The inspection took place on 13 December 2016, and the visit was unannounced.

Island Place provides accommodation and personal care for 39 adults with mental health needs and those who require support whilst dealing with substance misuse. There were 37 people living in the home at the time of the inspection.

Island Place had 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.

Staff worked as a team to ensure people received the appropriate level of observation to keep them and others safe. The provider had recruitment procedures that ensured staff were of a suitable character to work with people at the home. Staff had received training in the areas considered essential for meeting the needs of people in a care environment safely and effectively.

Staff knew people's individual communication skills and abilities and showed concern for people's wellbeing in a caring and meaningful way. Staff were observant of people and responded to their needs quickly.

New staff received an induction which included working alongside more experienced staff. This helped them get to know people’s needs and establish a relationship before working with them on a one to one basis. Staff felt there were enough staff to keep people safe and ensure people could attend activities and have planned trips out from the home.

Risk assessments and management plans covered all aspects of people’s needs and included safety when outside the home, travel, finances, health and daily routines. There were appropriate arrangements for the recording and checking of medicines to ensure people’s health and welfare was protected against the risks associated with the handling of medicines. However some improvements are required to ensure people’s medicines are administered consistently and safely.

Staff worked within the principles of the Mental Capacity Act 2005 and had a good understanding of their responsibilities in making sure people were supported in accordance with their preferences and wishes. Staff knew people's individual communication skills and abilities and showed concern for people's wellbeing in a caring and meaningful way. They were observant of people and responded to their needs quickly.

Care records were personalised and each file contained information about the person's likes, dislikes, preferences and the people who were important to them. Plans around behaviours were written to reinforce positive behaviour rather than concentrating on negatives. Care plans also included information that enabled the staff to monitor the well-being of people. There were systems in place for staff to share information through having very detailed daily records for each person.

Audits and checks of the service were carried out by the management team and the provider. These checks ensured the service had continuously improved, though this had not identified in action to ensure comprehensive cleanliness or good repair of all facilities. The provider ensured all notifications required by law had been sent to us in accordance with the legislation.

When we inspected the service in January 2014 we found improvements were required to the environment. We received information from the provider as to the improvements they planned to undertake, which included the relocation of the dining room, improvements to the décor of communal areas and identified bedrooms. The provider also said they would be replacing some furniture, flooring and soft furnishings in some areas.

When we returned to inspect the service in March 2014 to review the improvements we found a majority of the work had been completed, where work was ongoing the provider was able to provide documentary evidence of the ordering of furniture and soft furnishings. The manager had introduced systems to ensure that the cleaning of the service was monitored and recorded.

We spoke with one person who showed us their bedroom, they told us they had chosen the colour and that they were happy with the changes made. Two other people told us of improvements to the service and the decoration and cleaning which had taken place.

People we spoke with told us they were happy with the service they received and that they did not have any complaints or concerns. Throughout the day we noted some people who used the service went out independently, whilst others were supported to access their local shops. People approached staff when they needed support and we found staff to provide appropriate advice giving consideration to people’s rights and choices.

We looked at five people’s care plans and found these had been regularly reviewed and included the views and comments of people who used the service and had been signed by them. People who used the service were supported by a range of external health and social care professionals and staff at the service supported people where necessary to arrange and attend appointments.

We found improvements were required to the maintenance and cleaning of the building and equipment, which included communal areas and facilities, such as lounges, dining areas, kitchens, bathing and shower facilities, corridors and individual bedrooms. Soft furnishings and furniture in some instances, which included sofas, chairs, lamp shades, windows, curtains and blinds required replacement or cleaning. People we spoke with told us they were happy with their bedrooms and did not raise any concerns about the environment. The provider has provided us with information as to what action they will be taking to address the issues identified.

The providers’ complaints procedure was displayed and records and discussions with the registered manager showed the service had not received any complaints within the last twelve months. People who used the service told us they did not have any concerns and would speak with manager or a member of staff if they did.

People using the service told us they felt safe and cared for. They told us "The staff are always there to help me if I need it."

We found people's care records to be up to date and accurately maintained. All the staff had received appropriate training and fully understood their responsibilities. We also found that the provider respected people's choices if they had the capacity to make their own decisions. When such decisions did not fully meet someone's care needs of people, the staff would actively support the person and seek alternate ways to obtain a decision that better supported them.

People were kept safe from abuse and the staff fully understood their responsibilities to keep people safe at all times.

People who used the service told us they felt safe and supported by the staff. The also told us the care staff encouraged independence and provided support and assistance that allowed people to become more independent.

The people we spoke to told us they were happy and felt safe living at the service. One person said "I really enjoy living at Island Place. It’s right up my street. I like to gain more independence.” They said they thought care workers knew what they were doing and were happy working there. Two people's comments about staff were: “I think they’re brilliant.” “Great. I get on with them all.”

People felt they had choices about what they did and were involved in decisions about the service.