This service provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. Cosford House is registered to provide personal care to men with mental health needs. At the time of inspection eight people were receiving personal care.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing 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. We have rated well led as requires improvement. However, the overall rating remains Good.

People told us they felt safe and were happy with the care they received. Staff had knowledge of their responsibilities with regards to safeguarding. Safe recruitment practices were in place to employ suitable staff. Staff understood the importance of good infection control and wore appropriate equipment provided to keep people safe. People were happy with the support they received with their medication.

Staff had completed training to meet people's needs effectively. 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 care needs were assessed and reviewed. Peoples nutritional needs were met.

People were positive about the staff and the care they received. Staff respected people's privacy and dignity and supported people to maintain relationships and their independence. People were involved in deciding how their care was provided.

Care plans were in place and contained detailed information of how people wanted to be supported. People confirmed they had been involved in the development of their care plans. People knew how to raise any concerns or complaints if required.

All staff were positive about the management team and the amount of support they received. At the last inspection we made a recommendation regarding quality monitoring of medication. Although quality assurance procedures had been implemented, further development was still required. We found some areas at inspection that audits had failed to identify. The service did not always seek formal feedback to continue to develop the service. We were unable to see evidence of meetings with staff and people who use the service. Following the inspection, the manager organised for staff meetings and formal supervisions to take place.

Further information is in the detailed findings below.

This inspection of Cosford House took place on 31 March 2016 and was unannounced. At the last inspection on 3 September 2014 the service met the regulations we assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These regulations were superseded on 1 April 2015 by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Cosford House is registered to provide personal care to men with mental health needs. The service has been in operation for more than ten years as a supported people service providing a supportive environment for the men, who all live there as tenants. However, the service registered with the Care Quality Commission in autumn 2013 in order to provide personal care, when necessary, for up to 10 of the people living there. This enables those people to remain as tenants, but receive care and support from the established staff team working at Cosford House. The service is located in the centre of the town of Bridlington; just a few minutes’ walk from the harbour and is provided from a large property that has been divided into two: there is a secure back yard/garden. At the time of this inspection the service was providing personal care to 10 people and 23 people were living at the service.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager that had been registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

During this inspection people told us that they felt safe whilst living at Cosford House. People’s needs were assessed and risk assessments put in place to reduce the risk of avoidable harm. People were protected from the risks of harm or abuse because the registered provider had effective systems in place to manage any safeguarding concerns. Staff were trained in safeguarding adults from abuse and understood their responsibilities for protecting people from the risk of harm.

The premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to evidence this. Staffing numbers were sufficient to meet people’s needs and we saw that staff rotas accurately cross referenced with the people that were on duty. People’s medicines were administered safely by trained staff and the arrangements for ordering, storage and recording were satisfactory.

The registered provider had an effective recruitment and induction programme and provided on-going training to make sure staff had the necessary skills for their roles. Staff told us they felt well supported and understood their roles and responsibilities. They told us they had positive relationships with other healthcare professionals and this enabled them to effectively support people when the need arose. Communication was effective and we found that staff understood the requirements of the Mental Capacity Act 2005 (MCA) and they encouraged people to make their own choices and decisions about daily living.

We assessed that people received compassionate care from kind and considerate staff and that staff knew about people’s needs and preferences. People were supplied with the information they needed at the right time and were involved in all aspects of their care and support.

People’s wellbeing, privacy, dignity and independence were respected by staff and people were supported according to their person-centred care plans, which reflected their needs well and which were regularly reviewed. People had the opportunity to engage in a variety of pastimes and activities if they wished to.

People had opportunities to make their views known through direct discussion with the reg

At our last inspection to the service in May 2014 we issued the provider with two compliance actions. One this occasion two inspectors visited the service to see what action the provider had taken to become compliant with regulations 13 and 20 of the Health and Social Care Act 2008. The information collected by the inspectors helped answer one of our five questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? 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 staff and from looking at records.

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

Is the service safe?

People were treated with respect and dignity by the staff. Improvements had been made to the care and support records kept for each individual. This meant people received appropriate support and person centred care in accordance with their needs.

Staff knew about the risk management plans that had been written for some people with particular needs, which meant these people were kept safe from harm. However, the manager was aware that the development of the risk management plans could be better and work was on-going to ensure this improved.

People were protected against the risk associated with the use and management of medicines. They received their medicines when they needed them and in a safe way. Medicines were recorded appropriately and stored safely.

Is the service effective?

Not applicable.

Is the service caring?

Not applicable.

Is the service responsive?

Not applicable.

Is the service well-led?

Not applicable.

This was the first inspection carried out by the Care Quality Commission (CQC), since the service registered with CQC in autumn 2013. 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, 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?

People were safe because staff recognised and respected people’s rights and dignity needs.

People were kept safe because staff recognised and understood people’s behaviours and took prompt action to manage distressed behaviours appropriately.

People were kept safe because the service followed robust recruitment practices.

The arrangements in place to manage medication were not robust. We told the provider to take action to improve this area of care.

Is the service effective?

People were involved in the assessments of their needs however, records did not evidence this process well.

Staff were knowledgeable about people’s personal care needs and how they were to be met.

Staff were alert to changes in people’s behaviours that may indicate their health needs had changed and that specialist support was required. One mental health professional told us “We have absolutely no concerns about the way people’s mental health care needs are managed at Cosford House.”

Is the service caring?

People told us they were treated well, and the staff were kind and helpful. They commented “The staff are absolutely brilliant” and “It’s very nice here. The staff know what they’re doing.”

Staff knew all about the people they were supporting and they interacted with people in a caring way.

People were treated in a respectful way and their views and opinions were listened to and acknowledged.

Is the service responsive?

People and staff were encouraged to provide their views and opinions about the service. People were given the time they needed to make decisions about the support they received.

Independent advocates were used, when necessary to provide independent advice and support to individuals.

Is the service well-led?

The owners were in day to day charge of the service so were informally monitoring staff behaviours and attitudes.

Staff were motivated, caring, well trained and supported, and had a common aim of promoting people’s independence and life skills.

Whilst we saw good leadership, the provider needed to familiarise themselves more with the standards of care, by which they were regulated against. Some records describing the care delivered were not available to look at. We told the provider to take action to improve this area of care.