The inspection took place on 12 and 13 June 2017 and was unannounced.

Church View is registered to provide care and support for up to eight people with a learning disability who present behaviours which challenge. At the time of our inspection there were eight people using the service. Church View is a converted residential property which provides accommodation over three floors. Communal areas are located on the ground floor; bedrooms are all single occupancy with en-suite facilities. There is an accessible garden to the rear of the service. The service is located within a residential area with nearby shops and community facilities.

The overall rating of good, which was awarded following the CQC's previous inspection of 1 and 2 June 2015, was displayed along with a copy of the inspection report in the hallway. At this inspection we found the service was now to be 'Outstanding'.

Church View had a 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 told us they felt safe at Church View and that they had information about who to contact if they had any concerns. People understood potential risks and the ways in which their safety was promoted from an environmental perspective. People took an active part in the promotion of their personal safety and welfare and, where necessary, were supported by staff on a one to one basis.

People told us their rights and opinions were listened to and they were aware of the measures necessary to promote their safety, where their behaviour became challenging. Staff had a positive approach to risk taking. People’s rights and choices were promoted with staff following clear guidelines reflective of the training they had received and people’s individual needs to reduce the potential of risk. This positive approach to risk taking meant people were able to lead fulfilled lives and seek new opportunities.

People living at Church View were aware of safeguarding and had information so they could report concerns independent of staff. Staff were trained in safeguarding (protecting people who use care services from abuse) and knew what to do if they were concerned about the welfare of any of the people who used the service Medicine was safely managed in the home by staff who had received training and who had their competency to administer medicine regularly assessed.

Staff underwent a robust recruitment process, which involved people living at Church View having a say as to which staff to appoint. Staff induction was comprehensive to ensure staff had the necessary knowledge before they supported and cared for people. Staff had access to training, which was regularly reviewed and reflected changes in good practice guidance, which enabled them to meet people’s needs. Staff were committed to the rights of people and actively worked with them to promote independence, as detailed within the staff’s codes of conduct. Staff received on-going supervision and appraisal which ensured they worked to the standard expected by the registered manager to ensure people received a high quality service.

People spoke positively about the meals. We saw and open and inclusive approach between people living at the home and staff, in the shopping, preparation and cooking of meals. People living at the home viewed Church View as their home, which was reflected by offering visitors and staff, food and drink. People’s dietary needs were met and people were supported to go out so that they could enjoy food at a range of eateries.

People were aware of their health care needs and were supported by staff to make and attend appointments. We received positive feedback from a person’s relative and we heard how staff respon

We spoke with four people living at the service and they told us that they were happy and were given choice about how they lived their lives. We observed staff in positive interaction with people and there was a relaxed atmosphere within the home. We looked at support plans and these were thorough and detailed providing information about people's likes and dislikes.

Some people told us that they were unhappy about how some other people using the service treated them, we looked at incident logs and these showed that there were many incidents which should have been reported to safeguarding to be investigated and then for the service to receive extra support for people with behaviour that challenges.

We were told that there were enough staff for people using the service to be able to access the community safely and when they wanted to. We looked at rotas and saw that staff were employed in sufficient numbers to support people as their plans indicated but there no first aider on each shift to ensure that should an injury occur it could be dealt with promptly.

We looked at the records for the service and these were accurate, people using the service told us that they were involved in reviewing their plans and keeping them up to date.

We spoke with four people using the service they told us that that staff always speak to them about the help they need and don't rush them.

"The staff always ask me if I want my PRN (medication to be taken as required) and if I don't want it they listen to me."

"I feel the staff listen to me and they treat me with respect."

We spoke to two people who use the service and they told us.

"I was able to pick my room when I first came here and decorated it as I wanted to".

"I sit with staff and we talk about what help I need and I then sign my plan".

"I decide how I spend my day if I don't want to do something the staff understand".

"I am happy living here this is the best place I have lived and I have lived in lots of places".

This inspection took place on 1 June 2015 and was unannounced and we returned on 2 June 2015.

Church View is registered to provide residential care and support for eight people with a learning disability who present behaviours which challenge and who have complex needs. At the time of our inspection there were seven people using the service. The service is a converted residential property which provides accommodation over three floors. Communal areas are located on the ground floor; bedrooms are all single with en-suite facilities. There is an accessible garden to the rear of the service. The service is located within a residential area with nearby shops and other community facilities.

At the last inspection of the 17 December 2013 we asked the provider to take action. We asked them to make improvements in the reporting and management of safeguarding concerns and to ensure a member of staff with a qualification in first aid was on duty. We received an action plan from the provider which outlined the action they were going to take which advised us of their intention to meet the regulation by 17 March 2014. We found that the provider had taken the appropriate action.

Church View had a registered manager 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 told us they felt safe at Church View and that they had information about who to contact if they had any concerns. Staff were trained in safeguarding (protecting people who use care services from abuse) and knew what to do if they were concerned about the welfare of any of the people who used the service. Where people were at risk, staff had the information they needed to help keep them safe.

People were supported by knowledgeable staff who had a good understanding as to people’s needs. Staff provided tailored and individual support to keep people safe and to provide support when their behaviour became challenging.

People received their medicines in a timely manner. People told us they were able to request additional medicines, which they were prescribed, when they needed them These helped them to manager their anxiety and behaviour.

Staff were seen to support people in a confident manner as they knowledgeable about their needs. We saw people were relaxed in the company of staff and talked openly with them about issues affecting their health. People told us they attended regular health care appointments with staff support. Staff understood people’s health care needs and referred them to health care professionals when necessary.

Staff told us that training had helped them to understand the needs of people, which included their right to make decisions about their day to day lives. People told us that decisions about their lifestyle choices were supported by staff and were not restricted.

People’s dietary needs were met and people were encouraged to take part in grocery shopping and to prepare and cook food if they wished to.

People were supported by staff who had developed positive and professional working relationships with them, this gave people who used the service the confidence to speak with staff and talk about issues affecting them. People were relaxed in the company of staff and were able to talk about their lifestyle choices and the impact their decisions had on their well-being and future plans.

People had their needs assessed by the registered manager prior to moving into the service to ensure their needs could be met and that they would complement and fit in with those already receiving a service.

People were involved in the day to day running of the service, which included the recruitment of staff, social events and activities along with household chores. People attended meetings within the local community and within the service to ensure their views were heard. People were confident that any concerns were responded to by the provider and registered manager.

The registered manager and staff were committed to meeting the needs of people and improving their sense of well-being by encouraging people’s independence and the achievement of their goals and aspirations.

Staff were complimentary about the support they received from the registered manager and regular meetings, supervision and appraisal provided an opportunity for them to develop and influence the service they provided.

The provider had a robust quality assurance system which assessed the quality of the service. Information gathered as part of the quality audits was used to continually develop the service and look for ways in which people using the service could achieve greater autonomy.