Bethia Cottage is a care home that provides support and accommodation for up to five people with a learning disability or with autistic spectrum disorder. On the day of the inspection there were five people living at the home. All of the accommodation is on the ground floor. People have single bedrooms with specially adapted en-suite facilities, and there is a communal bathroom should that be required. Communal space consists of a kitchen / dining room, a living room, a sensory room and an enclosed outside area.

At the last inspection in April 2015 the service was rated as Good. At this inspection we found that the service remained Good.

Care plans described the person and the level of support they required in great detail. Staff demonstrated a good knowledge of people's individual support needs and every effort was made by staff to ensure people had an enhanced sense of well-being.

Care plans were reviewed regularly to ensure they remained an accurate record of the person and their day to day needs.

There continued to be sufficient numbers of staff employed to make sure people received the support they needed, and those staff had been safely recruited.

Staff had continued to receive appropriate training to give them the knowledge and skills they required to carry out their roles. This included training on the administration of medicines and on how to protect people from the risk of harm.

People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were kind, caring, supportive and patient and they respected people’s privacy and dignity.

People’s relatives told us they were aware of how to express concerns or make complaints and people were also given the opportunity to feedback their views of the service provided.

The manager carried out audits to ensure people were receiving the care and support that they required, and to monitor that staff were following the policies, procedures and systems in place.

The feedback we received and our observations on the day of the inspection demonstrated that the home was well led.

Bethia Cottage is a residential care home that provides accommodation for up to five people who require support with personal care and all aspects of daily living. The service supports people with physical and learning disabilities. At the time of the inspection five people were permanently living at the service. The service has an open plan communal kitchen and dining area, communal lounge, sensory room and outdoor space featuring seating areas and adapted swings to accommodate wheelchairs.

The inspection was unannounced and took place on 9 April 2015. The service had 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.’

The last inspection took place on 4 July 2013. At that inspection we found the provider was compliant with all the standards we assessed.

We found the service to be safe in its delivery of care. Staff were recruited safely and appropriate checks were completed prior to working with vulnerable people. Staff had good knowledge and an understanding of the needs of the people who used the service. On occasions there was not enough staff to cover the allocated shifts identified by the provider, that were required to meet people’s needs. This meant that trips into the community and activities were sometimes cancelled. The registered manager was aware of this and we saw that recruitment is on-going to ensure staffing numbers are increased.

Staff received regular supervision which enabled them to discuss any matters relating to practice or their personal development. There was a full training programme in place which ensured staff were equipped with the knowledge and skills required to carry out their role effectively.

We observed that staff spoke in a positive way to people and treated them with respect. Staff and the people who used the service interacted and observations showed good relationships between them. The people who used the service participated in a range of activities and days out. Relatives of those who used the service told us on occasions due to staffing levels some of these had to be cancelled.

Interventions of support were sought from outside agencies when required and a relative told us that health issues “Got sorted quick” at the service. The registered manager was following the principles of the Mental Capacity Act 2005 (MCA) and we saw that applications, where required, had been submitted in respect of people being deprived of their liberty. The Mental Capacity Act 2005 (MCA) legislation is designed to ensure that when an individual does not have the capacity, any decisions are made in the person’s best interest.

The inside living environment was well maintained however there were some issues with some of the paving slabs being uneven on the pathways around the property. The car park at the service was also very uneven. This posed a risk to the people living at the service and any visitors. The registered manager was aware of these issues and since our inspection provided us with a plan that highlights the measures which are in place to improve these areas.

People who used the service had clear, personalised care plans in place and individual’s choices and preferences were clearly documented. Personalised communication plans, risk assessments and eating and drinking plans were all in place within peoples care records. Family and friends were always welcome to visit the service and people living at the service were encouraged to participate in activities and daily living tasks as much as possible. Relatives told us they were “Generally happy” with the care their loved one received living at the service.

We visited Bethia Cottage and spent time with people who used the service and staff. We saw that the service provided was personalised to each individual and people were able to choose how they would like to spend their time. We saw that people were given chances to make decisions wherever possible.

We looked at the systems that were used for administering and recording medication and found that these were followed appropriately. We found that there were robust systems in place for recruiting and induction for staff. Staffing levels were monitored and managed in a way that meant support was available to meet people’s needs.

There were audits and monitoring taking place on a regular basis and the service had ways of gathering feedback from people who used the service, their relatives and staff. Complaints received followed a process that included investigation and a full response. Records were kept securely and were accurate and fit for purpose.

People who use the service at Bethia Cottage had complex needs and we were not able to talk to everyone in detail about their care. However, during our inspection we observed the interactions between members of staff and people being supported. We saw that staff understood what people needed and how to engage them in a positive way.

We found that staff were very attentive to people’s needs and consistently chatted to all. Members of staff were kind and patient and showed a good understanding of the needs of the people in their care. They made sure they let people who use the service know what was happening and included them in general conversations.

We saw people who use the service were pleased to see individual members of staff and members of staff treated people respectfully by greeting people when they came into work. One person we spoke with told us they liked living at Bethia Cottage and staff were ‘nice’ to them.