The inspection took place on 26 November 2015 and was unannounced. At the last inspection in May 2014 we found that the home was meeting the regulations that we checked.

Creative Support - Robert Heath Street is registered to provide accommodation and personal care for up to 10 people who have mental health needs. The service is split into five bungalows and five flats with a shared lounge, kitchen and dining room. At the time of our inspection there were 10 people using the service.

There was a registered manager but they were no longer working at the service 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.

People felt safe and systems were in place to ensure that people were protected from avoidable harm and abuse. Staff understood different types of abuse and how to recognise signs of abuse. They were aware of the safeguarding adult’s procedures and how to report concerns so that people were protected.

There were sufficient numbers of staff to deliver safe care and support people who used the service. We saw that people were supported to attend appointments and access the community. People’s risks were assessed and plans were in place to minimise risks. Medicines were managed to ensure that people received them safely.

Staff had the knowledge and skills to ensure they could support people effectively. The principles of the Mental Capacity Act 2005 were being followed to make sure that people’s rights were respected.

People’s health needs were met and they were supported to have regular contact with health professionals when needed. People had enough to eat and drink and were offered choice and flexibility about their food and drinks.

People were treated with kindness and compassion by staff who knew their preferences and goals. People were encouraged to be involved in making decisions about their care and support and staff communicated effectively with each individual.

People’s privacy and dignity was respected and they were encouraged to be as independent as possible and participate in the local community.

People received personalised care and were enabled to follow their hobbies and interests. Staff were proactive in supporting people to be involved in work and learning opportunities if they chose to be.

People knew how to complain and there was an accessible complaints procedure available that people knew about. People were encouraged to give their views at regular residents meetings .

Quality monitoring systems were not always effective in driving continuous improvement. Staff felt they were receiving more support following changes in the management arrangements at the home and were aware of procedures in place to raise concerns.

This was an unannounced scheduled inspection, this meant the provider did not know we were coming. As part of the inspection we also looked at the progress the home had made in meeting the concerns we had raised, in respect of care records at our previous inspection. During the inspection we spoke with people who used the service, members of staff and the registered manager.

We considered our inspection findings to answer the questions we always ask;

Is the service safe?

People who used the service had their needs assessed and risk assessments had been completed to reduce any risks to peoples health and well-being.

There were evacuation and missing person procedures in place to protect people in an emergency.

Staff had received training and were aware of their responsibilities for safeguarding vulnerable people.

Behaviour that challenged was managed to prevent harm to people who used the service.

The environment was monitored to ensure it remained safe for the people living at the service.

Is the service effective?

People’s health and social care needs were assessed and plans were in place to provide the support they required.

People were encouraged to be involved in their care by completing a mental health tool to measure their current mental health and identify ways that could improve it.

Is the service caring?

The staff knew people well and the people who used the service looked relaxed and comfortable in the company of staff. We observed positive interactions between the people who used the service and staff. Staff were patient with people and encouraged them, with support, to take responsibility for their daily living tasks. One person told us, “I’m happy living here”.

Is the service responsive?

The home had a complaints procedure. People we spoke with said they would tell the staff if they were worried about anything.

An activity programme had been introduced to encourage people to enjoy time together as a community.

People living in the home had the opportunity to share their opinions with staff at residents meetings.

Is the service well led?

The registered manager had made changes to the care recording to ensure there was clear, comprehensive and detailed information to support staff in caring for people in a holistic way.

Systems were in place to monitor and audit the services including the quality of care records and maintaining a safe environment.

Staff were being supported through individual supervision which gave them the opportunity to discuss the care they provided and their own personal development.

One member of staff told us, “I feel very well supported working here”.

During our inspection we spoke with four people living at the home. Everyone we spoke with told us they were happy with the support they received from staff. One person said, " I love it here. I find it a very relaxing place to be". A relative we spoke with after our inspection said, "X has improved so much since they've been living here".

We saw that the manager had made some changes to encourage people to become more independent. This had been discussed with people so they were actively involved in the decision.

The way in which staff structured their working day had been changed to ensure individual responsibilities were identified.

We looked at four care records and saw that these had not been completed fully or regularly which could affect people's care.

We carried out this review to check on the care and welfare of people using this service. Five people each live in their own bungalow needing a low level of support and five have en-suite bedrooms in the main building, needing higher levels of support.

We arrived at breakfast time, some people had prepared their own breakfast in their bungalow other were assisted to prepare breakfast in the main building.

People told us they were looking forward to a coach trip to Leeds for Christmas shopping the following day, preparing for that by later drawing cash from the bank and discussing arrangements with staff.

One person told us that they went out each day, had many friends in the neighbourhood and needed little support from staff saying, “I please myself what I do, I have many friends and go out every day.”

Another person said, “My boyfriend visits me every day in my bungalow. He is coming at Christmas and we are cooking a Christmas meal.” This person said “I have been living here for about 12 months, I like living here staff are very friendly and help me.”

Staff were seen to be supportive to people, allowing them to make choices and assisting or prompting where appropriate, they listened to people and responded in a positive way.

During our inspection, we talked with three people living at the home. They were all very positive about the care and support provided. One person told us, “I do what I want, when I want and if staff want me to do something, we talk about it and I decide what I want to do.” Another person told us, "I am happy. I do not need anything to change. "

We also spoke with three members of staff and the manager. All the staff we spoke with had a good understanding of the types of abuse people living in the home could be at risk from. People told us that they felt safe living at the home. One person told us, “I really do not want to leave here. Why would I? I am settled and happy.”

There were effective recruitment and selection processes in place. All the necessary checks had been completed to ensure that staff working in the home were suitable to work with vulnerable people.

The planning and delivery of people's care and support ensured that clear and detailed information on people's needs and the support required was available. People’s general wellbeing was managed closely by staff and action taken to support them to stay healthy and well. Not everyone living at the home had a written health action plan in place to reflect the day to day support and monitoring that we found was taking place.