This inspection was unannounced and took place on 20 December 2016.The service was registered to provide supported accommodation and personal care for seven adults who have a learning disability. At the time of our inspection six people were using the service. Our last inspection took place in April 2014 and at that time we found the provider was meeting the regulations we inspected.

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.

Hilderstone comprises of seven self-contained flats with the addition of shared spaces including a dining area, lounge and outdoor space. The provider and manager demonstrated a strong and supportive leadership style, completing quality checks to further improve people’s life styles and the support available.

People lived in a safe environment that had been designed to meet their specific needs.. Staff made sure risk assessments were carried out and took steps to minimise risks without taking away opportunities for people to be independent. There was a system of audits, checks and analysis to identify how things could be improved and developed.

Staff had received training to enable them to know how to raise any concerns. Risk assessments had been completed to cover all aspects of the environment and to maintain people’s safety when outside of the service.

There were sufficient staff to meet people’s needs and we saw they had a flexible approach to the support they offered. Staff employed to work at the service had received the appropriate checks to ensure they were suitable. Medicines were administered safely by staff who were trained and regular audits ensured that any errors were addressed.

Staff had received a range of training to support the needs of the people. Additional training was available to increase the staff’s knowledge and support their career development. There was an induction for all new staff which involved training and shadowing with experience staff.

Staff understood the requirements of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards and acted in people’s best interests. Where people did not have the capacity to make a decision, they were supported through best interest assessments.

People were supported to choose what food they wished to eat. Where people had specialist diets these had been provided and when required specialist advice had been sought. Referrals to other health professional had been made to ensure the people maintained good health and well-being.

The staff had established positive relationships with the people to provide an individual level of care. Relationships with families had been promoted and they felt able to visit anytime. People’s dignity had been respected. The care plans provided details about people’s preferences and how they wished their care to be provided. Activities were available to suit people’s interests and hobbies.

Staff told us they felt supported by the management team and able to raise any idea or suggestions openly. The service had a complaints policy in place which was available in an easy read format.

This was an announced inspection. As part of this inspection we spoke with care and senior staff that worked at the service, relatives and health and social care professionals. People that used the service were unable to give us their views about the care they received.

We considered our inspection findings to answer the questions we always ask;

Is the service safe?

Safeguarding procedures were in place. Staff knew how to keep people safe and to act upon any concerns.

Risk to people were identified and plans were in place to make sure that risks were minimised. These were regularly reviewed.

The provider had an effective system in place to manage people’s medication. Staff were trained and there was a system in place to check that people had received their medication. This meant that people received their medication as it was prescribed by their doctor.

Care staff were trained to make sure they had the skills and knowledge to provide people with safe and appropriate care.

Is the service effective?

People’s health and social care needs were assessed. Comprehensive plans of care were in place that showed people’s individual needs. These were reviewed and updated to make sure that people’s care reflected their current needs.

Specialist needs were identified and addressed. People were supported to access a range of health professionals.

Relatives told us they were pleased with the care provided. One said: “They know my relative well. They do the things X likes. They cater for all X’s needs”.

Is the service caring?

People’s preferences and wishes about their preferred lifestyle were recorded in their plan of care. Our discussions with care staff and relatives confirmed that these wishes were acted upon.

Relatives told us that care staff knew their relative well. One told us: “The staff seem to be very committed to the people [they support]”. They also told us that they felt the staff were approachable.

Is the service responsive?

The provider had a complaints procedure and relatives told us that they would raise any concerns they had about their relative’s care. This meant that there were systems in place to take account of people’s concerns and to act upon them to improve the service.

The service gained the views of people who used the service and of relatives. Services were altered to take account of the views of people that used them.

Is the service well led?

The service had a quality assurance system in place. Records confirmed that when issues were identified these were acted upon promptly. This meant that there were processes in place to develop and improve the service people received.