety of activities of their choice.

Is the service well-led?

In this report the name of a registered manager appears who was not in post and not managing the regulated activities at this location at the time of the inspection. However in their new role as the operations manager, they have continued to support the deputy manager in the day to day management of the home. The process of recruiting a new manager was also underway. We saw that the provider had effective systems to assess and monitor the quality of the service they provided. They regularly sought the views of people using the service and their representatives, and took account of these to improve the service.

We found systems in place to obtain consent from people in respect of the care and support provided to them. Where this was not possible, appropriate arrangements were in place to ensure that decisions made on people's behalf, were made in their best interests.

Overall, people experienced effective, safe and appropriate care. However, we were concerned about one person whose needs were not being met fully by staff, despite their best efforts. There was evidence that the manager had sought more appropriate external intervention and support for the person, but this had not been put in place at the time of our inspection. This meant there were no clear plans for the person's future and their welfare and safety was at risk.

We found that people living in the home received their prescribed medication when they needed it and in a way that suited them.

Overall, there were enough staff on duty with the right knowledge and skills to meet the majority of people's needs. There were also plans to provide further training to staff; to ensure they were properly supported to meet everyone's assessed needs.

Suitable arrangements were in place to address people's comments and complaints, and ensure they were listened to.

People living in the home spoke positively about the service and told us that the staff were kind and 'did a good job.'

We observed some good interaction between staff and people using the service, which showed that staff understood the needs of the people they were supporting and how best to communicate with them.

We found that people were supported to maintain their independence as far as possible.

Staff supported people to stay safe and people's views were listened to.