The inspection took place on 1 November 2017 and was unannounced. At our last inspection in April 2015, the service was meeting the regulations inspected.

Claro Home is registered with us to support up to 54 people with mental health needs. At the time of our visit there were 51 people were living there.

There was a registered manager for the service who was also a company director for the provider organisation. 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.

Health and safety audits showed that risks to people had been identified and the actions that were needed to keep people safe were set out. However some risks had not yet been fully addressed, and some staff did not follow up to date infection control and food hygiene practices. This in turn could impacts negatively on the health, safety and wellbeing of people in the home. The registered manager acted on our concerns on the day or our visit.

People told us they felt safe and staff knew how to protect people from the risk of harm and abuse in the home and when they were in the community. Risks that people may experience were managed safely. Medicines were managed safely and people who wanted to were able to look after their own medicines with assistance from staff when needed.

People were involved in planning menus and their wishes in relation to meal choices were acted upon so that they were included in the options available. People were supported to eat and drink enough to stay healthy. Some people were supported to build up their confidence in self budgeting and preparing and cooking their own meals. This also helped people to gain independence.

The staff team were well supported by management to do their job effectively. This was because they were properly supervised in their work and this meant they knew how to provide people with effective care. Staff supervision meetings were kept up to date for all staff. These were used to review the progress and performance of individual staff members.

The people we met were positive in their views to us about the staff and the type of support and care that they received. This showed people felt well supported with their particular and often complex mental health needs. People were treated with kindness and care by the staff that supported them at the home. We saw how staff spent plenty of time to speak with people they were supporting. There were also many positive and very warm interactions between them. People looked really relaxed to engage with the staff when they wanted to speak with them.

Each person’s mental health needs were fully assessed and their care was well planned with the involvement of the person concerned. Some care plans did not show in sufficient detail how to meet certain people physical care needs. Some of this information was seen in individual risk assessments but it was not easily located. This could have meant staff did not fully know how to support those people with their physical care needs Care plans generally supported and guided staff so that care was delivered in a way that properly met the needs of the person. The staff on duty had an up to date understanding of the complex mental health needs of people at the home. People told us and we also saw that they were being enabled and encouraged to make choices about their care and in their lives.

We have made a recommendation about care planning processes.

There were systems in place to ensure that staff followed the Mental Capacity Act 2005 if people lacked capacity to make informed decisions in their daily lives. The provider had completed applications under the Mental Capacity Act Deprivation of Liberty Safeguards for a person. This had been accepted

The inspection took place on 28 April 2015 and was unannounced. At our last inspection in January 2014, the service was meeting the regulations inspected.

Claro Homes is one of the services provided by The Lodge Rest Limited. It is a home for 53 people with mental health needs. At the time of our visit there were 53 people living there.

There was a registered manager for the service. 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 spoke positively about the staff and the support given by staff with their particular mental health needs. People were treated in a kind and polite way and staff spent plenty of time with people. There were positive and warm interactions between them. People looked relaxed and approached staff when they wanted to talk with them.

People’s mental health needs were identified and the type of care they received was planned and delivered in a way that met their needs.

People were supported to eat and drink enough to be healthy. People were consulted in menu planning. Meal choices and individual preferences were included in the menu options available.

There were systems in place to ensure that the requirements of the Mental Capacity Act 2005 were followed. This law protects people who lack capacity to make informed decisions in their daily lives. The provider had completed one application under the Mental Capacity Act 2005 Deprivation of Liberty Safeguards. This had been accepted and necessary safeguards were in place for the person.

The staff understood the needs of the people they supported. People were encouraged to make choices about their care and to become more independent in their lives.

Staff supervision was in place and up to date for all staff. This meant there was a system in place to provide staff with the support they needed to do their jobs effectively.

The registered manager investigated and responded to people’s complaints by following the provider’s complaints procedure. Complaints were well managed when they were received.

The provider’s representative visited the home regularly. They carried out quality checks on the overall quality of care and service people received. Where needed they had identified actions for the registered manager to implement to improve the service. They had recently picked up that certain policies and procedures needed updating. This action had been carried out by the registered manager.

Our inspection helped answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that people were treated with respect and dignity by the staff who assisted them. People who used the service spoke positively about the way they were treated by the staff. Examples of comments made included, “the staff are all so kind”, “they treat us quite alright” and “they are lovely to us every one of them”.

People told us they felt safe at the home and with the staff who worked there. People were protected by safeguarding procedures that were robust and staff knew how to safeguard people who used the service.

