The inspection took place on 7 and 9 March 2016 and was unannounced. We last inspected the service in May 2014 and found it was complaint with all the regulations we looked at.

The service is registered to provide care for up to eight people with a learning disability or an acquired brain injury. Seven people were living there when we visited. There is 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. The registered manager was not available on the first day of our visit and so we returned on a second day to speak with them.

There were systems for making sure that staff reported any allegation or suspicion of poor practice and staff were aware of the possible signs and symptoms of abuse.

There were sufficient numbers of staff to meet people’s needs. We saw that pre-employment checks had been carried out for staff. These checks are important and ensure as far as possible that only people with the appropriate skills, experience and character are employed.

There were some improvements were needed to the systems of administering medication but we saw that this was usually done safely and that some recent improvements had been implemented.

Staff were appropriately trained and skilled to provide care and support to people. The staff had completed most of the relevant training to make sure that the care provided to people was safe and effective to meet their needs. The registered manager and staff we spoke with understood the principles of protecting the legal and civil rights of people using the service. We did not find anyone being unlawfully deprived of their liberty.

People’s nutritional and dietary needs were assessed and people were supported to eat and drink sufficient amounts to maintain their health. People had access to healthcare professionals when this was required. Most staff were aware of people's needs arising from their medical conditions.

Staff showed kindness and compassion to people who used the service. People told us that staff treated them with dignity and respect. Care had been planned around each person’s individual needs. Staff were able to describe how people preferred to be supported and told us how they worked with people to find out what they liked and didn’t like.

People knew how to raise complaints and the provider had arrangements in place so that people were listened to and action could be taken to make any necessary improvements.

The registered manager encouraged feedback from people who used the service and their family members, which she used to make improvements to the service, where needed. Systems to monitor and improve the quality of the service were in place and actions were in progress to improve the service people received.

On the day of our inspection we talked with the manager and looked in detail at the records for three people. We observed how people were being cared for and talked with three people who lived there. We visited on a weekday and people were at home for us to talk with. We talked with three staff members and one health professional. We also spoke with two relatives. One relative commented, “I think they do a wonderful job, X is definitely well cared for.” The manager told us that there was one deputy manager and 14 care staff who also took turns to help people cook and clean. There were seven residents on the day of our visit.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask.

This is a summary of what we found;

Is the service safe?

We saw that people had been cared for in an environment that was safe and appeared clean. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies. People told us they felt safe. Safeguarding procedures were robust and staff understood their role in safeguarding the people they supported.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been made in accordance with these safeguards, proper policies and procedures were in place, and the manager understood their responsibilities in relation to the law.

There were policies and procedures in place to make sure that unsafe practice would be identified and people would be protected. The staff and manager had a good understanding of whistle blowing policy.

Is the service effective?

It was clear from our observations and from speaking with staff that they had a good understanding of people’s care and support needs and that they knew them well. People told us that they were happy with the care that had been delivered and their needs had been met. Some people had certain dietary needs that staff supported them with, enabling people to make informed choices. This included taking people to the shops and supporting them to buy food of their choice.

We found that the home placed the needs of people at the centre of all the support provided. All staff were aware of peoples choices, preferences and support needs. Care plans had been written to reflect this. One staff member told us “I’ve done loads of training; I get good support from the seniors.”

Is the service caring?

We saw that people were supported by kind and attentive staff. We saw that the staff and manager showed patience and gave encouragement when supporting people. One staff member told us, “We’re very client centred here, the clients go out a lot, we’ve got a lovely home here.” We observed that when one person became upset and anxious that they were supported by two staff in an appropriate and caring way.

Is the service responsive?

People’s needs had been assessed before they moved into the home. People told us they had a lot of one to one time with the staff. People had access to activities that were important to them. We observed one person enjoying gardening in the grounds of the home and another person told us that a new shed was being bought to enable them to continue with their wood work. The person showed us the woodwork they had completed. One person told us, “If I’ve got any problems I just tell the staff and it’s fine.”

Is the service well-led?

