This inspection took place on 22 and 30 August 2018 and was unannounced.

Community Places 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 home is in Barnsley and provides accommodation for up to 16 people with learning disabilities or mental health needs who require varying levels of care and support. Accommodation is spread over two floors each with its own living space including a kitchen and lounge. The home has 13 bedrooms with en suite facilities. Some of the bedrooms have been converted to provide people with their own private living area and one person had a self-contained apartment. There is also a two-bedroom bungalow.

At the time of our inspection six people were living at Community Places. There were two people using the service for respite care.

The care service has been developed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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 were being recruited safely and there were enough staff to take care of people and to keep the home clean. Staff were receiving appropriate training and they told us the training was good and relevant to their role. Staff were supported by the registered manager and were receiving formal supervision where they could discuss their ongoing development needs.

People who used the service told us staff were helpful, attentive and caring. We saw people were treated with respect and compassion.

Care plans were up to date and detailed what care and support people wanted and needed. Risk assessments were in place and showed what action had been taken to mitigate any risks which had been identified. People felt safe at the home and appropriate referrals were being made to the safeguarding team when this had been necessary.

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 systems in the service supported this practice.

People’s healthcare needs were being met and medicines were being stored and managed safely.

Staff knew about people’s dietary needs and preferences. People told us there was a good choice of meals and said the food was very good. There were plenty of drinks and snacks available for people in between meals.

Activities were on offer to keep people occupied both on a group and individual basis. Visitors were made to feel welcome and could have a meal at the home if they wished.

The home was spacious, well decorated, clean and tidy. All the bedrooms were single occupancy.

The complaints procedure was displayed. Records showed complaints received had been dealt with appropriately.

Everyone spoke highly of the manager who said they were approachable and supportive. The provider had effective systems in place to monitor the quality of care provided and where issues were identified they acted to make improvements.

We found all the fundamental standards were being met. Further information is in the detailed findings below.

This inspection took place on 3 and 10 May 2017 and was unannounced on the first day and announced on the second day. The service was last inspected on 22 September 2015. At that time the service was meeting the regulations.

Community Places is a 16-bed service for people with a learning disability or mental health needs. The home is in a residential area in the village of Great Houghton. The home comprises of 13 bedrooms with en suite facilities. Some of the bedrooms have been converted to provide people with their own private living area and one person had a self-contained apartment. At the time of our inspection eight people were living at the service and eight people were using the service occasionally for respite care. One person lived in a bungalow nearby. The service has a purpose built resource centre with an IT suite and an independent kitchen facility which has been specially designed for teaching.

The service did not have 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. Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

Effective recruitment and selection processes were in place and medicines were managed in a safe way for people.

There were enough staff to provide a good level of interaction. Staff had received an induction, occasional supervision, appraisal and role specific training. This ensured staff had the knowledge and skills to support people who used the service.

People’s mental capacity was not always considered when decisions needed to be made and evidence of best interest processes was not always available. This meant people’s rights were not always protected in line with legislation and guidance. This was a breach of Regulation11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People’s nutritional needs were met and they had access to a range of health professionals to maintain their health and well-being.

Staff were caring and supported people in a way that maintained their dignity and privacy. People were supported to be as independent as possible throughout their daily lives.

Individual needs were assessed and met through the development of detailed personalised care plans and risk assessments. Some people’s annual person centred reviews were being planned to set more long term goals.

People and their representatives were involved in care planning and reviews. People’s needs were reviewed as soon as their situation changed.

People engaged in social activities which were person centred. Care plans illustrated consideration of people’s social life which included measures to protect them from social isolation.

Systems were in place to ensure complaints were encouraged, explored and responded to in good time and people told us staff were always approachable.

People told us the management of the service had been inconsistent in recent times; however, this had now been addressed. The company directors and management team were visible in the service and knew the needs of people who used the service. The culture of the organisation was open and transparent.

People who used the service, their representatives and staff were asked for their views about the service and they were acted on.

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of the people were met but this system had not identified and addressed some of the concerns we found.

Community Places is a 16-bed service for people with a learning disability and/or mental health needs. The home is in a residential area in the village of Great Houghton. The home comprises of 13 bedrooms that have en suite facilities. There is also a self-contained apartment and a two bedroom bungalow that is used to promote personalisation. The service has a purpose built resource centre with IT suite and independent kitchen facility which has been specially designed for teaching independent living skills.

