The inspection took place on 10 November 2016 and was announced.

Kirk House is registered to provide accommodation and personal care for up to 11 people who have a learning disability or autistic spectrum disorder.

There was a registered manager in post at the time of our inspection. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act, 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect them. The management and staff understood their responsibility and made appropriate referrals for assessment. Some people living at the service had their freedom lawfully restricted under a DoLS authorisation.

Relatives told us that their loved ones were cared for by kind, caring and compassionate staff. Staff undertook appropriate risk assessments for all aspects of a person’s care to keep them safe from harm inside and outside of the service. Care plans were developed to support people’s individual needs. Staff knew what action to take and who to report to if they were concerned about the safety and welfare of the people in their care. People received their prescribed medicines safely from staff that were competent to do so. The registered provider ensured that there were always sufficient numbers of staff on duty to keep people safe.

People were supported to have a nutritious and balanced diet and hot and cold drinks and snacks were available throughout the day. People had their healthcare needs identified and were able to access healthcare professionals such as their GP and dentist. Staff knew how to access specialist professional help when needed.

People were at the centre of the caring process and staff acknowledged them as unique individuals. Relatives told us that staff were kind and caring and we saw examples of good care practice. People were always treated with dignity and respect. People were cared for by staff that were supported to undertake training to improve their knowledge and skills to perform their roles and responsibilities.

People lived busy and active lives and were encouraged to take part in hobbies and interests of their choice. Some people were supported in education, voluntary work and all enjoyed being part of a strong social network. Relatives commented that their loved ones were well looked after and their wellbeing had improved since moving into the service.

People were supported to make decisions about their care and treatment and maintain their independence. People had access to information in an easy read format about how to make a complaint.

The registered provider had robust systems in place to monitor the quality of the service and make improvements. Staff had access to professional development, supervision and feedback on their performance. People, their relatives and staff found the registered manager approachable.

The summary is based on our observations during the inspection, speaking with five people who used the service, five parents, a care manager (social worker), the service’s manager, deputy manager and four staff who provided support. We looked at the records of the support provided for three people, observed support being delivered and examined the accommodation.

We considered our inspection's 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? This is a summary of what we found:

Is the service caring?

All of the people who used the service had complex needs for support. They used a combination of words, sounds and gestures to communicate. People said and showed us by their relaxed manner that they considered staff to be caring and attentive. We observed staff speaking to people in a courteous and polite way.

Is the service responsive?

We saw that people's individual needs for support had been assessed and met. Staff knew about each person’s individual support needs, choices and preferred routines. People received the support they needed to do personal and household tasks. In addition, they were being supported to participate in social and occupational activities and to access the community. The accommodation was homely and people had been assisted to personalise their bedrooms so that they were comfortable and reflected their interests.

Is the service safe?

Staff understood their roles and responsibilities to ensure that people were protected from the risk of abuse. People were protected against the use of unlawful or excessive control or restraint because the provider had made suitable arrangements. These measures helped to keep people safe from abuse and to promote their welfare. There were safe and reliable systems for ordering, storing, administering and disposing of medication.

Is the service effective?

The provider had employed enough staff and had ensured there were sufficient staff on duty to enable people to receive the individual attention they needed. People’s needs for support had been kept under review so that their changing requirements could be met. The service had arranged for people to receive all the healthcare they needed. Staff had kept in touch with parents so that they could continue to contribute to the support their sons and daughters received.

Is the service well led?

People who used the service and their parents had been consulted about how well the provision was meeting their needs and expectations. There was a clear line of management. This meant that important decisions about organising people’s support were made by managers while staff who provided support could use their own judgement to provide a flexible service. Quality checks had been completed to ensure that important measures such as the management of medication, food hygiene and infection control were in place. Most of the necessary fire safety checks had been completed. However, one of them was overdue and the shortfall had not been identified. There was an effective system for responding to incidents and accidents so that lessons could be learnt to reduce the likelihood of them happening again.

During our visit we spoke with one person who lived at the home and two members of staff. We also looked at records and observed care. Overall we observed people were supported by skilled and experienced staff who understood their roles and responsibilities.

We observed care and saw staff were responsive to people and interacted with them positively. People told us the staff were caring and looked after them well.

People told us the food was good and we saw people were involved in planning and cooking.

When we spoke with staff they told us they had received training to enable them to provide safe and appropriate care to people. Staff were able to tell us about safeguarding people and what they would do if they saw incidences of concern. We saw processes around safeguarding were clear and available to staff.

We looked at staffing arrangements and found there were sufficient staff to meet the needs of people according to their assessed needs. We observed staffing levels fluctuated during the day time period. The provider told us this was to meet people's needs.

People told us that they liked living at the home.

They told us that they did activities such as swimming, walking and cooking.

Two people said they liked the food and it was good.

One person we spoke to told us she had her own pet fish which she kept in her bedroom.

We spoke with two people who use the service, both said they are happy living at Kirk House. One person said “I like it here, the staff take me to the disco, I like my bedroom, I like to listen to my music and I like the food”.

Another person said “It’s good here, I have chosen to have soup with toast for my lunch today. I like the meals”.

We also spoke with a relative who said “when my daughter moved in here we didn’t dream it would go so well. I have to pinch myself as I can’t believe we found such a nice place for her to live. She cannot speak but she would let it be known if she was unhappy, most of the time she is laughing and seems to be very happy.”