We carried out an unannounced comprehensive inspection of this service on 14 and 15 April 2015 at which a breach of legal requirements was found. This was because people had decisions made on their behalf that were not fully documented to make sure their changing needs and circumstances were addressed.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on 14 July 2015 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for ‘Hannacott ’ on our website at www.cqc.org.uk.

Hannacott provides accommodation and personal care for up to six adults with a learning disability, physical disability and/or complex health issues. Five people were living at the home when we visited and they had a range of support needs including help with communication, personal care, moving about and support if they became confused or anxious. Staff support was provided at the home at all times and people required the support of one or more staff when away from the home.

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 and associated Regulations about how the service is run.

At our focused inspection on 14 July 2015 we found the provider had followed the action plan which they had told us would be completed by 8 June 2015 and legal requirements had been met. Accurate records were kept when people’s mental capacity was assessed and decisions were made in their best interests.

The inspection took place on 21 March 2017. The last inspection took place in July 2015. There were no breaches of regulation at that time.

Hannacott is a care home providing accommodation and personal care to six people with learning disabilities, physical disabilities, sensory needs, complex health issues and communication difficulties. At the time of our inspection, there were six people living at Hannacott.

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.’

People experienced a high level of care and support that promoted their health and wellbeing. People were happy, felt safe and felt cared for. People were 'very happy' with the service they received. We received positive comments about their views and experiences. People told us they felt safe because the staff were "Caring and enjoyed what they did".

People's risks were identified and managed well and their care needs were met exceptionally well. People were cared for by staff who knew them really well and who had been well trained to support people. Where possible, people were involved in the planning of their care. If this was not possible, people's representatives were encouraged to be involved. People's care plans were detailed and very personalised which helped staff deliver the support people wanted and needed. For some people, this had resulted in real improvements to their health and abilities which in turn had meant people had become more independent. People had very good access to health care professionals when they needed this and their medicines were managed well.

Staff were very well supported and valued by the provider who invested well in their training and welfare. There was a strong sense of "family" and team work. Staff were proud of the work they did and were fully committed to ensuring people were at the centre of everything that took place at Hannacott.

People we spoke with told us staff were very caring. Relatives we spoke with informed us the staff showed a high level of compassion towards the people they supported. They used words such as “Compassionate”, “Caring”, “Excellent” and “Highly motivated” to describe the staff. All of the people we spoke with told us they felt staff went over and above what was expected of them and they couldn’t ask for more from the staff. Care staff spoke highly about the service provided. One said, “I love working here”. Another person said, “I am proud to be working here”. People told us they would recommend the service to others. There was a genuine sense of fondness and respect between the staff and people. Staff were positive about the people they supported. One member of staff said, “I love helping the people I work for”. Another person said “It means so much to make somebody smile and their compliments mean so much to me”.

Staff were constantly looking for ideas on how to improve people's quality of life. People's likes, dislikes, preferences and aspirations were explored with them. Staff worked hard to make sure, that where it was possible, people had opportunities to lead as full a life as possible. They made sure daily activities were tailored to meet people's preferences and abilities. Staff made sure people had opportunities to enjoy themselves. People's suggestions and ideas were sought and valued when it came to planning these activities.

The registered manager offered strong and experienced leadership and had a clear vision about the direction of the service. They were highly committed to improving people's lives and ensuring people had the best care they could receive, and expected the same high standards from the staff who were as committed to these values as the regis

We used a number of different methods to help us understand the experiences of people using the service. This was because people using the service had complex needs which meant they were not all able to tell us their experiences. We observed staff interacting with people and spoke with staff about people's needs and examined their care records. We spoke with the relatives of one person who said they were very pleased with the care and support their relative received and they were very settled living at the service.

Care and support plans were in place for all assessed needs. These were personalised to the individual and any risk to their welfare and safety had been identified, with plans in place to assist staff with the management of these. Other formats had been used for care and support planning to enable people to be actively involved in the process. For example, a hand held computer. Staff demonstrated good knowledge of people's care and support needs. The service worked in partnership with external health and social care professionals to make sure people's care and support needs were being met.

People who used the service were protected from the risk of abuse. Information was provided for people in a format to meet their needs about abuse and the ways to report it is required.

The provider had an effective system to regularly assess and monitor the quality of service that people received.

During our visit we spoke with one person who was able to tell us about their experience of living in the home. We also spent time observing people in the communal areas. The atmosphere in the home was relaxed and people were able to move freely around the home, some with the assistance of staff, choosing where and how to spend their time. Staff were observed interacting with people in a respectful manner that showed that they understood each individual’s needs and how best to communicate with them. The home supported people to take part in a wide range of activities that were individualised to each person’s needs and choices.

Care plans were personalised to each individual's needs and detailed the wishes of the person and how they wanted to receive their support. Risk assessments had been completed where necessary and all care records were regularly reviewed.

There were enough qualified, skilled and experienced staff to meet people’s needs. We spoke with a relative of one person living in the home and they told us, “…is very happy here. They look after … well and staff are consistent in their approach”. Staff we spoke with told us they enjoyed working in the home and felt supported to carry out their role. People’s complaints were fully investigated and resolved, where possible, to their satisfaction.

This inspection took place on 14 and 15 April 2015 and was unannounced. Hannacott provides accommodation and personal care for up to six adults with a learning disability, physical disability and/or complex health issues. Five people were living at the home when we visited and they had a range of support needs including help with communication, personal care, moving about and support if they became confused or anxious. Staff support was provided at the home at all times and people required the support of one or more staff when away from the home.

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 and associated Regulations about how the service is run.

We found one breach of our regulations. People had decisions made on their behalf that were not fully documented to make sure their changing needs and circumstances were addressed. You can see what action we told the provider to take at the back of the full version of this report.

People were supported by a caring and dedicated staff team who knew them well and treated them as individuals. Staff worked hard to understand what was important to people and to meet their needs despite the difficulties some people had communicating. Staff were patient and respectful of people’s unique preferences. One relative described a “professional and committed staff team” that “went out of their way” to care for their loved one.

Staff supported people to take part in activities they knew matched the person’s individual preferences and interests. People were encouraged to make choices and to do things for themselves as far as possible. In order to achieve this, a balance was struck between keeping people safe and supporting them to take risks and develop their independence.

Some people had complex physical needs and these were met by staff who worked closely with health and social care professionals. This included providing people with nutrition and helping them maintain a healthy posture. Staff understood when they needed guidance from professionals. People were helped to keep safe and take part in activities as the building and furnishings had been adapted to meet their needs.

Staff felt well supported and had the training they needed to provide personalised support to each person. Staff met with their line manager to discuss their development needs and action was taken when concerns were raised. Learning took place following any incidents to prevent them happening again. Staff understood what they needed to do if they had concerns about the way a person was being treated. Staff were prepared to challenge and address poor care to keep people safe and happy.