The inspection took place on 6 and 17 October 2016 and was unannounced.

Coveham provides residential care for up to ten people with learning disabilities. An outreach service supporting people living in supported living accommodation also operates from the same site. At the time of the inspection there were six people living at Coveham and one person within supported living who required support with personal care.

The home had 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 were protected from the risk of harm as systems were in place to keep them safe. Risk assessments were completed which identified control measures to mitigate the risks of harm. Accidents and incidents were monitored and action taken to keep people safe where trends were identified. Staff had a clear understanding of how to safeguard people and knew what steps they should take if they suspected abuse.

Equipment was regularly checked and there were plans to keep people safe during significant

events such as a fire. Evacuation plans had been written for each person, to help support them safely in the event of an emergency.

Medicines were managed well and records showed that people received their medicines in accordance with prescription guidance. People were supported to maintain good health and had regular access to a range of healthcare professionals. People were supported to have a nutritious diet and were able to make choices regarding what they had to eat and drink.

There were sufficient staff deployed in the service and staff worked flexibly to meet people’s needs. Prior to starting work at the service recruitment checks were completed to help ensure only suitable staff were employed. All new staff completed an induction to enable them to learn about the service and people’s needs. Training was provided which staff told us gave them confidence in their role. Regular supervision was provided to staff to monitor their performance and staff appraisals were completed annually.

People’s legal rights were protected as the service acted in accordance with the Mental Capacity Act 2005. Capacity assessments were completed and where best interest decisions were made relevant people were involved in the decision.

People were supported by staff who showed kindness and compassion. Their dignity and privacy was respected by staff and people were able to choose where they spent their time. Staff had a good understanding of people’s communication needs and supported people to make decisions about their care. People were supported to develop and maintain their independent living skills and were involved in decisions regarding the running of the service.

Each person had an individualised support plan in place which detailed their needs and preferences. Staff were knowledgeable about people’s needs and we observed people’s likes and dislikes were respected. A range of activities were available both within the service and in the local community. People were supported to maintain relationships with people who were important to them.

Feedback on the quality of the service provided was obtained from people and their relatives. Annual surveys showed a high level of satisfaction and any concerns were addressed promptly. A complaints policy was in place and displayed in an easy read format. People told us they knew how to make a complaint and were confident their concerns would be addressed.

Relatives and staff told us they felt the service was well-led and that the registered manager was approachable. Regular audits of the service were completed to monitor the quality of the service provided. Action was taken to address any concerns identified.

During our inspection we set out to answer five questions: Is the service caring? Is the service responsive? 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 who used the service, the staff supporting them and from looking at records.

For further evidence supporting our summary please read the full report.

Is the service safe?

We saw that people were treated with respect and in a dignified way by staff. We saw that safeguarding procedures were in place and staff understood their responsibilities in safeguarding the people that they cared for.

The service was clean, hygienic and safe, providing safe access to all areas of the home.

We looked at staff training arrangements that were in place and saw and that staff were provided with the appropriate training to ensure safe and appropriate care was being provided.

We saw that systems were in place to record, report and monitor incidents and complaints. There were policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards, although no applications had needed to be submitted. This ensured that people were protected from the risk of unlawful restraint.

Is the service effective?

People`s health care needs were assessed as required and people and their families were included as part of that process. Arrangements were in place for people to have support from other health care professionals. People`s health care needs were assessed with them.

Is the service caring?

We saw that people were supported by kind and caring staff who spoke to people in a polite and respectful manner. People commented." I like it here, I also like going out with the staff"

Staff were able to tell us about the people that they supported. They knew people's individual histories and support needs without having to refer to the care records. Staff were seen to take time to talk and listen to what people said, and they encouraged people to be independent by encouraging them to complete tasks such as making cups of tea.

People`s preferences, interests, and diverse needs had been acknowledged and recorded in the care records and support provided to meet these needs and interests. Family links were maintained and the people that used the service had access to email and other online technology to support them to keep in contact with their family members.

Is the service responsive?

We saw that people were involved in a variety of activities in and outside the service. People had access to the community and could participate in activities that they chose. People were involved in choosing the weekly menu and the shopping and could vote to have some take away food on a particular day if they wished.

Where additional care needs have been identified provision is made for other professionals to become involved, such as speech and language therapists and dieticians.

Is the service well led?

The manager had a good understanding and knowledge of the needs of the people that used the service, as well as the management requirements of the home. Staff told us that they were clear about their roles and responsibilities, and they had a good understanding of the values of the home and the organisation that they worked for.

Care records were updated regularly to monitor the service that people were receiving. This helped to ensure that people received a good quality service at all times.

People said "l like it here". Staff were caring and very supportive and knowledgeable of people`s need and expectations.

You can see our Judgement on the front of the report.

During our inspection we spoke with five people who used the service, one care manager, a health care professional, two members of staff, the assistant manager and the registered manager.

People who used the service told us they were happy living at the service. People told us they had a care plan, but they know them as their ‘files.’ One person told us, “I look at my file with my key worker every month.”

People told us they made decisions for themselves but staff would help them if they found things difficult to understand. One person told us, “I can go for walks when I want to.” People were complimentary about the staff who looked after them.

People told us that the food was always good and they chose the menu. One person told us, “I like to have a brunch at the weekends.” Another person told us, “We choose what food we want.”

People were aware of what their medication was for. They told us that they always received their medicines on time.

We found the service was compliant with the seven outcomes we looked at.

During our inspection we spoke to four people who used the service, two of whom were able to provide responses to our questions. One person was the main responder to our questions but they did seek the views of the other three people who were present at the time. People who used the service told us that they made choices every day. They told us that they chose the activities they wanted to do and how they wanted to spend their days. One person told us, “Oh yeah, we choose to go on the bus and to go shopping. I like to watch the television and have my own baths.” Another person told us, “I like going on trips, discos and to the pictures.” People told us that staff treated them with respect. They told us that staff knocked on the bedroom doors and waited for them to answer. They told us that they were happy living at the home. They said they “Would tell their key worker if any one had treated them badly.” One person told us, “I have never been mistreated by staff.” People told us that they had a care plan and they had seen them. One person told us, “We discuss our care plans every month with our key worker.”

We saw care plans for people who used the service, however, we noted that one had not been updated to included changes to a person’s healthcare needs. Records of incidents were maintained at the service but they had failed to notify the Care Quality Commission of incidents as required in the Health and Social Care Regulations.