We inspected this service on 24 November 2016 and it was announced. This meant the provider and staff knew we would be visiting the service before we arrived. At our last inspection in May 2014 there were no breaches in the regulations we looked at.

The service was registered to provide accommodation for up to eight people. A total of 43 people used the service at varying times of the year. There were five people using the service at the time of this inspection.

The service had 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.

Staff understood what constituted abuse or poor practice and systems and processes were in place to protect people from the risk of harm. People were protected against the risk of abuse, as checks were made to confirm staff were of good character and suitable to work in a care environment. We saw there was sufficient staff available to support people and they were supported to take their medicine as prescribed. Following assessment’s equipment was in place to meet people’s diverse needs which enabled them to maintain choice and independence.

People received support from staff that were trained. Staff received support and supervision, to monitor their performance and develop their skills. Staff knew about people’s individual capacity to make decisions and understood how to support people to make their own decisions. When people were unable to consent mental capacity assessment and best interest decisions had been completed.

People were treated with respect and supported to maintain their dignity. The staff worked in partnership with people when supporting them. Staff knew people’s likes and dislikes and support records reflected how people wanted to be supported and how care was provided.

The staff team actively sought and included people and their representatives in the planning of care. There were processes in place for people to raise any complaints and express their views and opinions about the service provided. There were systems in place to monitor the quality of the service to enable the registered manager and provider to drive improvement.

As part of our inspection we spoke with three people receiving care, the registered manager and staff working at the service. We also observed people receiving care and examined records relating to the service.

Below is a summary of what we found.

Is the service safe?

The premises were clean, well maintained and accessible for physically disabled people. We saw appropriate security measures were in place to protect people using the service. Procedures were also in place for responding to foreseeable emergencies to reduce the risks to people receiving care. We found other systems were in also place to reduce risks, for example for the safe storage and use of hazardous substances such as cleaning products and medication. The registered manager was aware of how to recognise if people were at risk of being deprived of their liberty and what action to take if this was the case. Equipment provided to ensure people were comfortable and safe was in good working order and we saw records showing regular safety checks were completed.

Is the service effective?

People’s needs were being met at the service. We found people's needs were assessed and care files included detailed information about how they received their care. Records included information about any diagnosed health conditions and disabilities. Risks that could affect people had been adequately assessed and guidance produced for staff as part of the care planning process. This meant that care planning protected people's welfare and safety. Consent was obtained for people's care and appropriate arrangements were in place if people could not consent for themselves, for example due to their learning disability.

Is the service caring?

People told us they were happy with the care they received at the service. One person said, "I love it here. I get to cook, just like a chef.” We observed staff providing people’s care were positive and encouraging in their approach. We saw they offered people options and ensured they were happy with their activities and day to day care.

Is the service responsive?

People’s preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. We found people were asked for their views about the care delivered at the service. People receiving care told us they knew how to raise concerns or complaints and that these were responded to by the registered manager. The provider had taken steps to ensure the premises were suitable for peoples' needs, for example people who had a visual impairment, dementia or an autistic spectrum disorder.

Is the service well-led?

The registered manager completed regular checks and audits of all aspects of safety and care at the home. Records showed checks of incidents, accidents and complaints were completed by the registered manager or delegated to staff. Other quality audits were completed regularly to ensure the service was safe. People involved with the service completed satisfaction surveys and records showed action was taken where any improvements were required. Professional advice was sought and used to provide people with safe, appropriate care, for example from external health professionals.

People we spoke with told us that East Fields provided high quality care that met people’s needs. One person's relative said, "The staff are great. Very experienced and trustworthy.” All of the families of people receiving care said their relatives spoke about East Fields very positively and always looked forward to staying there.

We found care was planned and delivered effectively by the provider. People's needs were assessed and staff had access to detailed care plans and risk assessments to enable them to deliver safe and appropriate care.

We examined records and spoke with staff and relatives of people receiving care and found sufficient numbers of experienced and skilled staff were provided to support people safely.

Although no-one we spoke with had needed to make a complaint, we found the provider had appropriate procedures in place for dealing with people’s concerns or complaints.

We found that appropriate procedures were not in place for obtaining consent where people were unable to make decisions about their care.

People we spoke with were happy with the service. One family member told us that they felt people were safe at East Fields. Another person told us “Staff are well trained and care really about people”. We found that the service had appropriate systems to ensure that people received safe, individualised care and support.