About the service: Casa Ma is a residential care home that was providing personal care to 36 people at the time of the inspection.

People’s experience of using this service:

¿ People were at the heart of the service. The provider's philosophy, vision and values were understood and shared across the staff team. People were supported to maintain their purpose and pleasure in life.

¿ People received care which was highly responsive to their individual needs. Staff had an excellent understanding of people and ensured this was used to provide exceptional individual care which took account of people’s life histories

¿ The provider and staff team were passionate about providing high quality care tailored to people's individual needs and preferences. Staff invested time to understand the experiences of people who lived at the home.

¿ People told us they had formed excellent relationships with the provider, staff team and other people who lived at the home, built on trust and respect. People contributed to the running of the home and were listened to.

¿ People were supported to maintain relationships with people important to them. Visitors were welcomed at the home and were encouraged to be actively involved in people's lives.

¿ People, relatives and staff agreed the service was extremely well managed and Casa Mia was an exceptionally caring home. Everyone consistently praised the skills of the management team and emphasised they were motivated to provide an exceptional service.

¿ The provider ensured care was based upon good practice guidance. Exceptionally good governance was embedded into the provider and registered manager’s processes. This ensured people received people received a highly effective service which put them at the heart of their care.

¿ The home had a vibrant and welcoming atmosphere where visitors were welcomed and encouraged. There were processes to monitor the quality and safety of the service provided and actions were taken to drive continuous improvement for the benefit of the people who lived there.

¿ The staff provided a flexible care approach and people were empowered to decide how and when their care was provided. People, relatives and health professionals told us the care provided was effective and people experienced positive outcomes. People and relatives told us staff were empathetic and gave compassionate care.

¿ Staff understood their responsibility to safeguard people from harm and had a good understanding reporting concerns both within and outside the home. Where risks associated with people's health and wellbeing had been identified, there were plans to manage those risks.

¿ Risk assessments ensured people could continue to enjoy activities as safely as possible and maintain their independence. Staff had a good knowledge of how to support people at these times.

¿ 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.

¿ Staff with a range of skills were available at the times people wanted to receive support, in all aspects of their lives. Staff had received training so people's specific care and support needs were met, and we saw training was put into practice.

¿ Staff told us the provider proactively ensured they had many opportunities to further develop their skills and knowledge. Staff felt supported and valued by the provider and they prided themselves on providing high quality care.

¿ People received a nutritious diet, had a choice of food, and were encouraged to have enough to drink. The provider and staff team worked closely with external healthcare professionals to ensure people's health and wellbeing was promoted and maintained.

¿ Wherever possible staff supported people to retain responsibility for their own health. Medicines were managed so that people received their medicines as prescribed.

Rating at last inspection: Good. Report publis

The inspection was unannounced and took place on 12 and 14 July 2016.

Casa Mia is registered with the Care Quality Commission to provide accommodation and personal care for a maximum of 25 people with mental health needs or with learning disabilities. There were 25 people living at the home on the day of the inspection. There was a registered manager in place who is also the registered provider. 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 protected from harm as staff knew how to protect them from abuse. Relatives told us that people were supported when required and they were happy with the support people received.

People received their medicines in a way that kept them safe. Staff had received medication training and there were arrangements in place for managing people’s medication.

Staff had been recruited following the appropriate checks on their suitability to support people living in the home. Staff were available to meet people’s needs promptly and they demonstrated good knowledge about people living at the home. Staff received training to provide appropriate knowledge to support people and staff felt supported by the registered manager and management team.

Care and support was provided to people with their consent. Staff understood and recognised the importance of this. We found people were supported to maintain a healthy lifestyle through diet and exercise. People had access to healthcare professionals and were supported to attend appointments. Staff showed knowledge of people’s health needs and their relatives were informed of any changes in their family members’ health and support.

People and relatives consistently praised staff and the provider and the support they provided, which they described as ‘excellent.’ People demonstrated to us that they valued their relationships with the staff and relatives told us they felt valued and supported by staff too. Relatives told us there were no restrictions on when they could visit and they were always made welcome by staff and often enjoyed meals their family members.

People were supported to do the things they enjoyed and maintain links with family and friends and the local community. People and relatives told us care was provided focused on people and took account of their individual needs and preferences. People had developed in confidence because of how the staff cared for them and we saw people had a sense of purpose. People chose how they spent their days in their home and what they wanted to do and were encouraged to engage in their personal interests and the activities they enjoyed.

People and relatives knew how to make complaints and told us they would speak to staff and the provider about any concerns. The provider advised that any concerns were picked up and dealt with immediately.

