Hemmet House is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Hemmet House accommodates eight people with a learning disability in one adapted building. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

This inspection took place on 10 January 2018. At the last inspection in November 2015 the service was rated Good. At this inspection we found the service remained Good.

People were safe at Hemmet House. Staff protected people from the risk of abuse and knew how to use the provider’s safeguarding policy and procedure for reporting any concerns they had about people to the appropriate person and authority. Risks to people's health, safety and wellbeing were assessed and reviewed and staff followed current guidance on how these should be minimised to keep people safe from injury or harm.

The provider continued to maintain a servicing programme of the premises and the equipment used by staff to ensure those areas of the service covered by these checks did not pose unnecessary risks to people. Some windows in the premises did not have appropriate restrictors in place to protect people from a fall from height and hot water from two outlets appeared to exceed a safe temperature to reduce the risk to people from scalding. Immediately after our inspection the provider fitted new window restrictors around the premises, undertook checks of all hot water outlets and adjusted these so hot water was maintained at a safe temperature. Daily checks had also been introduced to ensure this safe level was appropriately maintained.

The premises was kept clean and clear of slip and trip hazards so people could move freely and safely around. Staff followed good practice to ensure risks to people were minimised from poor hygiene and cleanliness when providing personal care, cleaning the premises and when preparing and storing food. Medicines were stored safely and securely and people received them as prescribed.

There were enough staff to keep people safe. The provider maintained recruitment checks to assure themselves of staff's suitability and fitness to support people. Staff had regular and relevant training to keep their knowledge and skills up to date with best practice. Staff were supported by the provider to meet the values and vision of the service which were focussed on people experiencing good quality care and support. Staff knew people well and understood people’s needs, preferences and choices. They were aware of people’s preferred communication methods and how people wished to express themselves.

People remained actively involved in planning and making decisions about their care so that they received support that was responsive and tailored to their specific needs. Staff used information and guidance, based on best practice and current standards to plan and deliver care that would support people to experience good outcomes in relation to their healthcare needs. People’s care and support needs were discussed and reviewed with them regularly to ensure the support provided continued to meet these. People were encouraged to keep healthy and well, to eat and drink enough to meet their needs and helped to access healthcare services when needed.

People were encouraged to do as much as they could to retain their independence and control over their lives. The design and layout of the premises provided people with flexibility in terms of how they wished to spend their time when at home. People were supported to participate in activities and events to meet their social and physical needs and to build and maintain friendships and relationships with others. Staff were warm and welco

This inspection took place on 24 November 2015 and was unannounced. At the last inspection of the service in May 2014 we found the service was meeting the regulations we looked at.

Hemmet House is a small care home which provides care, support and accommodation for people with learning disabilities and/or physical disabilities. There were eight people living at the home at the time of our inspection.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People and relatives said people were safe at Hemmet House. Staff knew how to protect people if they suspected they were at risk of abuse or harm. They had received training in safeguarding adults at risk. They knew how and to whom they should report their concerns, if they suspected someone was at risk of abuse so that they could be sufficiently protected. They were also trained to support people in a way which protected them from harm that could arise from discrimination at home and in the community

There were appropriate plans in place to ensure identified risks to people were minimised. Staff had a good understanding of the specific risks to each person and what they should do to minimise these without restricting people’s rights to undertake activities or tasks. The provider ensured regular maintenance and service checks were carried out of the premises to ensure the environment and equipment was safe. Staff kept the home free of obstacles so that people could move freely and safely around.

There were enough suitable staff to care for and support people. Senior staff planned staffing levels to ensure there were enough staff to meet the needs of people using the service. The provider carried out appropriate checks on staff to ensure they were suitable and fit to work at the home. Staff received relevant training to help them in their roles. Staff felt well supported by senior staff and were provided with opportunities to share their views about how people’s experiences could be improved.

People and relatives were complimentary about the care and kindness shown by staff. We observed many instances of warm and caring interactions between people and staff. Staff knew people well. Their priorities were clearly focussed on ensuring that people's care and support needs were met and they had a good understanding and awareness of how to do this.

Staff treated people with respect. They knew how to ensure that people received care and support in a dignified way and which maintained their privacy at all times. Staff supported people to retain as much control and independence as they wanted. They did this by encouraging people to develop independent living skills which they were supported to use at home and in the community.

