This inspection took place on 17 and 18 October 2017 and was unannounced. It was the service’s first inspection since its new registration with the Care Quality Commission in June 2016

The service was on the same site as one of the provider’s nursing homes but was managed separately. It had its own secure grounds. The service provided care and rehabilitation to a maximum of nine people who lived with acquired brain injuries. It did not provide nursing care.

It was managed by an experienced 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.

People lived in a safe environment and risks which could have an impact on people’s health, safety and welfare were assessed and managed. People were also supported to recognise their own personal risks and taught to manage these as part their rehabilitation. People were looked after by staff who received appropriate training and support to be able to meet people’s very specific and diverse needs.

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 ethos of the service supported this practice. Where people were unable to make their own decisions about where they lived and about their care and treatment, these were made in their best interests and according to the principles of the Mental Capacity Act. Authorisations under Deprivation of Liberty Safeguards were met. People were supported to eat and drink in a healthy way and they had access to health care professionals when needed.

People’s care was delivered in a caring and thoughtful way. People had good relationships with the staff who afforded them respect and maintained their dignity. People’s human rights were upheld and their preferences in life were supported. Family members were encouraged to be fully involved and to support their relative, where this was appropriate and where the person wanted this to happen. People were involved in the planning of their care and were able to discuss this with staff on a daily basis if needed. Opportunities for people to be involved in social and therapeutic activities had increased over the last year. If people want to commit to some form of work they were supported to do so. People were taught new life skills with the aim of them living more independently where this was possible. People were supported to go on holiday.

The service had a strong leader who valued staffs’ ideas and commitment. There were good communication arrangements in place with relatives and their suggestions and involvement was also valued. Quality monitoring arrangements were in place to ensure the standard of care and service provided remained in line with people’s expectations. These arrangements also ensured the service complied with relevant regulations. Improvements had been made to the service and these were continuing to be made when we visited.