Constable House 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. Constable House provides long-term accommodation and care for up to six people, across two floors. There were six people living at the home at the time of our visit.

At the last inspection in September 2016 the service was rated Good. At this inspection we found the service remained Good. The evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

A registered manager was not in place at the time of our inspection, however, the provider was taking reasonable steps to address this. 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 continued to be cared for in ways which took their individual safety and risks into account. Staff adapted how they supported people so people could do things which were important to them and to continue to develop their independence, as safely as possible.

Checks were made on the suitability of staff before they were recruited and there were enough staff to care for people. Systems were in place to manage people’s medicines so they received them as prescribed. People benefited from living in a home where steps were taken to reduce the chance of people having infections. Staff reviewed and untoward incidents and were supported to learn from them.

People’s needs and lifestyle choices were taken into account when their care was first planned. Systems were in place to enable staff to obtain input from other organisations and health and social care professionals, so staff would be assured they would meet people’s needs.

People were positive about the skills and knowledge staff used when caring for them. We found staff were provided with opportunities to develop their skills and knowledge they needed to support people living at the home.

Staff supported people to have enough to eat and drink so they would remain well. People told us they enjoyed their meal time experiences, which reflected their choices. Some people took pride in making their own drinks and meals. People told us if they wanted support to attend health appointments this was always provided. By doing this, staff helped to ensure people’s well-being and health was promoted.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

The caring approach of staff was highlighted by people and people chose to involve staff in their daily lives. Staff encouraged people to make their own decisions about the care they wanted and spoke respectfully to the people they supported. People’s right to dignity and privacy was considered in the ways staff cared for them.

Care was offered to people which reflected their individual preferences, aspirations and needs. Staff supported people to make their own decisions about their lives and care. The views of other health and social care professions were listened to, to help to ensure people’s care was planned in the best way for them.

There were systems in place to support people to raise any concerns they had or to make a complaint. Everyone we spoke with told us they had not wanted to make any complaints because the care provided was good.

The provider’s repres

This inspection took place on 29 September 2016 and was unannounced. Constable House provides accommodation for up to six adults who have a learning disability who require a respite service. There were six people who were living at the home on the day of our visit.

There was a registered manager in place at the time of our inspection; however they were not available at the time of our inspection. 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.

We carried out an unannounced comprehensive inspection of this service on 25 November 2015. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to Safeguarding service users from abuse and improper treatment, regulation 13 of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014.

We undertook a further comprehensive inspection on 29 September 2016 to check that they had followed their plan and to confirm that they now met legal requirements. We found at this inspection the provider was now meeting the legal requirement.

People and relatives told us that they did not have any concerns regarding the management of money. We found that written agreements were in place so people were clear about how their money would be managed.

People lived in a safe environment as staff knew how to protect people from harm. Staff recognised signs of abuse and knew how to report this. Risk assessments were in place and staff took appropriate actions to minimise those risks without taking away people’s right to make decisions.

There were sufficient staff on duty to meet people’s needs and keep them safe. Staff worked flexibly to reflect people’s activities and work that were happening that day. People’s medicines were administered and managed in a way that kept people safe.

The provider supported their staff by arranging training in areas that were specific to the people who lived in the home. People received care and support that met their needs and reflected their choice. Staff provided people’s care with their consent and agreement; staff understood the importance of this. We found people were supported to eat a healthy balanced diet and with enough fluids to keep them healthy. People had access to healthcare professionals when they required them.

We saw that people were involved in the planning their care. Where people had expressed their views and decisions they were listened and acted upon. People told us that staff treated them kindly, with dignity and their privacy was respected. People received individual, responsive, care and support that was in line with their preferences which had a positive outcome for people who used the service.

People and relatives knew how to complain and felt comfortable to do this should they feel they needed to. We looked at the providers complaints over the last 10 months and found that no complaints had been received.

People told us the provider was visited the home and ensured people were happy with the service they were receiving. The registered manager demonstrated clear leadership. Staff were supported to carry out their roles and responsibilities effectively, so that people received care and support which was in-line with their needs and wishes.

This inspection took place on 25 November 2015 and was unannounced. Constable House provides accommodation for up to six adults who have a learning disability who require a respite service. There were three people who were living at the home on the day of our visit.

There was a registered manager in place at the time of our inspection. 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.

Prior to our inspection we received concerns about the staff used people's personal money to pay for their meals while they were supporting them with social activities, for example, going for a pub lunch. We reviewed people’s financial records and found some discrepancies in the way people’s money was managed. We found that the provider had not taken appropriate steps to ensure that arrangements made for payment of meals for staff were agreed by those who were able to do so. We raised our findings with the registered manager who was aware that this arrangement happened and told us that it would be stopped immediately. Following our inspection we shared our findings with the local authority.

