This inspection was unannounced and took place on 11 October 2016.

Danemere is registered to provide accommodation and personal care for one adult with an acquired brain injury and associated learning disability.

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.

Relatives were happy with the support arrangements provided. They told us their family member was safe and treated with respect. The person was cared for by an established, motivated and well trained staff team.

The person had their needs assessed and received care and support in accordance with their needs and wishes. They said they were able to make choices about their day to day life and were involved in decisions about their care and support.

There were procedures in place to help keep the person safe. These included a robust recruitment process and training for all staff to make sure they were able to work with vulnerable people and recognise and report any suspicions of abuse. The person told us they felt safe at the home.

New members of staff received an induction which included shadowing experienced staff before working independently. One member of staff said, “It was not just a case of shadowing a more experienced member of staff and then you got on with it. It was a case of shadowing a member of staff and then being shadowed to ensure we were competent”.

Staff received training to understand their role and to ensure the care and support provided to the person was person centred, meeting their individual needs. Staff received supervision and appraisals and told us they felt supported by the registered manager.

Staff monitored the person’s health and sought advice from healthcare professionals to meet their specific needs. The person had access to equipment to assist them to maintain their independence and ensure their comfort. The person was supported by a consistent staff team in a relaxed and unhurried manner.

The care plan provided information about how the person wished to be cared for and staff were aware of the person’s individual care needs. The person was able to take part in activities both at the home and in the local community. The home had access to a vehicle which enabled the person to get out and about on a regular basis.

Risks were assessed and appropriate control measures implemented in areas such as travelling, preparing meals, and having a presence in the community as well as relevant environmental risk assessments being carried out within the home.

Systems were in place to ensure the person received their medicines safely. All staff had received medicine administration training and had been assessed as competent before they were allowed to administer medicines.

Staff we spoke with demonstrated a good understanding of the legal processes that protect people’s legal and human rights including decision making and consent .

As much as possible the person using the service was supported to make choices and decisions about daily life. Opportunities were taken to consult with them. Staff communicated in a respect manner, giving the person time to make choices and decisions. When the person had made their decision this was seen to be respected.

The service sought the views of the person and their relatives as appropriate to gauge their satisfaction and used the information to make improvements to the service. The registered manager and provider had systems in place to monitor the quality of the service.

At the time of our inspection we saw that the home was clean and well maintained and that the environment was personalised to the needs and wishes of the person who used the service. We observed care workers interacting with the person who lived at the home in a relaxed, friendly and professional manner.

As much as possible the person using the service was supported to make choices and decisions about daily life and we saw that opportunities were taken to consult with them. We saw that staff communicated well with the person's relatives and took care to ensure that the person's likes, dislikes and preferences were incorporated into the care planned.

During our visit we spoke to three staff members including the registered manager, the person using the service and a relative. The relative told us "I am very happy with the quality of care. Staff go way over and above what they need to." The person using the service told us "I am very happy here."

We saw that the provider had effective systems in place to ensure the safety and welfare of the person using the service both in the home and on visits out in the community and we were told by staff that they felt supported to deliver care effectively. One staff member told us "It's a great team and the support is good."

Care workers had formed close professional relationships with the person using the service. The premises were clean and well maintained and the atmosphere was relaxed and homely.

As far as practicable, the individual was enabled and supported to make choices about their daily life. Consultation was used at every opportunity to promote choice and autonomy.

The person who used the service was safe and was protected from the risk of abuse,

We found that that there was sufficient care workers on duty at all times to meet the assessed support needs of the person using the service.

Care workers had developed awareness and a sound understanding of the individual's support needs. This was evident from direct observation of the person using the service being supported in a professional, sensitive and respectful manner.

The provider had effective systems in place to identify, assess and manage risks to the health, safety and welfare of the person using the service and others.

Positive comments received from the person using the service and their relatives indicated a high level of satisfaction with the care provided:

“I like living here and am very happy. The staff know me very well and I have everything I need”.

“I’m very, very happy with the home and the care that my daughter receives. I have total confidence and trust in the manager and have so much faith in her and the other staff, who have all got their own qualities and different skills to offer”.

Observation confirmed that consultation was used at every opportunity to promote choice and autonomy.

The person using the service said that they were happy with all the care and support provided to them and that they liked where they lived.