The home had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards to guide and inform the staff. One application had been properly submitted by the registered manager in the last twelve months. This meant that people who used the service were safeguarded and their rights were upheld.

People were protected by recruitment procedures that were robust and ensured that suitable staff were employed to work at the home.

Regular health and safety audits were carried out to ensure that the home environment was safe and suitable for people who lived there, staff and visitors.

Is the service effective?

The people who used the service who we spoke with told us they were happy and satisfied with the care and support that they received from the staff.

We observed staff assisted people in a calm and attentive way with their care and support needs. One person told us. "my keyworker encourages me along” another comment made was “they are all really kind and they are helping me to be more independent”.

Staff had an in depth understanding of the complex needs of the people who lived at the home. The staff we spoke with gave us example of approaches they took when they assisted people. For example they made sure they spoke calmly to people and used open and relaxed body language.

Care plans included evidence that they had been written based on the needs and wishes of the person concerned. We saw that people were involved, if they wanted to be, in devising their own plan of care to meet their needs.

Is the service caring?

We observed staff assisted people in a caring manner with their care and support needs. One person told us. "my keyworker encourages me along” another comment made was “they are all really kind and they are helping me to be more independent”.

People who used the service were encouraged to take part in a varied range of therapeutic activities. People told us that they also went out regularly with the support of staff. For example people told us they went out to a weekly bowling afternoon at a nearby bowling alley.

Is the service responsive?

People told us they spoke with their key workers frequently and were able to talk with them about any issues they had. One person told us “my keyworker helps me build my confidence”.

Regular ‘residents meetings’ took place and the minutes confirmed people’s views were sought about the way the home was run and a number of different matters related to it. For example we saw that people were regularly consulted about menus and we saw that individual preferences were included where possible.

Is the service well-led?

People who used the service spoke highly about the registered manager. One person told us that they were “lovely”. Another person said they were “very kind and always listened”. . We saw people approached the manager when they were in their office. They had an ‘open door’ policy and were attentive and made time for each person who wanted to see them.

There were systems in place to monitor the quality of care that people received. People were regularly consulted as part of the process of monitoring quality in the home.

We spoke with the manager, the team leader, staff and people who received care and treatment at the home. We asked people to tell us about their experiences of living at Claro Homes. We reviewed care records, staff files, policies and procedures, quality audits and risk assessment documentation.

One person told us, "I'm very happy here. Staff are good to me. I feel safe and comfortable". We observed care being provided in a dignified and respectful manner. People were engaged with in an unhurried and supportive way.

The service demonstrated practice that ensured that people were safeguarded against abuse. One person told us, "this place is safe and my keyworker support me to make decisions about my care. I am happy here”..

Care practice and record-keeping were clear with regular auditing procedures. This meant that care plans were current and reflected how to meet people’s needs.

There were effective processes in place for how staff were supported such as regular supervision, training and appraisals.

The provider had quality assurance systems in place to check that the quality of the service people were receiving met their needs.

We spoke with eight people receiving a service, five members of staff and the manager during our visit.

As part of our review of Claro Homes, we also used our SOFI (Short Observational Framework for Inspection) tool to help us understand people’s experiences in the home and whether they got the support that they needed as not everyone was able to tell us about their experiences due to their medical condition. During a half hour period of observing people in the communal area of their accommodation, we found that overall, staff interactions with people were positive. For example, we saw that staff explained what they were doing when they were supporting people in tasks. One person was given powdered medication to thicken their drink and make it more manageable and we saw that staff explained “this will help you drink it”. We also saw that a person’s request for a specific meal was acknowledged and acted upon.

People told us they liked living in the Claro Homes. They told us that the staff were supportive and friendly.

People told us that staff spoke to them with respect and treated them in a dignified manner.

People told us that they have monthly meetings about life at Claro Homes.

People told us they knew about their care plans and they were enabled to contribute towards their care.

People described good relationships with each other and staff and said they were involved in the running of the home and their views on the service were listened to and acted upon.

People said that they felt safe and well supported by the staff working in the home. People said they were encouraged to be as independent as possible.

People told us they were aware of who to complain to if they were not happy with the services provided.

People said they were encouraged to participate in various activities in the home which included accessing different facilities within the local community. People told us they believed that staff were well trained to do their job.

In summary one person said "The home is run very well indeed. Staff are pleasant and helpful. They are invariably always available for help and assistance and because of their professional motivation it makes living here a pleasant experience"