People told us there were enough staff to help them when they needed them. Staff told us there were enough staff to provide safe care and support to people. The provider did not use agency staff and used their own staff to cover any staff shortages, to support people with continuity of care. People’s medicines were checked and managed in a safe way.

People received care and support that met their needs and preferences. Care and support was provided to people with their consent and agreement. Staff understood and recognised the importance of this. People’s independence was promoted to eat a healthy and balanced diet. We found that people had access to healthcare professionals, such as their doctor when this was required.

People were regularly involved in planning their health and social care. People’s views and decisions they had made about their care were listened and acted upon. People told us that staff treated them kindly, with dignity and their privacy was respected.

People told us they knew how to make a complaint and felt comfortable to do this should they feel they needed to. The provider had not received any complaints over the last 12 months.

People felt listened to by the registered manager. The registered manager demonstrated clear leadership and staff told us they felt supported to carry out their roles and responsibilities effectively.

We found that the checks the registered manager completed focused upon the experiences people received. Where areas for improvement were identified, systems were in place to improve the service.

When we visited Constable House we found that three people used the service and we met and spoke with two of these people. We spoke with one member of staff who delivered care and the registered manager. We read the care records for everyone who used the service. We read all of the staff records.

We found there was a policy concerning people giving their consent to care they received and there were consent documents on people's care records.

We found that staff had a good understanding of the needs of the people who used the service. We found that care and support was planned and delivered in a safe way, in line with people's individual care needs and preferences. One person told us, "They ask us what we want and I have lots of privacy."

We found that people's dietary needs were well met and that people had good choice about what they ate. We found that there was an effective recruitment process in place to ensure that staff had the skills to meet people's needs. We found that the provider worked well with other services to ensure the health and wellbeing of the people who used the service.

People we spoke with were positive about the care they received. People told us that care staff had the right training and that their knowledge and skills were adequate. One person told us that, "There is nothing I am unhappy with." Another person told us that, "They talk to me and help me."

We spoke with three out of the five people who lived at the home. All of the people we spoke with told us that they liked living there. One person said, "The staff look after me, they're nice," and "Staff understand what I need."

People told us that they were able to make choices about things that were important to them. This included making decisions for themselves about what they wore, what they ate and the things they wanted to do. One person told us, "I choose when to get up and what I put on."

During our inspection we saw that staff encouraged people to do as much for themselves as they could manage. This included everyday activities such as making drinks and snacks as well as household chores. One person said, "I sort the washing out on my own. I put it in the machine and I let it spin. I hoover sometimes." Another person said, "It's nice - the staff support me to make cups of tea."

We found that people who lived at the home felt safe and that staff had received training in safeguarding, knew how to raise concerns and felt they would be supported by the provider if they did raise concerns. Staff had also been trained in areas relevant to the specific needs of the people they were providing care for. We looked at care plans for two people living in the home and found that these contained guidance for staff on how to meet their needs.

We also looked at records which showed that the provider was regularly monitoring the quality of its service.

We spoke to all the people who use the service that were available at the time of our visit. People told us about the amount of help they needed from staff to ensure that they were able to undertake their daily personal and recreational care. This corresponded with the information in their care records. One person told us that they needed the staff to give them their medication as they could not manage this. People told us they had a choice of food each day and they told us about some of the hobbies they did and places they went with the staff. They told us they liked watching television, doing crafts at home, watering the garden, shopping, football, playing games, listening to their music, visiting garden centres and going out for a meal.

We found that people who use the service were supported to make decisions and choices about their care and treatment and overall had their privacy and dignity respected at all times.

When we visited the service we spoke with the people who were available about their care. People said that the care was “good”, and that Constable House was “one of the best places he has seen”. People told us they felt “safer here” and “likes being treated well”. They said that the food was “nice”. We spoke to a visitor who told us that they “can’t fault this place”. “This is the best place X (person’s name) has been at”. There is always continuity of staff and the staff “make you feel very welcome”. The home was providing care of a good standard, which took into account people's individual needs and preferences.

People we spoke with told us that they were not able to manage their own medicines and wanted the staff to give them their medication. Their medicines in use were stored securely in a locked cupboard in their individual bedrooms along with their medication administration charts (MAR). We found that there were some shortfalls in the management of medication at the home which may place people at risk of harm.

We spoke with people about the staff who work at the home and they told us they are “kind”, “perfect and “can’t fault them”. A visitor told us the “staff are excellent”.