There was a manager at the service who was registered with CQC. 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 and associated Regulations about how the service is run.

Our last inspection at Community Places took place on 12 August 2013. The home was found to be meeting the requirements of the regulations we inspected at that time.

This inspection took place on 22 September 2015 and was unannounced. This meant the people who lived at Community Places and the staff who worked there did not know we were coming. On the day of our inspection there were 11 people living at Community Places.

The registered manager was not present during our inspection visit and the unit manager was in charge of the home.

At this inspection we found that people who used this service were safe. The care staff knew how to identify if a person may be at risk of harm and the action to take if they had concerns about a person’s safety.

There were sufficient staff, with appropriate experience, training and skills to meet people’s needs.

Staff recruitment procedures were thorough and ensured people’s safety was promoted.

We found the home was clean, with no obvious hazards noticeable, such as the unsafe storage of chemicals or fire safety risks.

Systems for managing medicines were safe.

Staff knew the people they were supporting and the choices they had made about their care, support and their lives.

Staff training was up to date. Systems for supporting staff were in place.

People had access to a range of health care professionals to help maintain their health. A varied and nutritious diet was provided to people that took into account dietary needs and preferences so that health was promoted and choices could be respected.

People living at the home said they could speak with staff if they had any worries or concerns and they would be listened to.

We saw people participated in a range of daily activities both in and outside of the home which were meaningful and promoted independence.

There were systems in place to monitor and improve the quality of the service provided. Regular

checks and audits were undertaken to make sure procedures to maintain safe practice were adhered to.

People and their relatives had been asked their opinion of the quality of the service via surveys and by the regular meetings with the managers.

People told us that they were happy living at the home and satisfied with the care and support they received. Their comments included, "It’s OK here, staff are good, spot on,” “It’s good here” and “I’m very happy, I love my house, I like the staff.”

Comments from relatives included,”My son is very happy and content at the home” and "Community Places has helped turn my son’s life around.”

We sat with people in the lounge and resource centre and observed the support offered by staff and saw how staff interacted with people. We saw that staff treated people in a kind, considerate and empathic manner.

During this time we observed that the body language of people was positive and their facial expressions and actions conveyed contentment.

We found that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

We found that people's needs were identified in care plans. Records showed that people had been involved in the care planning process. People told us that they had regular access to healthcare professionals.

We found that medicines were being obtained, recorded, handled, dispensed and disposed of in a safe way.

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed.

The provider had an effective complaints system available. All of the people we spoke with said they had no complaints or concerns about the home.

Eight people were living at the home at the time of this inspection. Some people who live at Community Places have some conditions that mean we had difficulty talking with them. Other people were able to express their views clearly.

Due to people’s communication needs we used different methods of gathering people’s experiences during the site visit. We sat with people in the lounge, observed care practices, and saw how staff and people interacted with each other. Throughout the observation we saw all staff treated people with dignity and respect by using a positive, friendly and kind approach. We observed examples of good communication skills by staff that utilised eye contact and touch to engage people who use services. We also saw that staff were observant and responded quickly when people needed support. Staff responded positively and with empathy when a person became upset.

We spoke with five people. All spoke very highly about the service and the staff working there. One person said "It’s really nice here, I like all the staff, they are lovely.” Another person said “The staff are very good, I’m happy here.”

We spoke with 3 out of the 5 people currently resident at Community Place. They told us that overall they were very happy living at the service and satisfied with the care and support they were receiving.

People’s comments included:

“I’m really happy here”.

“It’s the best place for me, nothing could be better”.

“The staff are very nice”.

One relative commented” Since coming to Community Places my son/daughter has become a person in their own right, we are very happy”.

Throughout our visit we observed staff interactions with people and at all times we found staff empowering in their approach, respectful but informal with people and they were tuned in to people's communication styles and needs.

We saw that staff were very proactive with people in supporting them to access the community. The people we spoke to presented as relaxed and happy in their environment.

Health and social care providers said they were very happy with the care at Community Places. They said the service has improved significantly over the last year and people were living fulfilled lives and were involved in activities at the service and in the community.