About the service:

Agnes House is a residential care home that was providing personal care to 13 people who were recovering from mental health conditions at the time of the inspection.

People’s experience of using this service:

Staff understood their responsibilities to protect people from abuse and discrimination. They knew to report any concerns and ensure action was taken. The registered manager worked with the local authority safeguarding adults team to protect people.

Staff were supported in their roles and received an effective level of training. They told us they were happy with the level of training and support they received and we saw them supporting people in a competent manner.

People continued to be supported by an established team of staff who provided kind and personalised care to people living in the home. Safe recruitment ensured people were supported by staff of good character.

People were protected from harm by the provider having effective systems in place to monitor medicine management, staffing, infection control and the safe upkeep of the premises.

Staff promoted people's dignity and privacy. Staff provided person-centred support by listening to people and engaging them at every opportunity. Staff were caring and understanding towards people. People using the service appeared comfortable in the presence of staff working in the service.

The premises provided suitable accommodation for people with communal areas and bedrooms which were personalised to people's individual choices and personal items.

Support plans were detailed and reviewed with the person. Staff worked with and took advice from health care professionals. People's health care needs were met.

People had a variety of activities that took place inside and outside the home. They enjoyed on a regular basis. Formal supervision meetings were carried out with staff. They told us they were supported and clear about what was expected of them.

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.

Audits and checks of the premises, equipment and care delivery were carried out, and any issues identified and rectified.

The home continued to meet the characteristics of a rating of good in all areas. More information about the inspection is in the full report.

Rating at last inspection:

The home was rated Good at the last inspection (report published in June 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 19 and 27 April 2016 and was unannounced. We returned for a second day on the 27 April 2016 to follow up on some concerns that had been raised with us since our first day of inspection. The service was last inspected on 5 November 2014 when we found that the quality monitoring of the service needed to be improved. At this inspection we found that improvements had been made.

Agnes House – Residential Care Home provides care to up to 15 people who have an enduring mental health diagnosis. At the time of our inspection there were 14 men living at the home. Accommodation was provided over three floors. All bedrooms were for single occupation and there were shared bathing and toilet facilities except in one bedroom where there was an en-suite facility. The accommodation is not suitable for people who are not independently mobile.

There was a registered manager in post at the time of our 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 service was well led and the accommodation was being refurbished to improve the environment in which people lived and worked. Audits were being carried out to ensure a good quality service was provided. However, there continued to be areas in the home that needed to be improved and some mattresses that needed to be replaced.

People were safe because there were sufficient numbers of appropriately recruited staff available with the skills and knowledge to recognise abuse and harm and take the appropriate actions to protect people.

People were involved in planning their care and knew about potential risks to their health and welfare and the actions taken to minimise them including regularly taking medication.

People had built up good relationships with staff that were kind and supportive and that encouraged people to remain as independent as possible.

People were able to express their views and felt listened to. People were supported to maintain their hobbies and contact with people important to them.

People were supported to eat and drink a healthy diet and received medical care and attention when needed.

This inspection took place on 5 November 2014 and was unannounced At the last inspection carried out on 26 November 2013 we found that the provider was meeting all of the essential standards we inspected.

Agnes House – Residential Care Home provides care to up to 15 people who have an enduring mental health diagnosis. At the time of our inspection there were 14 men living at the home. Accommodation was provided over three floors. All bedrooms were for single occupation and there were shared bathing and toilet facilities except in one bedroom where there was an en-suite facility. The accommodation is not suitable for people who are not independently mobile.

There was a registered manager in post at the time of our 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.

People were not protected from harm because the systems for monitoring the service were not sufficient to ensure that risks were identified and people that lived and worked in the home were protected from harm. Systems in place were not effective in ensuring that people had a safe, pleasant and comfortable environment to live in. We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to not monitoring the quality of the service well enough. You can see what action we told the provider to take at the back of the full version of this report.

People received a safe and responsive service from staff that had the skills and knowledge to meet their needs. People’s individual needs such as dietary and mobility requirements were met by staff who understood their needs and through the provision of appropriate equipment.

There were sufficient numbers of staff to support people as required. Staff were provided with the training and supervision they needed to meet the needs of people.

Systems were in place that ensured people received their medicines as prescribed and supported to have their health needs met and reviewed regularly.

People were supported to do the things they liked to do including attending college, using community facilities and visiting friends and relatives.

All the people living in the home were able to make decisions about their care and no one was under any restrictions in their day to day lives. People were supported to make choices and were treated with respect by staff who treated them as individuals in a caring way.

On the day of our visit there were fourteen people living at the home. No one knew we would be visiting. We spoke to three people who lived at the home, two relatives, two members of staff, and the manager.

All staff spoken to were able to tell us about people's needs and records seen confirmed that staff were knowledgeable about the people they cared for. We saw positive interactions between staff and people that lived at the home. One person said, “The staff are very good and care is genuinely given to us.’’

Systems were in place to ensure that people were safeguarded from harm. People told us they felt safe living there. One person said, “I feel safe here.’’

The provider had arrangements in place that ensured that people's prescribed medication was managed safely.

Staff spoken with told us they felt supported by the manager, and had regular training so they knew how to support the people living there. One staff said, “There are lots of training opportunities here.’’

There were systems in place to monitor how the home was run, to ensure people received a quality service.

On the day of our visit there were thirteen people living at the home. No one knew we would be visiting. We spoke to four people who lived at the home, three relatives, three staff, and the owner.

The people who lived at the home had mental health care needs. People told us about their experiences, we looked at records and observed staff caring for them. Staff we spoke to was able to tell us about people's needs so that they received care in a way that they preferred. Relatives told us they were kept informed about their relative's health so they felt involved in their care. One relative said ‘since X has been there they have been very very happy.’’

We saw that systems were in place to keep people safe from harm. A relative told us ‘They do care about them.’’ Staff received a range of training to support the people who lived in the home. There were systems in place to monitor how the home was run, to ensure people received a quality service.