Chrislyn House provides accommodation, care and support for up to 19 people. People who live in the service have a range of needs which include learning disabilities and/or associated mental health needs. There were 14 people living in the service when we carried out an unannounced inspection on 2 November 2016.

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

People received care and support that was personalised to them and met their individual needs and wishes. Staff respected people’s privacy and dignity and interacted with people in a caring, compassionate and professional manner. They were knowledgeable about people’s choices, views and preferences. The atmosphere in the service was friendly and welcoming.

People were safe and staff knew what actions to take to protect them from abuse. The provider had processes in place to identify and manage risk. Assessments had been carried out and care records were in place which reflected individual needs and preferences.

Recruitment checks on staff were carried out with sufficient numbers employed who had the knowledge and skills to meet people’s needs.

Appropriate arrangements were in place to ensure people’s medicines were obtained, stored and administered safely. People were encouraged to attend appointments with other health care professionals to maintain their health and well-being. Where people required assistance with their dietary needs there were systems in place to provide this support safely.

People and or their representatives, where appropriate, were involved in making decisions about their care and support arrangements. As a result people received care and support which was planned and delivered to meet their specific needs. Staff listened to people and acted on what they said.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). Support workers understood the need to obtain consent when providing care. Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLs and associated Codes of Practice

Consideration had been given to maintaining relationships that were important to people. They were supported with regular opportunities to participate in activities outside the service and to sustain links within in their local community.

There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the care they received. People’s feedback was valued and acted on. There was visible leadership within the service and a clear management structure. The service had a quality assurance system with identified shortfalls addressed promptly which helped the service to continually improve.

During our inspection we spoke with three people who used the service. We talked with the manager and three members of staff. We spoke with three relatives. The detailed evidence that supports our findings can be read the full report.

Is the service safe?

Staff had received a range of training to protect people from harm. Safeguarding of vulnerable adults from abuse (SOVA), Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) training were completed every year. Staff we spoke with told us that they were aware of the action they would take if they suspected abuse was or had taken place. They were also aware of what it meant to deprive someone of their liberty.

We found that the service had suitable arrangements in place to gain people's consent to and assess people's mental capacity to make decisions should they not be able to consent to their care.

The policy, procedures and quality monitoring of the service included health and safety and reviews of care planning and delivery. This system was comprehensive and ensured people lived in a safe environment with safe care.

Is the service effective?

People were satisfied with the care and support they received. This was consistent with the positive feedback received from people as reported in the provider's own quality assurance survey. All of the staff we spoke with were knowledgeable about individual people's care needs, and this knowledge was consistent with the care plans in place.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people. We saw good interaction between staff and people who used the service. Staff were caring and courteous in their manner. People told us that the staff were very kind and gentle. One relative said, "The staff are very caring here, very caring indeed and always make me feel welcome."

People's preferences and diverse needs had been recorded in their care files and care and support had been provided in accordance with their wishes. This showed that people were cared for by kind and caring staff.

Is the service responsive?

We saw that care plans and risk assessments were informative, up to date and regularly reviewed. The registered manager responded in an open, thorough and timely manner to complaints. This meant that people could be assured that complaints were investigated and action was taken as necessary.

Is the service well led?

We found that effective systems had been put in place to assess and monitor the quality of services provided and to identify, assess and manage risks posed to the health, welfare and safety of people who lived at the home. We saw that the home worked well with healthcare professionals to make sure that people received care that met their individual needs in a joined up way. We spoke with members of staff who told us that the manager demonstrated strong, visible and consistent leadership in a way that made them feel valued and supported.

During our inspection we used different methods to help us understand the experiences of people who used the service. Where people were unable to tell us about their experiences, we used observation and noted people’s responses to staff. We saw that people appeared calm and relaxed in the presence of staff.

We saw that staff were knowledgeable about people’s needs and promoted their independence. When we talked with staff we found that they had a good understanding and awareness of people’s care needs and preferences. A person who used the service told us: "The staff are kind and patient with me, they help me manage my money."

Staff told us that there were sufficient numbers of staff on duty to meet the needs of the people who lived in the home. One person told us: "The senior staff are very supportive, they step in to provide additional care and support when required."

A person who used the service told us they were aware of how to make a complaint and who to make it to, but they had not felt the need to.

We gathered evidence of people's experiences of the service by talking with people, observing how they spent their time and noted how they interacted with other people living in the home and with staff.

We saw that Chrislyn House provided a relaxed and homely environment for people. Staff were friendly and respectful in their approach and interacted with people using the service in a confident and considerate manner.

During the course of our visit we saw that people were supported to express their views and choices by whatever means they were able to and staff clearly understood each person's behaviours and their way of communicating their needs. Staff looked after people's healthcare needs in a proactive way.

The staff team were well trained and supported to carry out their role.

The provider had effective systems in place to monitor the quality and safety of service that people received.

Where people were unable to provide a verbal response or tell us verbally their experiences, for example as a result of their limited verbal communication or poor cognitive ability, we noted their non verbal cues and these indicated that people were generally relaxed and comfortable and found their experience at the service to be positive.

People with whom we spoke told us that generally they were able to make choices about some aspects of their care. For example, we spoke with four people about how they are supported to choose what to eat each day. They told us that staff offer them a choice of meals each day and that they can also choose where they have these, for example in the comfort of their own rooms or in the dining room. They are also able to make a decision as to whether or not they participate in social activities.

Another person who uses this service told us they are able to make decisions about going out and what craft activities they took part in.

People spoken with indicated that they were satisfied with the level of care and support they received at Chrislyn House.

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.

The people with whom we spoke made the following comments "I like it here." and "They take me out if I want to."

People using the service told us that staff helped them with their medication when they needed it and indicated that they were happy with their rooms and found them comfortable.

People told us that they feel well looked after by the staff at Chrislyn House. One person with whom we spoke said "I need a lot of help and they are very kind to help me."