This was an announced inspection carried out on 26 October 2016.

Coopers Mill can provide accommodation and personal care for 20 people who have a learning disability, who have sensory needs or who are younger adults. There were 20 people living in the service at the time of our inspection all of whom had a learning disability. The accommodation is a courtyard development where there is a main house and a separate wing where there are a number of self-contained flats.

The service was owned and operated by a company. It was owned by two directors both of whom were involved in the day to day running of the service. One of the directors was the registered manager and the other was the head of care. 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

At our inspection on 20/21 November 2015 there were four breaches of legal requirements. We found that some people had not always received all the assistance they needed to reduce the risk of experiencing harm as a result of having accidents. We also found that some people had not been consistently supported to eat and drink enough. In addition, we found that people had not always received support that fully respected their legal rights and that quality checks had not been robust. After the inspection the registered persons wrote to us to say what actions they intended to take to address the problems in question. They said that all of the necessary improvements would be completed by 21 January 2016. At the present inspection we found that the necessary improvements had been made and that the four legal requirements had been met.

At the present inspection we also found that staff knew how to respond to any concerns that might arise so that people were kept safe from abuse, including financial mistreatment. There were reliable arrangements for managing medicines, enough staff on duty to provide people with the support they needed and background checks had been completed before new staff were appointed.

Staff had been provided with support and guidance and they knew how to support people in the right way. People enjoyed their meals and staff had supported them to obtain all of the healthcare assistance they needed.

Staff had ensured that people’s rights were respected by helping them to make decisions for themselves. The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered manager had taken the necessary steps to ensure that people only received lawful care that respected their rights.

People were treated with kindness and compassion. Staff recognised people's right to privacy, promoted their dignity and there was provision for confidential information to be kept private.

People had been gently encouraged to be as independent as possible. In addition, they had also received all of the practical assistance they needed. When people became distressed they had received individual support and reassurance. People had been encouraged to pursue their hobbies and interests and there was a system for resolving complaints.

People had been invited to suggest improvements to their home. The service was run in an open and inclusive way, good team work was promoted and staff were supported to speak out if they had any concerns. People had benefited f

People said that they liked living at Coopers Mill. This was because they were provided with opportunities to engage in a range of recreational, social and work-related activities. They were also provided with support and were encouraged to maintain and promote their mental and physical health and wellbeing.

People’s health was protected from inadequate amounts of food and drink and they were encouraged and supported to eat a healthy diet. People who used the service could eat where and when they wanted, including eating when they were out of the home.

There were effective communication systems in place to support people to access a range of health and social care agencies. This was so that people’s health and social support and care needs were safely and appropriately met.

There were infection control and cleaning systems in place to ensure that people lived in a safe and comfortable home. The home was clean and smelled fresh.

Members of staff were supervised and trained to safely do their job, which they said they had found rewarding. People who used the service had confidence in the members of staff’s abilities and said that they liked the staff.

A number of records that we saw were kept up-to-date and held securely. This demonstrated that people who used the service received safe and appropriate support and care. The records also demonstrated that Coopers Mill was a safe place to live, work or visit.

People who used the service were treated with respect and their privacy and dignity were valued.

People who used the service had the right level of information to make a decision about their support and care, including information about their health care treatments.

People enjoyed living at the home. This was because they were given choices of how they wished to live and were actively asked for their views about their support and care. People also told us that they were looked after by a, “Good team of staff”.

People’s standard of health and welfare was maintained. Staff had access to detailed care records to ensure that they provided people with safe, appropriate and individual support and care.

Arrangements were in place to ensure that equipment accessed by people who used the service was safe to use.

There were selection and recruitment systems in place to ensure vulnerable people were protected from the risk of harm from unsuitable staff. People who used the service were also actively involved in the recruitment and selection procedure.

There was an effective complaints system in place to ensure that people had no reservation in making their concerns or complaints known.

During our visit we spoke with five people who use the service and a staff member helped us communicate with two people who used BSL, British Sign Language.

People told us that they were happy with the service. They also told us that their care workers were, “Very good”. They stated that staff knew BSL, British Sign Language and used it to communicate with some people who were deaf. Two people who use the service also used BSL to communicate amongst themselves. One person stated: “I teach staff BSL spelling and help them practice it, as I also can lip read very well.”

People stated that there were enough staff on duty for each shift, days and nights. We saw one person following a staff member and getting attention when they wanted it.

People told us that they felt safe and protected. Both people who use BSL told us that staff interpreted for them when they were going out from the home.

People told us that they were happy for staff to keep their money and help them with financing. One person explained that they themselves would, “Waste my money and buy things I don’t need, but staff help me.”

Six people told us that they felt respected and one person stated that they were, “sometimes”, respected and that staff “sometimes” helped them. In further conversation they explained that they felt that the home was “marvellous”, that there were enough staff on duty all the time, that staff fully met their personal care needs, but that social support could be better. They added that they could go out whenever they want, except when they had to do “House chores, then staff would not let me go before I finish my chores.”

People confirmed that they knew their care plans and were actively involved when their goals were set.

This was an unannounced inspection carried out on 20 and 21 November 2015.

Coopers Mill provides accommodation for up to 20 people some whom have a learning disability. There were 20 people living in the service at the time 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.

At this inspection we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The first breach referred to the provision that was in place to reduce the risk of people being harmed when they had accidents. The second breach referred to the provision that had been made to support people to eat and drink enough. The arrangements were not robust or reliable. The third breach referred to the arrangements that were in place to protect people’s legal rights when it was likely to be necessary to deprive them of their liberty. Steps had not been taken to seek the necessary permissions to act in this way. The fourth breach referred to the way in which quality checks had been completed. They were not rigorous or effective and this had resulted in a number of shortfalls not being quickly identified and resolved. These breaches had increased the risk that people would not always safely and responsively receive all of the care they needed. You can see what action we told the registered persons to take in relation to each of these breaches of the regulations at the back of the full version of this report.

Although staff knew how to recognise if people were at risk of harm some of them did not know which agencies to contact outside of the service in order to raise a concern. The registered persons had not informed the necessary external agencies about an incident that could have put people at risk of harm. As a result the external agencies had not been able to check that people were safe. In addition, the arrangements to protect people from the risk of financial abuse were not robust. Although medicines had been correctly dispensed some of the records staff needed to complete to manage this process were not accurate. There were enough staff on duty and background checks on new staff had been completed.

Staff had not received all of the support they needed and did not have all of the skills that were necessary for them to reliably assist people in the right way. This included caring for people so that they had enough nutrition and hydration. However, staff recognised when people were unwell and had arranged for them to receive a range of healthcare services. In addition, staff had helped to ensure that people’s rights were respected by supporting them to make decisions for themselves.

Although arrangements had not been made for one person to make their bedroom a comfortable and welcoming space, most people had been supported to personalise their bedrooms. People were treated with kindness and compassion. Staff recognised people’s right to privacy and they respected confidential information.

People had been consulted about the care they wanted to receive. In addition, they had been supported to pursue their hobbies and interests and to express their individuality. There was a system for resolving complaints.

People had been involved in the development of the service and they had benefited from staff acting upon good practice guidance. The service was run in an open and inclusive way so that there was good team-work which encouraged staff to raise any concerns they had.