Staff told us they were clear about their roles and responsibilities. The service worked well with other agencies and services to make sure people received their care safely and effectively. A visiting professional said, “Staff seem to be pretty on the ball, they are involved and know what’s going on. There’s always enough staff here.”

At our inspection in June 2012, we identified minor concerns in the area of record keeping that still had not been fully addressed at our last inspection in September 2012. However, at this inspection we found that the files we looked at had been reviewed and updated to cater for the changing needs of people.

We spoke to three people, four staff and one social worker. We found that the service was well-led and staff were knowledgeable about the people who used the service and were responsive to their needs. This meant that people were cared for in an appropriate manner and their changing needs were taken into account. There were sufficient staff to meet the needs of people in a timely way. One staff member told us that: "Management is good, approachable and effective."

We observed good interactions between staff and people living at the home. This showed that people were at ease with the staff caring for them. One of the people we talked to told us that: "Staff are caring" and "I feel comfortable talking to staff about anything."

People living at the property had regular reviews with multidisciplinary teams and their relatives to ensure their health and wellbeing was monitored. This allowed the home to pick up any changes in people’s views about their care. One person told us: “The staff really let me get involved in the decisions about my care."

We inspected Evergreen on June 13 2012, and we identified minor concerns in the area of record keeping. We reported these concerns in our review of compliance, and we received an action plan from the registered provider informing us of the action they would take. They informed us this work would be complete within 30 days. We returned to the home on September 6 2012. We found that some progress had been made to improve the quality of records but the concerns had not been fully addressed.

We did not speak with people who live at Evergreen about record keeping at this inspection. We did however meet three people who live at the home. People told us about their morning activities, and later we spoke with people and they told us they were enjoying the lunch time meal.

We inspected Evergreen on June 13 2012, and we identified minor concerns in the area of record keeping. We reported these concerns in our review of compliance, and we received an action plan from the registered provider informing us of the action they would take. They informed us this work would be complete within 30 days. We returned to the home on September 6 2012. We found that some progress had been made to improve the quality of records but the concerns had not been fully addressed.

We did not speak with people who live at Evergreen about record keeping at this inspection. We did however meet three people who live at the home. People told us about their morning activities, and later we spoke with people and they told us they were enjoying the lunch time meal.

We used a number of different methods to help us understand the experiences of people using the service. Three people were able to speak with us, and share their experiences directly. Three people using the service had more complex needs which meant they were not able to tell us their experiences. We observed the way these people were supported. We also contacted two of the health care professionals who support people living at Evergreen. We used feedback that the registered provider had gathered at their audits of the home, and in their annual quality report.

People told us that staff support was always very caring, and that staff worked in ways that ensured people's privacy and dignity was respected. One person said, "The staff are good and friendly" another person said, "Staff are friendly and respectful." We observed staff during our time in the home, and spoke with four of them in private. We found they all had a good understanding of how to help people be as independent as possible and they told us how they work to promote people's dignity in all they do.

We found people were supported each day to stay clean and healthy. People had individual care plans about how they preferred to be supported. People we spoke with told us they helped develop these, and were happy with the care and support they received each day. One person said,"I get all the support I need. I am very happy living here." People were being helped to see healthcare professionals. We spoke to two of these who told us,"People seem very well looked after. It is a very organised home."

People we spoke with told us they felt safe living at Evergreen. We found there were systems in place to keep people safe. Staff had been trained to recognise and report signs of abuse and the four staff we spoke with were confident about their responsibility to do this.

We looked at the shared areas of the home, and five bedrooms. We found the home had been decorated in a way that made it feel homely, and people had been able to choose colour schemes in their bedrooms. The home was maintained to a good standard.

We talked to four staff on duty, and they reported TRACS was a good employer and that they felt trained and supported to undertake their role. Staff we spoke with told us "TRACS offer very good training. It is from the day you start work and ongoing."

There were systems in place to check on the quality and safety of the service and staff had opportunities to make suggestions and give feedback about the running of the home.

Records about staffing and the management of the home were up to date and in good order. In one of the two files we looked at the care plan had not been developed to reflect the changing needs we were informed the person had experienced.