The inspection took place on 1 August 2017 and was unannounced. The service was last inspected in March 2015 and met with legal requirements at that time.

Evergreen is acting to provide accommodation and personal care for up to eight people with mental health needs, autism and/or a learning disability. On the day of the visit, there were eight people at the home.

There was an acting manager in post. They had been in the role for two and a half months. They had put in an application with us to apply to be a registered manager for the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like acting providers, they are ‘acting 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 because the staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. There were systems in place to support staff and people to stay safe. New staff were only employed after they had been through a thorough recruitment process. Risks to people were assessed and identified. Action was then taken to keep people safe. These actions were kept to a minimum and were undertaken in ways that did not impact unnecessarily on people and their independence.

People were supported by staff who assisted them with their needs in a way that respected their privacy and encouraged them to be independent. The home had a welcoming and friendly atmosphere. People who wished to were encouraged to keep close contact with family members and people who mattered to them.

There had been a lapse in the regularity of staff supervision for staff whose records we viewed. However the acting manager had put in place a programme of staff supervisions for all of the team to address this shortfall. Staff were now being supervised and formally supported on a regular basis.

Staff had been properly trained and developed to ensure they were aware of people's needs and how to meet them. People were supported with their complex health needs by health professionals. They received the treatment and help they required to maintain optimum health.

People were able to enjoy a wide range of meals and drinks that they chose. People were well supported with their nutritional needs by the staff. The staff team understood how to support people with complex dietary needs.

People received care that was flexible to their needs. Where possible they were involved in reviews of their care needs. This was to help to ensure that staff had up to date information to support them effectively. Care and support plans were individual and promoted people’s independence. For some people where it was beneficial, picture formats were used to help them be involved in their care.

The team were positive about the management structure of the service and the organisation. They told us that the acting manager was a caring and supportive manager. They also said they were a very good role model. The acting manager was also very positive about their role and the team that they had taken over managing. Staff said the acting manager was always there for them whenever they needed advice, guidance and support.

To properly monitor the quality of care and daily life there were checking systems in place. These were to ensure the service people received was safe, suitable and personalised to their needs. Audits had picked up some matters that required action, including the shortfall in frequency of staff supervision. The acting manager was acting on these issues. There were also a range of checks and audits in place that ensured the ongoing safety and quality of the home. These had been effective at providing assurance that the service remained good, and that the service was meeting people's needs and the regulations.

This inspection took place on 29 March 2015 and was unannounced. The previous inspection was carried out on 10 April 2014 and there had been no breaches of legal requirements at that time.

Evergreen is registered to provide accommodation and personal for up to eight people with mental health needs, autism and/or a learning disability.

A registered manager was in post at the time of 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.

At the time of our inspection there were seven people living in the home and they told us they were happy with the service they received. Comments included: “nice here. Staff are nice” and “I’m Happy I’m having my hair done”.

Staff received training and understood their obligations under the Mental Capacity Act 2005 and how it had an impact on their work. Within people’s support plans we found the service had acted in accordance with legal requirements when decisions had been made where people lacked capacity to make that decision themselves.

Staff had attended Deprivation of Liberty Safeguards training (DoLS). This is legislation to protect people who lack mental capacity and need to have their freedom restricted to keep them safe. Two people were subject to a DoLS authorisation and the others were awaiting assessment.

We found the provider had systems in place that safeguarded people. Staff we spoke with had a good understanding of what safeguarding processes to follow. Pictorial policies were also viewed on the notice board that helped people living in the home understand what safeguarding meant.

Staffing levels were sufficient on the day of our inspection and people told us there were sufficient staff to support them. People were observed going out in their local community with staff on a one to one basis during our inspection.

The provider had ensured that staff had the knowledge and skills they needed to carry out their roles effectively. Training was provided and staff we spoke with were knowledgeable about people’s needs.

Safe procedures and a policy was in place to guide staff to manage people’s medicines safely. Medicines that we checked correlated to the records that were kept.

People received and were involved in reviews of their care needs to ensure that staff had up to date information about how to meet their needs. The care reviews also ensured the support plans continued to effectively meet people’s needs. Care and support plans were individual and promoted people’s independence using pictures that helped people be involved.

Staff meetings took place on a regular basis. Minutes were taken and any actions required were recorded and acted on. Records that we viewed and a member of staff that we spoke with confirmed this.

Quality and safety in the home was monitored to support the registered manager in identifying any issues of concern. The registered manager undertook regular audits which were followed up by their line manager.

There were systems in place to obtain the views of people who used the service and their relatives and satisfaction surveys were used. This was provided to people, their relatives, staff and external professionals.

We looked at five standards during this inspection and set out to answer these key questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. This is based on our visit to the home when we met with the people who used the service and with members of the staff and management team. Not everybody who used the service was able to express their views verbally and our observations in the home helped us to make judgements about the support that people received. Observations of staff interactions with people that used the service, were conducted sensitively and were in line with people's individual assessed needs.

Please read the full report if you want to see the evidence supporting our summary.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. Safeguarding procedures were in place and staff understood how to safeguard the people they supported. One person told us “staff are nice X looks after me”.

