Hill View provides accommodation in a purpose built building for up to six adults with physical and learning disabilities. There is a second home on the same site and both are run by the Regard Partnership Limited, which is a national provider of care. There were six people living at Hill View at the time of our inspection. People's needs were varied and included requiring support associated with cerebral palsy and epilepsy. People had complex communication needs and required staff who knew them well to meet their needs.

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.

This comprehensive unannounced inspection took place on 20 and 23 June 2017.

At the last inspection we found some areas of practice that required improvement. For example, we observed some practices were not always caring. At this inspection observed a caring approach. Staff talked and communicated with people in a way they could understand. They had a very good rapport with them and people responded very warmly to staff.

At the last inspection we found improvements were needed in relation to some documentation for example in relation to satisfaction surveys and in relation to people’s records. At this inspection we found significant progress had been made in relation to record keeping. However, there were some areas where further development was needed and we made a recommendation about monitoring documentation.

Staff had a very good understanding of people as individuals, their needs and interests. Some people attended day centres and people were also supported with daily activities both within and outside of the home. Staff supported people in a way that suited them. Staff were kind and caring in their approach and spoke with people in a way people could understand. People were supported to take an annual holiday.

The registered manager and staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS are regulations that have to be followed to ensure people who cannot make decisions for themselves are protected. They also ensured people were not having their freedom restricted or deprived unnecessarily.

There were enough staff who had been appropriately recruited, to meet people’s needs. Staff had a good understanding of the risks associated with supporting people. They knew what actions to take to mitigate these risks and provide a safe environment for people to live. Staff understood what they needed to do to protect people from the risk of abuse.

Staff attended regular supervision meetings and told us they were very well supported by the management of the home. Staff meetings were used to ensure staff were kept up to date on the running of the home and to hear their views on day to day issues. Staff attended regular training to ensure they could meet people’s needs. There was a thorough induction to the service and staff felt confident to meet people’s needs before they worked independently.

People were supported to have healthy and nutritious diets that were varied and met their individual choices. They were also supported to attend healthcare appointments in line with their individual needs.

The provider had good systems to monitor the management and quality of the home and through regular internal monitoring the registered manager ensured a range of audits were carried out to monitor the care and support provided. Where shortfalls had been identified they were addressed in a timely manner.

Hill View provides accommodation in a purpose built building for up to six younger adults with physical and learning disabilities. There is a second home on the same site and both are run by the Regard Partnership, which is a national provider of care. There were six people living at Hill View at the time of our inspection. People’s needs were varied and included requiring support associated with cerebral palsy, and epilepsy. People had complex communication needs and required staff who knew them well to meet their needs.

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.

This comprehensive unannounced inspection took place on 17 and 18 March 2016.

Although we observed some very caring practices there were also times when some of the practices observed were not always caring or dignified. For example, one staff member assisted two people with their meal at the same time.

Although there were enough staff on shift, there were times when staff were out supporting people, which left fewer staff to support people at home.

The registered manager and staff had completed training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They had assessed that some restrictions were required to keep people safe for example, the use of bed rails and lap straps on wheelchairs. Where this was the case referrals had been made to the local authority for authorisations.

Staff had a good understanding of the risks associated with supporting people. They knew what actions to take to mitigate these risks and provide a safe environment for people to live. They understood what they needed to do to protect people from the risk of abuse. Appropriate checks had taken place before staff were employed to ensure they were able to work safely with people at the home.

Staff had a good understanding of people as individuals, their needs and interests. Each person had the opportunity to go out most days. A ‘You said, we did’ board was used to demonstrate that when people made choices about activities, arrangements were then made for these to happen.

People had access to healthcare professionals when they needed it. This included GP’s, dentists, speech and language therapists and community nurses. Communication passports were used to ensure that anyone supporting people could communicate effectively with them. They helped to identify the subtle ways that people indicated their choices and made their needs known.

People were asked for their permission before staff assisted them with care or support. Staff had the skills and knowledge necessary to provide people with safe and effective care. Staff received regular support from management which made them feel supported and valued.

Hill View was very homely and the decoration had been carried out to reflect the tastes and personalities of people living there. For example a transport theme was used in the entrance hall to reflect that two people particularly loved trains. A visiting professional told us, “the service users are happy, I’m very impressed with the informal homely environment.” A relative told us that they particularly valued the support provided by their relative’s keyworker.

The registered manager was approachable and supportive and took an active role in the day to day running of the service. Staff were able to discuss concerns with them at any time and know they would be addressed appropriately. Staff and people spoke positively about the way the service was managed and the open style of management.

We sampled two care files and found these contained personal likes and dislikes and preferences. Therefore making care plans more individualised. We noted there had been an initial assessment of care needs when an individual had first arrived at the home.

When we spoke with visitors in the home, we were told: "there is so much to do" and "The staff are so welcoming".

We found people's nutritional needs were being met and supported.

Staff were only employed following a structured recruitment and interview process and relevant checks were carried out prior to them starting work.

On the day of our inspection, we were not able to speak with people living in the service, who we were told were out, either at day services or in the community. However we visited the service again on 20 February 2013 and were able to speak with one person using the service. We also observed care practices in respect of the other five people using the service, who did not have verbal communication. Also as part of our inspection process, we were able to speak with their relatives, the manager of the service and two care workers.

We found that newly developed comprehensive and well maintained person centred support plans enabled care workers to meet people's assessed needs in a structured and consistent manner.

Risk assessments and safeguarding policies and procedures ensured that people using the service were safe.

Communication and consultation with people's family members was effective and ongoing. Relatives felt well informed and had the opportunity to partake in individual assessment, care planning and reviewing processes.

Positive comments received from people using the service and their relatives indicated a high level of satisfaction with the home and the services provided:

“I like it here, the staff are very good and I get on with everyone”.

“I’ve been very satisfied with the home and the care that my son receives and I’ve no complaints at all. It’s a lovely home and my son is very happy there”.