The Inspection took place on the 10 October 2017.

Bali Hai Care Home provides accommodation and personal care without nursing for up to 12 persons who may have mental health needs. At the time of our inspection 10 people were living at the service.

At our last inspection the service was rated as Good. At this inspection we found the service remained Good.

The service was safe. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. People’s medicine’s were dispensed by staff who had received training to do so.

The service was effective. People were cared for and supported by staff who had received training to support people to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to other health professionals were made when required.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.

The service was responsive. People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were supported to follow their interests and participate in social activities. The registered manager responded to complaints received in a timely manner.

The service was well-led. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis.

The Inspection took place on the 10 October 2017.

Bali Hai Care Home provides accommodation and personal care without nursing for up to 12 persons who may have mental health needs. At the time of our inspection 10 people were living at the service.

At our last inspection the service was rated as Good. At this inspection we found the service remained Good.

The service was safe. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. People’s medicine’s were dispensed by staff who had received training to do so.

The service was effective. People were cared for and supported by staff who had received training to support people to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to other health professionals were made when required.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.

The service was responsive. People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were supported to follow their interests and participate in social activities. The registered manager responded to complaints received in a timely manner.

The service was well-led. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis.

Our inspection team was made up of one inspector. Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw care plans that reflected issues identified in the assessment. These were sufficiently detailed to allow care staff to deliver safe and responsive care. A care worker said, "The care plans are written in enough detail to help us work confidently with that person."

CQC monitors the operation of the Deprivation of Liberty Safeguards which apply to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an

application should be made, and how to submit one.

People were cared for in a clean, hygienic environment. The service had systems in place designed to assess the risk of, and to prevent, detect and control the spread of infection.

Is the service effective?

We saw that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We saw that people or their representatives had been involved in their care assessments and reviews. People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. One person who used the service told us, " We are well looked after and I like the staff." Staff had received appropriate training to meet the needs of the people receiving care.

Is the service caring?

People were supported by kind, committed and attentive staff. We saw that care staff were patient and empathetic when supporting people. One comment from a relative's questionnaire was, "The care is excellent."

Is the service responsive?

People's needs were continually assessed. Records confirmed people's preferences, interests and diverse needs had been recorded and care had been provided in accordance with people's wishes. We observed people who used the service undertaking various activities whilst waiting to go to the day centre. One person was walking in the garden, one person was playing a game on the computer and another was reading a magazine.

Is the service well-led?

Staff had a good understanding of providing personalised individual care and the need to promote independence where possible. Quality assurance processes were in place to support this. People told us they were asked for their feedback on the service they received and they confirmed they had felt listened to. Systems were in place to help the service develop and learn.

People we spoke with told us that they were happy with the service they received. They told us that they received proper care and support and that they were involved in making decisions about the care they received.

We found that care, support and treatment was planned and delivered safely and that risks to the health, safety and welfare of people using the service were assessed and managed.

People received sufficient food and drink. They had good choices in respect of meals, drinks and snacks. Risks of inadequate nutrition and dehydration were assessed. The provider may wish to consider using the Malnutrition Universal Screening Tool (MUST) when assessing people's nutritional needs.

There were arrangements for ensuring that medicines were managed safely and people medicines as prescribed for them.

The premises, facilities and equipment were well maintained and there were arrangements for ensuring that they were safe, comfortable and suitable.

Staff were recruited robustly with all of the appropriate checks in place to minimise risks to people using the service and ensure that they were supported by suitably skilled and knowledgeable staff.

There was an effective complaints procedure and people were able to make complaints or comments about the service they received.

We spoke with most of the people who use the service during our visit in December 2012. One person said, “I am happy here. The staff are very kind.” Another person said, “All of the staff treat me well, they check that I have everything that I need.”

We looked at a sample of care files and found them to be detailed and informative. They had been regularly reviewed and updated to reflect any changes. People told us that their care plans met their needs. We found that staff had been trained and had received regular updates in their training. Staff told us that they felt well supported to do their work.

People were very complimentary about the quality of the service. One person said, “The food is really good.” Another person said, “I help out in the kitchen, preparing vegetables and making drinks.” Other comments included, “The food is nice and there is plenty of choice.”

The records showed that regular quality assurance surveys had been undertaken. The owner/manager had a hands-on approach. They told us that they monitored the service daily to ensure that they were providing safe and appropriate care to the people who use the service.

We talked with a number of people who use the service and staff, this included observing them together at the time of the visit.

The people with whom we spoke were happy with the service they receive. They told us that Bali Hai was a good place to live and they felt cared for, safe and supported.

People told us how they are involved in making decisions about their care and their privacy, dignity and independence is respected by all the staff. One person with whom we spoke told us “We are involved in everything here and asked what we want to do and when we want to do it – like going out to the shops or cooking.”

People are fully involved in the assessment of their needs and their care plan. One person told us “I have a plan that keeps me safe so staff know what to do to help me.” People told us that the staff are friendly and nice and one person said “Key workers get things sorted for you.” We saw that staff were respectful when speaking with people and gave people opportunities to make choices and decisions.

No concerns or issues were raised with us during the visit and people told us they knew who to speak to if they were unhappy about the service or any aspects of their lives.