This comprehensive unannounced inspection was carried out on 11 September 2018.

Clayburn Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is registered to support up to six people with complex and enduring mental health needs. On the day of our inspection, six people were living at the service.

At our last inspection on 5 January 2016, we rated the service as ‘good’ in all domains. At this inspection, we found the service had improved to ‘outstanding’ in two domains and therefore had improved to an overall rating of outstanding.

The service required, and did have, a registered manager, who was also the owner of the business. 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.

The service was extremely responsive to people’s individual needs which had a positive impact on their wellbeing, enabling them to lead meaningful and fulfilled lives. People were involved in the development and review of their care plans which were regularly reviewed. Care plans were exceptionally person centred, holistic and recovery focussed and clearly reflected people's individual needs. People and health care professionals were extremely complimentary about the service. People repeatedly told us the care and support they received from staff resulted in positive outcomes for them which had a significant impact on their well-being and recovery. Staff were fully committed to improving the lives of people living at the service and worked with people to achieve their goals and aspirations.

Staff recognised the importance of preventing social isolation and how this could be detrimental to people’s recovery and supported people to engage in meaningful activities and pursue their hobbies and interests. People were supported to maintain relationships with friends and families. Where necessary, this included working with people and families to rebuild their relationships and supporting families to gain a better understanding of their family member’s diagnosis and how their illness impacted on their day to day lives.

The registered manager provided outstanding leadership and had developed a strong and visible person centred culture which was open and inclusive, empowering people to lead fulfilling lives. They demonstrated an on-going commitment to developing an exceptionally skilled and motivated staff team, ensuring people received an excellent standard of care which promoted their recovery. Staff fully embraced the service’s vision and beliefs , felt valued and supported and enjoyed working at the service.

Quality assurance processes were robust. The registered manager expected high standards and attention to detail; this was reflected in the comprehensive systems and processes in place for checking the quality of the service and driving continuous improvement. The service was continuously learning and improving to ensure its sustainability. Management were able to demonstrate how they measured and analysed the care and support provided to people, and how this ensured the service was operating safely, continually improving to meet people’s needs and having a positive impact on people living at the service. Feedback from people, relatives, staff and external stakeholders was encouraged and valued. This was done in a number of ways such as daily interactions with people, through meetings and satisfaction surveys.

People living at the service felt safe and were empowered, as much as they were able, to take responsibility for their own safety. Individual risks

This inspection took place on 5 January 2016.

Clayburn Lodge provides accommodation for up to six people who are living with mental health issues. There were six people living in the service on the day of our inspection, but only four people were available during all or part of our inspection.

There was 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.

Staff had the necessary skills and knowledge to meet people’s assessed needs safely. Staff were well trained and supported. There were sufficient staff who had been recruited safely to ensure that they were fit to work with people.

People told us that they felt safe and comfortable living at Clayburn Lodge. Staff had a good understanding of how to protect people from the risk of harm. They had been trained and had access to guidance and information to support them in maintaining good practice.

Risks to people’s health and safety had been assessed and the service had support plans and risk assessments in place to ensure people were cared for safely. People received their medication as prescribed and there were safe systems in place for receiving, administering and disposing of medicines.

The registered manager and staff had an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) but had not had the need to make any applications.

People were supported to have sufficient amounts of food and drink to meet their needs. People’s care needs had been assessed and catered for. The support plans provided staff with good information about how to meet people’s individual needs, understand their preferences and how to care for them safely. The service monitored people’s healthcare needs and sought advice and guidance from healthcare professionals when needed.

Staff were kind and caring and treated people respectfully. People participated in activities of their own choice that met their needs. Families were made to feel welcome and people were able to receive their visitors at a time of their choosing. Staff ensured that people’s privacy and dignity was maintained at all times.

There were good systems in place to monitor the quality of the service and to deal with any complaints or concerns.

During our inspection we saw that staff were knowledgeable about people’s needs and promoted their independence. During our discussions with staff we found that they had a good understanding and awareness of people’s care needs and preferences. One person who used the service told us, "The staff are helping me to prepare for moving in to supported living accommodation. I can`t praise them enough."

People told us that they had been given the opportunity to visit the service prior to admission. We saw that care plans and risk assessments were regularly reviewed with people who used the service. People who use the service and staff formally review their progress and record the outcomes every three months.

There were policies and procedures, records and monitoring systems in place for the protection of people who used the service from abuse. Staff told us that they had participated in regular training, which had enabled them to gain the skills and knowledge required to recognise signs of abuse and report it.

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 who used the service told us, "The staff always have the time to talk to us."

We spoke with five people at Clayburn Lodge who spoke highly of the service. They told us they liked living there and staff gave them support. One person said, “Staff do anything for you. They’re brilliant.” Another said, “Staff give time to talk.”

A visiting professional told us, that the care at Clayburn Lodge was, “Very client centred.”

We found that people had been involved in care planning and assessments and we found that records were kept securely.

We found systems in place for infection control and maintaining safe and suitable premises.

Staff we talked with told us that they felt supported by their manager.

People living in Clayburn Lodge were very happy with the service they were receiving. They told us that they felt well supported by staff who were skilled and understood their needs.

People had good access to the local community and told us that they made good use of local amenities.

People enjoyed being involved with how the service was run and told us that they helped with the shopping, planning menus, cooking and other aspects of the service such as recruiting staff.

People felt that Clayburn Lodge provided them with a pleasant and safe place to live.

People using the service and those involved with their support were encouraged to give feedback on the home. People told us that any comments they made were listened to.