About the service: Bailey House is a care home for up to three people with learning disabilities. Two people were living at the service and one person was receiving respite care on a regular basis.

The 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 a learning disability were supported to live as ordinary a life as any citizen.

People’s experience of using this service: People were happy living at the service. Staff supported people to have a meaningful life and encouraged them to be independent.

Care and support was tailored to each person’s needs and preferences. People and their relatives were fully involved in developing and updating their planned care.

People who lacked capacity were supported to have maximum choice and control of their lives. Policies and systems supported them in the least restrictive way possible.

Detailed risk assessments were in place to support people to take positive risks and remain safe.

Staff understood how to safeguard people from abuse. The staff team empowered people to make choices about what they wanted to do.

Appropriate recruitment checks were carried out to ensure staff were suitable to work in the service.

Medicines were managed safely. Records confirmed people received their medications as prescribed. Training records showed staff received training and competency was checked on a regular basis.

The registered manager demonstrated a commitment to providing person centred care for people. Staff felt the registered manager was supportive and approachable. Staff were happy in their role which had a positive effect on people’s wellbeing.

Rating at last inspection: Good (Report published July 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection of Bailey House took place on 10 May 2016 and was unannounced. At the last inspection on 30 July 2014 the service met all of the regulations we assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These regulations were superseded on 1 April 2015 by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Bailey House premises consisted of a four-bedroomed, terraced property on a residential street in Goole. It provided care and accommodation for up to three people with a learning disability. All bedrooms were single occupancy. There was a lounge, a dining room and a kitchen, with a yard area to the rear of the property. There were two bathroom facilities. Car parking was on the street outside the property. All local services were within walking distance. There was local bus access to Goole town centre and Doncaster or beyond. There was local train access to larger cities such as Kingston-Upon-Hull, Leeds and beyond. At the time of our inspection there were two people using the service and one person accessing day care.

The registered provider is required to have a registered manager in post. On the day of the inspection there was a manager that had been registered and in post for the last three and a half years. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 protected from the risk of harm because the registered provider had systems in place to detect, monitor and report potential or actual safeguarding concerns. Staff were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing potential and actual safeguarding concerns. Risks were managed and reduced by implementing risk assessments so that people avoided injury or harm whenever possible.

The premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to show this. Staffing numbers were sufficient to meet people’s need and we saw that rosters reflected the staff that were on duty. Recruitment policies, procedures and practices were carefully followed to ensure staff were suitable to care for and support vulnerable people. We found that the management of medication was safely carried out.

People were cared for and supported by trained and competent staff. However, we were not completely assured that induction of new staff was effectively carried out in all cases. Staff were regularly supervised and their performance was assessed using an appraisal scheme. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected.

People received adequate nutrition and hydration to maintain their health and wellbeing and it was sometimes difficult for staff to ensure people ate a balanced diet because people’s choices were respected. The premises were suitable for providing care and support to adults who had a learning disability and/or mental health needs. However, there were parts of the premises that were unsuitably maintained.

We found that people received care and support from kind staff and that staff knew about people’s needs and preferences. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were always asked for their consent before staff undertook care and support tasks.

People’s wellbeing, privacy, dignity and independence were monitored and respected and staff worked to maintain these wherever possible. This ensured people were respected and that they were enabled to take control of their lives.

We saw that people were supported a

Our inspector visited the service to obtain information about the quality of the service provided. This helped answer our five questions; is the service is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report

Is the service safe?

We saw that there had been an extensive 'transition period' undertaken for people before moving to the service. This meant they could be safely monitored and their needs could be gradually assessed to ensure care and support given to them was accurate and would therefore meet their needs.

We found that the systems for managing medication were safe and well maintained, records were accurate and people received the drugs they required to maintain their wellbeing.

We saw that the premises were safe for use because they had been checked by competent personnel with regard to gas, electrics and fire safety and they were adequately maintained. The premises were suitable for providing care and support to people that were physically able, because people did not require any adaptations.

People had their needs appropriately met by sufficient numbers of experienced and trained staff, so people were safely cared for.

Is the service effective?

People had a 'transitional' plan in place which was carefully being added to as assessments were being carried out. This meant staff could assist people with their personal 'development and growth' and ensured staff supported people in the best way they could.

Is the service caring?

We observed staff interacting professionally with people that used the service while being kind and caring towards them. The nature of the service was such that staff encouraged people to be independent and to develop their skills, which removed the emphasis on 'doing for' people.

Is the service responsive?

We saw that where people needed guidance with social interaction or with patience in between activities, the staff were firm but polite. Staff were guiding but not overbearing and enabled people to express themselves as they wished or wanted to. The service was responsive to peoples' needs.

Is the service well led?

We found that the service was providing people with safe and varied care that reflected their needs based on the continuous assessment of those needs. This was done under a clear management style that expected thorough processes to be implemented.

Sufficient daily checks had been carried out and people that used the service had been asked about their satisfaction to enable the provider to conclude how individuals' care and support needed to be changed or improved on. The service was well led.