People, relatives and staff were all complimentary about the service provided. The provider demonstrated clear leadership. Staff were supported to carry out their roles and responsibilities effectively, so that people received care and support in-line with their needs and wishes.

During our inspection we spoke with eight people who used the service and three relatives. We also spoke with five staff, the assistant manager, the registered manager and the providers. A health professional who was visiting the home at the time of our inspection also spoke with us.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found –

Is the service safe?

One person told us, “All staff are good here, I feel safe.”

People were looked after by staff who had received training appropriate to their roles. The provider had completed all required checks to ensure staff were suitable and had the required skills and knowledge to work at Casa Mia.

Risks to the environment and people had been identified and managed in a way that ensured people’s safety.

The Care Quality Commission monitors the use of the Mental Capacity Act and Deprivation of Liberty Safeguards. Everyone living at Casa Mia were able to make their own decisions about their care. Staff had received training in the Mental Capacity Act and the Deprivation of Liberty Safeguards and understood the importance of people being supported to make their own decisions in relation to their care and treatment.

Is the service effective?

People told us their needs were met by the care staff. Care staff we spoke with understood people’s needs and how to support them.

Care staff were supported in their roles through regular supervision with the registered and assistant manager. This ensured they could meet people’s needs.

We saw evidence that the provider worked closely with other health professionals to ensure there was a joined up approach to meeting people’s care.

Is the service caring?

One person told us, “I like it here.” Relatives we spoke with told us, “It’s a lovely happy, friendly home.”

We observed staff treated people with respect, dignity and kindness. Staff told us, “It’s not like coming to work; it’s more like a second family.”

Is the service responsive?

Not all people’s needs had been assessed before care was provided. Where people’s needs were assessed their plan of care was individual to them. Staff showed a good understanding of how to respond to people’s support needs.

Activities were provided for people which were individual and relevant to them. People we spoke with talked about the different activities they took part in. This included working at a care farm, crafts, woodwork, shopping and baking.

Is the service well led?

People and staff told us that the provider asked their opinions on the service. They told us the provider listened to them and did what they said they would do. They told us they saw the provider often and were able to freely talk about any issues or concerns they had.

The provider monitored the quality of care provided through observation and supervision of staff. All staff we spoke with had a good knowledge of the needs of people who used the service and their care and support needs. This helped to ensure that people received a good quality service at all times.

We inspected Casa Mia and spoke with five people who lived at the home and a relative of a person who lived at the home. We also spoke with a healthcare professional who visited the home during our inspection. We spoke with the registered manager, assistant manager, one senior staff and two staff.

We looked at the care records for two people who lived at the home and we looked at other supporting documents for people who used the service. People that we spoke with were very satisfied with the care they had received. One person said: “I love living here, it’s great. Another person we spoke with said: “I love the people, the staff and the trust. It’s like a family”. A relative we spoke with said: “I have no worries about the staff. I know everything will be fine”.

We found consent had been obtained from people before care and treatment had been provided. Staff we spoke with told us they respected people’s individual choices and decisions. One staff member said: “I always offer a choice and respect people’s decisions”.

We found that people received care and support as planned according to their needs. Staff understood people’s needs and how to give the support that they required.

People were cared for in a safe and clean environment. The premises were suitable for people who required wheelchair access and people were able to access all parts of the home and garden.

We looked at the recruitment process in place. We saw that appropriate checks had not always been carried out before staff commenced employment.

We found people knew how to make a complaint and were supported by staff when required. We found the provider had dealt with people’s complaints in line with their own procedures.

During this inspection we spoke with six people who used the service, three people’s relatives, four members of staff and a visiting healthcare professional.

Everyone we spoke with was complimentary about the service and the way people were cared for and supported. One person who used the service said, “Everything is top class. I never ever want to leave”. Another person told us, “I have made a lot of friends”.

We saw that staff encouraged people to be independent and to make decisions about how they wanted to be treated and how they would like to spend their time.

People’s individual needs had been assessed and supporting care plans had been developed. This ensured their needs would be met by staff and that they received appropriate care.

When we spoke with staff we found they had a good understanding of the individual needs and preferences of the people they cared for. They told us that training was made available to them which enabled them to have the skills and knowledge to care for people appropriately. In addition to this we found that staff had a good understanding about what constituted abuse and the action they should take if they had any concerns about the people they cared for.

Since our last inspection to the service in 2010 there had been a number of environmental improvements which had resulted in an increase in facilities. This meant that the numbers of people who could be accommodated at the service and had changed from 15 to 22.