7 Birdhurst Rise is a residential care home for up to nine people who have a learning disability, some have mental health related issues and behaviour that challenges. The service is based in a large detached house with each person having their own en- suite bedroom and the use of communal facilities; these include a lounge, activities room, a large kitchen/ dining room and spacious garden. In the private garden at the rear of the house is a new detached purposely built annexe with self-contained accommodation for one person.

At the last inspection in May 2015, the service was rated Good. At this inspection we found the service remained good.

The service demonstrated they continued to meet the regulations and fundamental standards.

People were fully involved in how the service was run. The home had a homely feel and reflected the interests and lives of the people who lived there. The home was well decorated and safely maintained.

People received care and support from a regular group of staff who knew them well and understood their needs and preferences. Staff morale was good. There were sufficient numbers of suitably vetted and skilled staff deployed to meet people’s needs.

Staff identified risks to people’s health and safety and put necessary guidance and plans in place to manage the risks. People had access to the health care services they needed and received their medicines safely. There were checks in place to ensure staff managed people’s medicines appropriately. Staff treated people with compassion and kindness; and respected their dignity and privacy.

People's care records recognised their rights and were person centred. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The service was well managed by an experienced person who gave consistent leadership and direction. Quality assurance systems were robust and contributed to continued improvements. Record management was excellent and records were well organised and easy to access.

This inspection took place on 19 May 2015 and was unannounced.

7 Birdhurst Rise is owned by Care Management Group, a specialist provider of care homes for adults with learning disabilities and challenging behaviour. This service provides accommodation and personal support for up to eight people. There are eight single bedrooms all with en-suite bathroom facilities.

We last inspected in November in 2013. At that inspection we found the service was meeting all the regulations that we assessed.

There was a registered manager in post at the time of our inspection. 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 service had safeguarding policies and procedures in place and staff were trained appropriately. This helped protect people from the likelihood of abuse or neglect. Recruitment procedures were robust, and only suitably vetted staff were employed to work in the service

People were comfortable and relaxed in the company of the staff supporting them. They were cared for by staff who were familiar with their needs and who they could communicate effectively with.

The service promoted positive risk taking and actively supported people to be independent and involved in all areas of daily living. Risks people may experience were assessed, and there were effective procedures for ensuring that any concerns about people’s safety were appropriately managed.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Staff respected people's decisions about what they wanted to do such as choosing activities and lunch.

People received effective care and support because the service had sufficient numbers of staff to support people. The staff team had a variety of skills and experience and had undertaken relevant qualifications to care for people.

People using the service had up to date health action plans which gave an overview of the person's health needs and acted as an indicator of change in health requirements. Information on health and social care needs was kept up to date and reviewed regularly as people's needs changed.

There were hospital passports for each person to aid good communication with hospital staff. If they were unexpectedly admitted to hospital these contained essential information about the person, such as their age, any medical condition, medicines they were taking, known allergies and relevant contact numbers.

People were supported in a way that did not inappropriately restrict their freedom. Some people had some restrictions placed on their liberty to help ensure their safety. Staff had followed the procedures outlined by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) to ensure people’s rights were properly considered. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.

The service was well managed and run in the best interests of people using the service. People were empowered by being actively involved in decisions about their care and about the running of the service.

Due to their needs, some people that we met during our visit were unable to share their direct views about the standards of care. We therefore used observations and looked at care records to help us understand their experiences. We also looked at various records around the way the home was being run and toured the premises. We spoke with the registered manager and three members of staff during the course of our visit. We also telephoned three people’s relatives following our visit.

Throughout our visit, people were comfortable and relaxed in the company of the staff supporting them. One person using the service said the staff were “nice people”. Another person told us “I like it all here.”

The three relatives we spoke with were complimentary about the home and the progress made by people using the service. One told us their family member was “very well looked after” and had “come on leaps and bounds” since moving there. Another described the care provider as a “professional outfit.” A third relative said their family member was “extremely relaxed” and “very, very settled.”

People using the service had personalised support plans, which were current and outlined how they wanted their care and support to be provided. This meant staff had the information they needed to meet people’s individual needs. Where people did not have mental capacity to consent, care was provided in their best interests. Relatives of people using the service told us they felt involved and were in regular contact with their family members.

People received effective care and support because the service had sufficient numbers of staff to support people. The staff team had a variety of skills and experience and had undertaken relevant qualifications to care for people. Staff told us they had ongoing training and supervision and were supported by management to do their job.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There was a complaints process which showed that people who used the service and their families were supported to raise any concerns. All relatives we spoke with were aware of the complaints procedure but said they had “no complaints.” One relative told us, “I have all the numbers and would get straight on the phone if something was wrong.”

We met with the eight people living at Birdhurst Rise, the deputy manager and four members of staff. Due to their needs, most people were unable to share direct views about their care experiences. During our visit people were offered choices, spoken to respectfully, made to feel involved and showed signs of well being when interacting with both the staff and other people using the service. People who were able to communicate with us said they liked the staff and activities.

Plans of care were person centred, well created and closely reflected the specific needs of the person. People's needs were regularly reviewed to make sure they got the right care and support. Records showed us that families and professionals involved in people's care were consulted.

People benefitted from a stable staff team who had worked at the home for several years. Staff told us that they were happy working at the home and felt well supported by the manager.

The provider regularly monitored the care, facilities and support for people using the service and staff received appropriate training and support to meet people’s needs.

The reader should note that ‘CMG’ represents Care Management Group who are the owning company and that ‘PCP’ stands for person centred plan. This is a plan of care that is developed with a person using the service or their representative.

Due to their needs, many of the people that we met during our visit were unable to share direct views about the standards of care. During our visit people were relaxed and showed signs of well being when interacting with both the staff and other people using the service. Staff were alert to changes in people’s mood, behaviour and general wellbeing and knew how they should respond to individual needs.

The views of people who were able to comment on their experience can be summarised as follows, “I’m happy here, nothing could be better.”

” It’s nice here, I like X (name of the person’s keyworker) the best, “and “I can make a cup of tea and staff help me. They clean my room and help me put my clothes away.”

People told us that the staff were “nice” and “helpful”. They said that they met regularly with their key workers to discuss activities they wanted to do and also to plan holidays.

We saw that people were provided with a range of personalised and meaningful activities that they had chosen.

People told us that they felt safe and could tell staff if they were unhappy about something.

Staff told us that they were supported and were happy working at the home. They said that there was a good atmosphere and they had the training and information they needed to care for people.

The home was furnished and decorated to reflect the individuality, needs and chocies of the people who live there. People told us they liked their living environment and had the things they needed in their bedrooms.

Please refer to each outcome below and within the main report for more detailed comments about specific aspects of the service.

We would like to thank all those who took part in this inspection for their time, assistance and hospitality.