About the service: 14 Cook Close is part of the Disabilities Trust and is a community supported house. They promote independent living and aim to rehabilitate people into the community. It is registered to provide accommodation, and personal care for up to four people who have an acquired brain injury. Nursing care is not provided.

People’s experience of using this service:

People were supported in a homely environment where the culture of the service was positive, enabling and inclusive. People were supported to have maximum choice and control of their lives in the least restrictive way possible; the policies and systems in the service supported this practice.

There were systems in place to monitor the quality and safety of the service provided, and to drive improvements where this was required. The service considered people's feedback and was continuously trying to improve the service.

Staff had respectful caring relationships with people they supported. They upheld people’s dignity and privacy, and promoted their independence.

There were enough staff to support people, meet their needs and keep them safe. People were supported by skilled staff with the right knowledge and training.

People received their medicines as prescribed. Systems were in place for the safe management and supply of medicines. Incidents and accidents were investigated, trends analysed, and actions were taken to prevent recurrence.

Care plans were detailed with clear explanations of control measures for staff to follow to keep people safe. Support was planned and delivered in a structured way to ensure people's safety and wellbeing.

The service continued to be well led. The management team worked well to lead the staff team in their roles and ensure people continued to receive a good service. Staff and the registered manager showed a genuine interest and passion to deliver personalised care based on people's likes, wishes and preferences.

People had access to a variety of nutritious meals and snacks and were supported to learn skills in food preparation and cooking. People’s weights were monitored.

Staff were aware of people's life history and preferences. They used this information to develop positive relationships and deliver person centred care. People’s end of life care was considered, and people supported to express their views.

Staff roles and responsibilities were clear. Staff worked in partnership with professionals to deliver care and support and maintained links with the local community. There was a varied range of social activities on offer according to individual needs and choice.

Rating at last inspection: Good (report published on 21 October 2016).

Why we inspected: This was a scheduled inspection based on the previous rating.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection was unannounced and carried out on 31 August 2016.

Brain Injury Rehabilitation Trust - Cook Close is a community based residential support and enablement service. Care and support is provided for up to four people with complex neurological needs following a traumatic or acquired brain injury. The aim of the service is to provide continuing short and long term rehabilitation to enable people to maximise their potential for improvement. At the time of our inspection there was one person using the service.

A registered manager was 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was last inspected on 21 August 2013 and at that time requirements in the Health and Social Care Act 2008 and associated Regulations were met.

Cook Close provided a small homely environment and promoted a positive and inclusive culture. Staff had developed a caring and meaningful relationship with the person using the service and knew their individual care and support needs well. Staff spoke passionately about their role. The service had established firm links with the community and supported individuals to develop and maintain personal relationships with friends and family, which enhanced their wellbeing.

People were protected from avoidable harm and potential abuse. Safeguarding procedures were in place and people were encouraged and supported to raise any concerns.

Potential risks were identified and assessed. Management and staff had a positive attitude towards managing risk and balanced the need for people to have preference and choice with ensuring they were safe, both in the service and in the community. Detailed management strategies were in place to provide guidance to staff on the actions to take to minimise risk and provide appropriate and individualised support.

Safe recruitment practices ensured the suitability of newly appointed staff coming to work in the service. People were supported by sufficient numbers of staff with appropriate experience, training and skills to meet people’s needs. Staffing levels were flexible and supported people to follow their interests, take part in social activities and, where appropriate education and work opportunities.

Appropriate checks of the building and maintenance systems were carried out regularly to ensure people’s safety. Medication was stored safely and administered correctly. Robust systems were in place to ensure medication and people’s finances were managed safely and appropriately.

Management and staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals.

People were supported to maintain good health. They received continuing healthcare support to meet their needs and had prompt access to healthcare professionals when they became unwell. Staff promoted healthy eating. They supported people to balance choice with healthy options and people's preferences contributed to the menu planning.

The provider had arrangements in place to listen and learn from people's experiences, comments and views. There was a strong emphasis on promoting good practice in the service and there was a well-developed understanding of equality, diversity and human rights which management and staff put into practice. The registered manager was knowledgeable, inspired confidence in the staff team, and led by example.

Quality assurance systems were robust and helped to ensure the service was of a good quality, was safe and continued to improve.

Some of the people who lived at 14 Cook Close had complex needs but most were able to speak with us. We gathered evidence of people’s experiences of the service by observing how they spent their time and we noted how they interacted with other people who lived in the home and with staff.

We saw that people had individual ways of communicating and were able to make members of staff aware of their needs and preferences. We saw that people were comfortable in their surroundings.

We found that there were enough trained, skilled and experienced staff to meet people's needs. Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service. We saw that staff treated people with respect.

14 Cook Close was well managed and the registered manager had systems and processes in place which ensured people received a good service that took into account their needs and preferences.

We used a number of different methods to help us understand the experiences of people using the service and were able to observe staff supporting people.

We saw that the people living at the home were supported and encouraged to exercise choice in their day to day lives. Independence was also promoted and staff worked with people to achieve this. People received the care, support and treatment they needed and this was provided in an individual way.

We found that the staff at the home were well trained and supported to undertake their role and responsibilities.

We found that the provider had systems in please to assess and monitor the quality of the service provided.

Some people with whom we spoke had limited verbal communication skills but were able to participate in a conversation and we noted their non verbal cues.

Staff with whom we spoke told us that people's privacy, dignity and independence are respected and that their views on the support and care they receive are taken into

account.

Those people with whom we spoke indicated they could choose whether or not to join in activities and could spend time alone in their room pursuing their own interests if they preferred.

People spoken with indicated that they were happy with their rooms and found them comfortable.

People spoken with indicated that they were well looked after by the staff at 14 Cook Close.