Systems were in place to make sure that managers and staff learnt from events such as accidents, incidents, complaints, concerns, whistleblowing and investigations. Learning from any such events was cascaded to the staff team during team meetings. The provider audited such systems on a monthly basis. This reduced the risks to people and aided service improvement.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). The home had policies and procedures in relation to the Mental Capacity Act and Dols. The deputy manager confirmed no one currently living in the home was subject to such safeguards. However relevant staff had been trained to understand when an application may be required. This meant that people’s rights would be upheld.

The management team set the staff rotas, they took people’s care needs into account when making decisions about the numbers, qualifications, skills and experience required to make sure that that were enough staff on duty. This helped to ensure that people’s needs were met.

Is the service effective?

People’s health and care needs were assessed with them and they were involved in developing their plans of care. People told us that they had been involved in the care planning process and we found care plans reflected their current needs. People had signed their care plans where possible that showed their involvement.

The deputy manager told us no one currently living in the home had specialist dietary, mobility or equipment needs. However they told us people needs would be assessed and their care plans would reflect any specialist requirements and advice would be sought. We viewed evidence in people’s care files of referrals to external professionals to gain advice as and when required.

People received co-ordinated care. We saw evidence in people's care plans that demonstrated people had been visited by their GP and other health care professionals. For example, people's personal care files held information of how the home worked in partnership with family members and external professionals that ensured care and support plans were 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.

Is the service caring?

People were supported by sensitive and attentive staff. We saw that support workers showed patience and gave encouragement when supporting people. Not everyone was able to verbally tell us of their experience of living in Evergreen. The observations we made demonstrated staff supported people in a calm unhurried manner, using communication methods conducive with their individual assessed needs.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Comments viewed were positive. Comments included: "I like the food" and "the staff are nice".

People’s preferences, interests, likes and dislikes had been recorded and in a format that supported their individual needs. Care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly. The home has its own minibus, which helped to keep people involved with their local community, especially for some people who found using public transport difficult. People we spoke with confirmed some day trips they had recently enjoyed. One person told us “we went to Weston. I like fish and chips”.

People knew how to make a complaint if they were unhappy. A pictorial complaints policy was in place to support people and was discussed on a regular basis by the management team and support workers, during monthly care reviews and resident meetings. One person was able to tell us how they would make a complaint. We looked at previous complaints and how they had been dealt with. Complaints had been investigated and action was taken as necessary in line with the organisation’s policy.

Is the service well-led?

There was a well-established management team in place. Staff understood the ethos of the home. The deputy manager told us "We are well supported by the management team to provide the best care to people. We can always contact the manager they are always available for advice and support”.

The service had a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly and reviewed by the provider. As a result the quality of the service was continuingly improving.

On the day of our inspection there were seven people living at the home. People we spoke with told us they were happy living at Evergreen. Some comments included; "I’m going out in a minute”. “I like it here”. Another person told us "just had a bath it was nice and hot".

On the day of our visit people appeared relaxed and engaged in their own environment. Some people were not able to verbally tell us of their experiences. Therefore we observed staff interactions with people to gain a view of what it was like for them living in the home.

People were observed being supported by staff to prepare for the day’s activities. Staff were observed engaging with people in a positive way, and were heard asking people if they wanted to go out for a ride in the mini bus and what they wanted to do.

Staff were knowledgeable about the needs of people living in the home, and told us that training was sufficient and relevant to the needs of people they were supporting. Staff comments included; “we are a good stable staff team and we help each other”. “We get good support from the management team and the regional management team there is always someone to contact for support”. “Training is plentiful and we can do it at home on the computer”.

We were told by staff that they felt a good standard of care was delivered to people living in the home. Staff said they ensured people were asked their opinions and were encouraged to be as independent as possible.

On the day of our inspection there were seven people living at the home. People we spoke with told us they were happy living at Evergreen. Some comments included; "I went on holiday and I bought a toy", "I go on walks", "staff are good, I'm going out again later we go out to the cafe". Another person told us about their key worker and how they support their needs, this person said "I like x I'm going bowling next week".

On the day of our visit people appeared relaxed and engaged in their own environment. People were observed in the kitchen area being supported by staff to prepare their breakfast. Staff were observed engaging with people in a positive way, and were heard asking people what they wished to do with their day.

Staff were knowledgeable about the needs of people living in the home, and told us that training was sufficient and relevant to the needs of people they were supporting. Staff also told us they provided a good standard of care to people living in the home, and that they ensured people were asked their opinions.

A relative who was visiting the home told us "they are amazing here, I cannot fault what they do here". Another relative told us "the home has the best management team, things get done and things are organised for people". People we spoke with told us the staff team were approachable, and felt able to take any concerns to the management team if needed.

People who spoke with us were able to discuss their life at the home and what they

enjoyed about living there.

People said that they appreciate having their own rooms, and being able to choose how

they are decorated. One person told us "I like Thomas the tank". A member of staff told us " we often go out in the minibus to large post offices so we can see the post vans. People really like going".

We met and talked with two people who use the service and they told us that they were included in decisions about their care. For example, one person told us" I like to go out in the minibus". They also told us that they assisted the staff prepare meals in the home.

Four people who use the service told us that they felt safe at the home and that staff are "nice".

People told us that the food was "good".

We saw that that there was assistance for people to maintain their personal hygiene if

required and that their privacy and dignity was respected by staff members. We saw people went to their rooms for privacy when they so wished.

Staff members that we spoke with showed a good understanding of peoples needs. They knew what was in people's care plans and they had a plan of action about how to meet these needs.