Blamsters Link is a ‘care home’. People in care homes receive accommodation and personal care under a contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Blamsters Link accommodates up to five people who may have a learning disability, in one adapted building. At the time of our inspection, five people were using the service.

This inspection took place on 5 April 2018. The inspection was unannounced, this meant the staff and provider did not know we would be visiting.

There was no registered manager in post at the service, but a staff member had been recruited who planned to apply for their registration. 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 supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice. A range of activities was provided, which included involvement and use of local and wider community based activities.

The service had appropriate systems in place to keep people safe and staff followed these guidelines when they supported people. There were sufficient numbers of care staff available to meet people’s care needs and people received their medication as prescribed and on time.

People were cared for and supported by staff that understood their needs and knew them well. Staff treated people with dignity and respect and were sensitive to their needs. The care and support people received was individualised.

The provider had a robust recruitment process in place. Staff had been recruited safely with the skills and knowledge to provide care and support to people.

People’s health and emotional needs were assessed, monitored and met in order for them to live well. The service worked closely with relevant health care professionals and people received the support they needed to have a healthy diet that met their individual needs and choices.

There were systems in place to drive improvement and audits were carried out on a regular basis, which looked at the quality of the service people received. The registered manager had a clear oversight of the service.

Further information is in the detailed report below.

The inspection took place on the 02 September 2015 and was unannounced. Blamsters Link provides care and accommodation for up to five people who have a Learning Disability and there were five people living there at the time of our inspection.

There was a not a registered manager in place on the day of our inspection and we were assisted by the assistant manager. The provider had recruited a new manager who had commenced employment but they had not yet applied for registration. 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.

At the last inspection on 09 December 2013, the service was in breach of the legal requirements as they did not have adequate arrangements in place to ascertain people consent. At this inspection we found that improvements had been made.

Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that decisions were taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

Staff were clear about what was abuse and the steps that they should take to protect people. Risks were identified and management plans were in place to minimise them. Strategies were in place to support people to manage their behaviour reduce the risk of harm.

Medication was safely managed, and there were effective arrangements in place to oversee the arrangements which ensured that people received their medication as prescribed.

Staff were inducted into their role and received training to support their learning and development.

People were involved in the developing of the menu and in meal preparation. The quality of the meals observed was good.

Staff were proactive in their contacts with healthcare agencies and acted on their guidance, in people’s best interests.

Interactions between people using the service and staff were warm and friendly. Staff knew people they were caring for and what their care preferences were. Care plans were detailed and informative and reflected people’s needs. Where people’s needs changed, advice was sought and the plan evaluated. People were involved in planning their care and this endured that people were provided with care in a way that they wanted to be supported.

People were enabled to access person centred activities and were encouraged to maintain hobbies and interests. Staff supported people to maintain relationships which were important to them.

People were positive about the leadership of the service and the levels of support. Quality assurance systems were in place but were not comprehensive. Staff were not familiar with the findings or the plans to drive improvement.

We found that the service had appropriate arrangements in place for obtaining consent to care. The service had mental capacity assessments in place for people’s day to day decisions but did not always have mental capacity assessments in place for best interest decisions around treatment for health or medical conditions in accordance with the Mental Capacity Act 2005.

We found that the provider had systems in place to maintain the safety and welfare of people who used the service. We found that the care plans were specifically written for a person’s individual needs. We saw that behaviours were monitored, assessed and managed to ensure that people received safe care. We observed care provided to people in the service and observed that people were treated kindly and were treated with dignity and respect.

Staff had received training on matters relating to safeguarding and were knowledgeable about the signs of abuse, how to report and escalate any concerns. This meant that people were protected from the risk of abuse as staff understood safeguarding requirements.

We viewed the staffing rotas for the service and found that there were suitable and sufficient numbers of staff on duty to meet people’s needs. The rota was scheduled in advance and showed how the service would be managed during the Christmas holiday period. This demonstrated that the staffing was well thought out and that management for the service was effective.