We inspected Halland Hose on the 12 June 2017 and the inspection was unannounced. Halland House provides care and support for people living with learning disabilities and complex communication needs. The service is registered to accommodate up to 30 people, and is split across three separate residential units. At the time of our inspection, there were 27 people living at the service.

At the last inspection on 28 April 2015, the service was rated ‘Good’. At this inspection we found some areas of practice that need improvement, however the overall rating for Halland House remains as ‘Good’. We will review the overall rating at the next comprehensive inspection, where we will look at all aspects of the service and to ensure the improvements have been made and sustained.

Environmental health and safety checks took place on a regular basis. However, monthly water temperature checks identified that the service’s hot water in communal bathrooms was running above 44c. Guidance produced by the Health and Safety Executive advises that hot water in care homes should not exceed 43c. The provider was responsive to our concerns; however, documentation reflected that water temperatures had been running above the recommendation temperature for the past three months. No harm had occurred to people; however, we have identified this as an area of practice that needs improvement.

Staff continued to demonstrate a good knowledge and understanding of the Mental Capacity Act (MCA 2005). Mental capacity assessments were in place but had not considered people's ability to make a capacitated decision about living at the service when an application for deprivation of liberty safeguard had been made. Improvements were made during the inspection. However, we have made a recommendation about the oversight of mental capacity.

People were encouraged and supported to eat and drink well. Care plans included clear guidance on people's nutritional needs and the level of support required. There remained an open, transparent culture and good communication within the staff team. Staff spoke highly of the registered manager and their leadership style. There were sufficient numbers of staff to meet people's needs and to keep them safe. The provider had effective recruitment and selection procedures in place.

People continued to be protected from the risk of potential abuse. Staff were aware of the signs of abuse and understood the safeguarding procedures in place about how to report any concerns to protect people from possible harm. Staff assessed risks to people and the registered manager put plans in place to reduce the impact of those risks.

Staff continued to receive the training and support they needed to undertake their roles. Staff attended specific training to help enhance them to understand people's individual needs and how to support them. The management of epilepsy and seizure’s remained safe. Clear guidelines were in place and all staff had received training in the administration of emergency medicines.

People continued to receive individualised care. People's needs were assessed to identify each person's needs and wishes. People had care plans that staff regularly reviewed to ensure people received support in line with their changing needs and preferences. The service worked positively with healthcare professionals and organisations to ensure people's needs were met.

Staff told us they continued to work as part of a team, that the home was a good place to work and staff were committed to providing care that was centred on people's individual needs. There was a strong caring culture in the care and support team.

The provider continued to have arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get their medicines safely when they needed it.

Staff continued to treat people as individuals with dignity and respect. Staff were knowledgeable about people's likes, dislikes, preferen

This inspection took place on 28 April 2015 and was unannounced.

Halland House is registered to provide care for up to 30 people who have a learning disability. At the time of our inspection there were 27 people living at the service. The age range of people living at the home at the time of our visit was from 31 to 80 years. The home is run by a registered manager.

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 provider had developed a culture where people were safe. People told us they felt safe with staff and there were always sufficient staff to meet people’s needs.

Staff had the required skills and abilities to meet people’s needs. They received regular training, supervision and appraisals to maintain their performance and promote their development.

Staff treated people with kindness and respect. Staff spoke with people in a dignified way and knew how people liked to receive care. People told us they liked the staff and were always treated with respect and dignity. We observed good care, a gentle manner and what looked like genuine friendship between people and carers and among people themselves.

People received care that was responsive to their needs by thorough assessment and reviews of care plans, involving people or their relatives. People were involved in choosing activities, menus and the décor of their rooms. People and their relatives told us they could make a complaint and that the provider would address their concerns. People were encouraged to comment on the service through surveys and questionnaires provided to influence how the service was developed. There were audit processes in place intended to drive service improvements.

Staff we spoke with had received training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). This legislation sets out how to proceed when people do not have capacity and what guidelines must be followed to ensure people’s freedoms are not restricted.

Records showed that the Care Quality Commission (CQC) had been notified, as required by law, of all the incidents in the home that could affect the health, safety and welfare of people.

The manager understood when an application should be made and how to submit one and was aware of a recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The manager had submitted a DoLS application to the local authority for all people at the home in relation to the secure main front gate. Six had been authorised and she was awaiting a response regarding the remainder.

The provider had put policies in place to support staff with medicines, safeguarding and whistleblowing. Medicines were managed safely and there were schedules and audits in place to ensure cleanliness and hygiene throughout the building was maintained.

Staffing levels were managed and planned to ensure consistency and staff who were familiar to people at the home. This was flexible with extra staffing available if required. Staff told us they worked extra shifts if needed to ensure staffing levels were maintained.

Contingency plans were in place, including arrangements for alternative accommodation and there were regular evacuation drills so that staff knew how to respond. People were risk assessed to ensure they received appropriate support to be safe in the event of an evacuation of the home.

During our inspection we spoke with three people who used the service. We also spoke with seven staff members; these were the manager, the assistant manager / training officer, the cook, an occupational activities assistant and three care workers.

The people we spoke with told us they were happy with the care they had received and with the staff team. One person who used the service told us “I like it here”.

We saw that the service had systems in place to gain and review consent to care and treatment from people who used the service.

Staff we spoke with told us that on the whole they felt valued and supported and that their training needs had been met.

We saw that people were provided with a choice of suitable and nutritious food and drink. One person used the service said, “I think I get nice food.”

We also found care plans, staff records and other records relevant to the management of the home were accurate and fit for purpose.

During our visit we spoke with some of the people who lived at the service and staff members.

We used a number of different methods to help us understand the experiences of people using the service. Most of the people using the service had complex needs which meant they were not always able to tell us their experiences.

We took information from other sources to help us understand the views of people living at the home to include written feedback from relatives and visiting professionals. We also observed how people living at the service were being supported during the course of the inspection.

The people we spoke with told us they were happy living at Halland House and with the staff team.

Staff we spoke with knew the people living at the home well and had a good understanding of their support needs.