We inspected Blenheim House on 11 May 2017. We informed the registered provider on the morning of our inspection (90 minutes before). We did this because the service is a small care home and people who use the service are often out and we needed to be sure somebody was in.

When we last inspected the service in March 2015 we found the registered provider was meeting the legal requirements in the areas that we looked at and rated the service as good. At this inspection we found the service remained 'Good'.

Blenheim House is a large end terraced property which is registered to accommodate a maximum number of seven people with a learning disability. The property is within walking distance of the beach, town centre and many local amenities, including transportation links to nearby towns. At the time of the inspection there were three people using the service.

The service had a registered manager in place. 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 kept safe from avoidable harm and staff understood the process to follow to safeguard people if they needed to report any concerns. Medicines were managed safely with an effective system in place. Staff competencies around administering medication were regularly checked. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained.

There were sufficient numbers of staff on duty to meet people's needs. Staffing levels were determined by looking at people's needs and activities including appointments. Risks to people were assessed and managed appropriately to ensure that people's health and well-being were promoted. Action plans to manage risks were in place and staff followed them. There was a system in place to ensure that staff recruited had the appropriate skills and experience and were of good character.

People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. Staff had been trained and had the skills and knowledge to provide support to the people they cared for. Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were able to make decisions about their day to day care and support and staff supported people to maintain their health and attend routine health care appointments.

Care plans detailed people’s needs and preferences and were person-centred. Care plans were reviewed on a regular basis to ensure they contained up to date information that was meeting people’s care needs. People were actively involved in care planning and decision making. People who used the service had access to a wide range of activities and leisure opportunities. The service had a clear process for handling complaints.

The registered manager promoted a positive, person-centred culture and was committed to making continued improvements to the delivery of care. Regular audits were carried out to identify areas for improvement.

We inspected Blenheim House on 17 March 2015. This was an announced inspection. We informed the provider at short notice (the day before) that we would be visiting to inspect. We did this because the location is a small care home for people who are often out during the day; we needed to be sure that someone would be in.

Blenheim House is a large end terraced property located in Redcar. The service is a residential care home that provides care and support for up to six people with a learning disability. There are six bedrooms of which five are in the main house and there is one in a separate annex with a separate access in the rear of the premises. There is a communal lounge and kitchen / diner. The bedrooms are situated on both floors. There are two flats with their own kitchen and lounge areas, and en suite facilities, these are on the first floor. On the ground floor there are three bedrooms with en suite facilities. To the rear of the service there is one flat type accommodation with its own kitchen and bathing facilities.

The service had a registered manager. 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.

There were systems and processes in place to protect people from the risk of harm. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

Assessments were undertaken to identify people’s health and support needs as well as any risks to people who used the service and others. Plans were in place to reduce the risks identified. Person centred plans were developed with people who used the service to identify how they wished to be supported.

Staff told us that they felt supported. There was a regular programme of staff supervision in place. Records of supervision were detailed and showed the registered manager worked with staff to identify their personal and professional development.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. There was enough staff on duty to provide support and ensure that their needs were met. Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

There were positive interactions between people and staff. We saw that staff treated people with dignity and respect. Staff were attentive, showed compassion, were patient and gave encouragement to people.

We saw that people were involved in planning the menus and were provided with a choice of healthy food and drinks. Staff had undertaken nutritional screening to identify specific risks to people’s nutrition.

People were supported to maintain good health and had access to healthcare professionals and services. People told us that they were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments. People had a hospital passport, however these documents contained limited information. The aim of a hospital passport is to assist people with a learning disability to provide hospital staff with important information they need to know about them and their health when they are admitted to hospital. We discussed this with the registered manager and they undertook to ensure these were made more informative.

People’s independence was encouraged and their hobbies and leisure interests were individually assessed. Staff encouraged and supported people to access activities within the community.

The provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take action to support them.

There were effective systems in place to monitor and improve the quality of the service provided. Staff told us that the service had an open, inclusive and positive culture.