Abbeyfield House is based in Gatley, Stockport and is part of Caritas Services Limited. The home provides personal and nursing care for a maximum of seven people with physical or learning disabilities. At the time of the inspection there were seven people living at the home.

At our last inspection in March 2016 we rated the service Good overall. At that inspection we found one breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because two people's risk assessments had not been reviewed in accordance with providers stated frequency and there was no trends analysis of accidents and incidents.

Following the last inspection, we asked the provider to complete an action plan to tell us what they intended to do and by when to improve the key question; is the service effective to at least good. At this inspection, we found that required improvements had been made.

We found the evidence continued to support the overall 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. At this inspection we found the service remained Good overall.

Why the service is rated good.

The care service has 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.

Care records were detailed and person centred. They identified what was important to and for the person.

People were safe because there were effective risk assessments in place, and systems to keep them safe from abuse or avoidable harm. Risk assessments were person centred and gave guidance to people and staff on how risks could be minimised and managed whilst promoting people’s independence and opportunity’s. Risk assessment had been reviewed regularly and updated if people’s needs had changed.

Accidents and incidents were monitored. These records were analysed each month so that they could review the action taken and identify any patterns or lessons that could be learned to prevent future occurrences.

People were supported by staff who knew them very well. People’s individual communication styles were respected, this included using body language, signs, photographs and pictorial prompts.

Staff received the training and support they needed to carry out their roles effectively. Staff members had been safely recruited and there were sufficient numbers of staff to provide people with the person-centred support they needed.

The service has a registered manager. 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. People were very positive about the registered manager and the way the home was run. We found the registered manager to be passionately committed to providing responsive, person-centred support to people. All the staff we spoke with shared this commitment and enthusiasm.

Medicines were managed safely and people were supported to ensure their health needs were met.

The service had detailed guidance for staff on how to support people when they showed behaviour that challenged the service. Records contained information about what may make someone upset or angry and guided staff in how to respond, what to say and what to do to help the person and diffuse situations.

Health and safety checks had been carried out and there was a programme of regular maintenance to the bui

We carried out this unannounced inspection of Abbeyfield House on Friday 11 March 2016. At the previous inspection in January 2014, we found the service was meeting each of the standards assessed.

Abbeyfield House is based in Gatley, Stockport and is part of Caritas Services Limited. The home provides personal and nursing care for a maximum of seven people with both physical and learning disabilities. At the time of the inspection, the home was fully occupied.

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.

People told us they felt safe living at the home. The staff we spoke with demonstrated a good understanding of safeguarding procedures and how they would report concerns.

Medication was given to people by nurses who worked at the home, who we found had received appropriate training and were assessed by management to ensure this was done safely.

We looked at how the service managed risk and looked at the risk assessments in place for four people who lived at the home. Although these provided a clear description about how individual risks were being managed, two people’s risk assessments had not been reviewed since January 2015. The manager told us that these had fallen behind but would update them following our inspection. We were also unable to see any evidence of trends analysis following accidents and incidents, to help prevent future re-occurrences and promote learning. These issues meant there had been a breach of Regulation 12 (b) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to Safe Care and Treatment because the service was not doing all that was reasonably practicable to mitigate any such risks.

We found the home had a robust recruitment procedure in place, with appropriate checks carried out before staff began working at the home, to ensure they were fit to work with vulnerable adults. During the inspection we looked at four staff personnel files which contained all appropriate documentation to show staff were recruited safely.

We looked at how the service ensured there were sufficient numbers of staff to meet people’s needs and keep them safe and reviewed the staff rotas. We found the home had sufficient skilled staff to meet people's needs, with staff and people who used the service telling us they had no concerns about the current staffing levels.

We found staff were given all of the training and support they needed to undertake their roles effectively. Two people who lived at the home had also given talks to staff about their experiences of living with different health conditions, with such as Asperger’s and Addison’s Disease. This allowed staff to gain a better insight into living with these types of conditions and how best to support people.

We observed staff being kind, friendly and respectful of people's choices and opinions. The atmosphere in the home was relaxed and the staff spoken with had a good knowledge of the people they supported. People were supported by staff to undertake activities of their choice and saw staff were flexible, based what people wanted to do.

People living at the home were supported with certain aspects of daily living, in order for them to improve their skills in these areas and maintain independence. This included support with food preparation, laundry and cleaning their bedroom.

The Mental Capacity Act 2005 (MCA 2005) sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The Deprivation of Liberty Safeguards (DoLS) provides a legal framework to protect people who need to be deprived of their liberty to ensure they receive

This was the first Care Quality Commission inspection visit since the service was registered in October 2011.

At the time of this visit there were four people living at Abbeyfield House and we were able to speak to one of those people.

To help us understand the experiences of people using the service we also looked at people's records, how people interacted with the staff, general observations throughout the visit and discussions with staff.

We saw that people were comfortable in their surroundings and in their interactions with the staff.

One person told us “I am happy living here,” and when asked they said that they felt safe.

Staff told us that people were treated with respect and dignity and everybody was treated in accordance with their individual needs. Staff said that people were encouraged to make choices around their day to day lives and individual personal preferences were always respected. One member of staff said “We work closely with the people living here and we involve their family.” Another staff member said “Everybody is an individual and needs treating with respect.”

Staff told us that care needs were met to a high standard and they were good at promoting individual activities as well as creating a homely and relaxed atmosphere.

During the inspection, we spoke with one person who used the service. They told us they were asked for consent and that the staff kept them involved in the review of their care.

We found that people were asked for consent and the provider acted in accordance with people’s wishes. People’s health, safety and welfare was protected because the provider worked in co-operation with other health professionals.

We found that people were cared for by staff that had been through the appropriate recruitment checks. The person we spoke with told us they were happy with the support received and the staff were friendly and helpful.

There was an effective complaints system available, in case anyone wished to raise a complaint. The person we spoke with told us they had no concerns about the services they received and would speak to the staff if they had any concerns. People's care records contained enough information to show how they were to be supported and cared for.