People were supported to keep healthy and well. Staff ensured people were able to access healthcare services when needed. Medicines were stored safely, and people received their medicines as prescribed. People were encouraged to drink and eat sufficient amounts to reduce the risk to them of malnutrition and dehydration.

Support plans had been developed for each person using the service which reflected their specific needs and preferences for how they were cared for and supported. They gave guidance and informed staff on how people’s needs should be met. People were appropriately supported by staff to make decisions about their care and support needs. These were discussed and reviewed with them regularly.

People were encouraged to maintain relationships that were important to them. People were also supported to undertake activities and outings of their choosing. There were no restrictions on visitors to the home. Relatives to

We considered our inspection findings to answer questions we always ask: 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. The summary is based on our observations during the inspection, speaking with people using the service and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People using the service told us they felt safe. We saw from recent satisfaction surveys the relatives of people using the service thought people were well cared for. One relative had noted, “Hemmet House provides a safe home environment.” Another stated, “The residents all appear well cared for and come across very happy at Hemmet House.”

Senior staff assessed potential risks to people’s safety, health and welfare both within the home and in the community. There was appropriate guidance for staff on how to prevent or minimise these risks, which meant people were protected from the risk of harm when they received care and support. There were enough staff to meet the needs of people using the service.

People were cared for in an environment that was kept clean and hygienic. Staff knew how to maintain good standards of cleanliness and personal hygiene to reduce the risk of cross infection. The home was free from clutter and obstacles which meant people were able to move freely around the home.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant people would be safeguarded as required.

Is the service effective?

Staff encouraged and supported people to make choices and decisions about how they lived their lives. People’s wishes were respected and consent was sought before staff carried out any care and support. This meant people did not receive care or support they did not want or ask for.

People using the service and their relatives were involved in planning their care and support. People’s specific needs were taken into account and there was guidance and instructions for staff on how these needs should be met. People’s care plans were reviewed regularly and any changes to these were updated promptly. This meant staff had up to date, accurate information about the care and support people needed.

Is the service caring?

People were supported by kind and caring staff. We observed staff were patient and gave positive encouragement when supporting people. These interactions were warm, kind and respectful. People were clearly comfortable with the staff that supported them.

A relative had commented in the recent satisfaction surveys, “Hemmet House provides the residents with a very comfortable, caring and happy place to live.”

Is the service responsive?

Staff were responsive to any changes and deterioration in people’s general health and well-being. They took appropriate action to ensure relevant healthcare professionals were kept informed about any changes so that people got the appropriate medical care and attention they needed.

People told us they were comfortable speaking to staff if they had any issues or concerns. One of the people using the service had commented in the recent satisfaction survey, “I feel complaints I make are dealt with quickly.” A relative had noted, “I appreciate being able to approach staff with any concerns.”

Is the service well-led?

The service used the views and experiences of people using the service, their relatives and staff to assess and monitor the quality of service provided. They sought people’s ideas and suggestions for improvements and made changes that people wanted or needed. They took appropriate action to address any issues or concerns about service quality.

Senior staff demonstrated a good understanding and awareness of how regular audits and checks improved the service that people experienced.

We reviewed four care files and saw evidence that peoples' needs were assessed and their care planned before care was delivered. The care plans we looked at were personalised and reflected people's individual needs, preferences and diversity. People were protected from the risks of inadequate nutrition and dehydration. One person told us, "I love it here, it's like being at home." Another person told us, "I like living here, it's really fun."

A relative told us, "They've done everything they can to make them happy and keep them safe. This is the first place they have been really happy." People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The provider had taken steps to provide care in an environment that was safe, suitably designed and well maintained.

We saw evidence that there were effective recruitment and selection processes in place and appropriate checks were carried out before staff were allowed to work with people using the service. We found that people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

People we spoke with told us that they were happy with the care that they receive. One person told us “I like it here and the staff are great”.

People were supported in promoting their independence and community involvement. People told us they were given opportunities to express their choices and to make decisions in their daily lives. We observed that staff were aware of people’s preferences and routines so they could support people in their daily lives. For example they knew at what time people preferred to eat and what time they went to bed or got up.

We saw the satisfaction surveys that had been completed by representatives of people using the service and they were happy with the care being provided in the home. The provider had a system to assess the feedback provided in the satisfaction questionnaires and to take action where required to address areas where improvement had been identified.