About the service: Leighton House provides personal care within people’s homes and when they access the community, to ten adults who have an acquired brain injury.

People’s experience of using this service: People and staff were complimentary of the service. People were asked for feedback on their experience of the service through surveys and telephone calls. Staff felt supported, listened to and able to contribute to the running of the service. A number of quality audits were in place and the provider and the registered manager had plans in place to drive improvement in the service.

Staff were professional and competent; people and relatives said the service was safe. Staff demonstrated a good awareness of each person's safety and how to minimise risks for them.

Staffing arrangements were consistent and reliable.

Staffing levels were safe, and people and relatives told us they received consistent support from the same carers.

Staff were recruited safely and the appropriate pre-employment checks were in place.

Staff were given an induction and training suitable to their job role. Staff told us they were given time to get to know people as part of their induction. People and relatives felt this was good practice as staff got to know the people they were supporting on a personal level.

People’s calls were on time or staff called if they were going to be late. The provider monitored care staff attendance at calls using electronic call monitoring.

The provider arranged training for staff that met the needs of people using the service. They were assessed for their competency which helped to ensure they were safe to work with people.

The service worked in line with the Mental Capacity Act 2005 and staff had a clear understanding of how to support people with fluctuating capacity and giving support with decision making.

Feedback from relatives and staff was that the service was well-led. They told us the management team was always available to speak with.

People told us they would feel confident to raise any complaints they might have. We saw complaints were identified, investigated and used to improve the service.

Rating at last inspection: The service was last rated as Good (2 February 2016)

Why we inspected: This was a planned inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our reinspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 26 November 2015 and was announced. Leighton House provides personal care within people’s homes and when they were out in the community, to twelve adults who have an acquired brain injury. Some people who were receiving support live on their own whilst other people live with their relatives. This was the service’s first inspection since they were registered with the Commission.

There was a registered manager at the service. 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.

People told us that they felt safe whilst receiving support from staff. Staff were able to tell us potential signs of abuse and how to raise concerns should they need to. Risks to people had been assessed and measures put in place to reduce the risk for the person. Staff informed us that they also assessed risks daily depending on the person’s abilities that day. Staff had received training about the care needs of the people they were supporting to enable them to provide safe and effective care.

People and their relatives told us that they were supported by sufficient staff who knew people well. Relatives were very complimentary of the caring nature of staff and made positive comments about the staff. People told us that they received support from regular staff who they had got to know well.

Staff spoke enthusiastically about the people they were supporting and it was evident that they had a good knowledge of the person and of acquired brain injuries. Staff felt valued and supported in their role and there were systems in place for staff to seek advice should they have any concerns.

We found that people were involved in planning their care to ensure that they received care in the way they wished. People had their care reviewed regularly and changes to care were made in response to people’s requests. We saw that people were enabled to regain skills in independence and we were provided with many examples of how the service had supported people in this way.

We looked at whether the service was applying the principles of The Mental Capacity Act 2005 (MCA) effectively. We found that staff had received training on this MCA although understanding of this legislation varied amongst staff.

People and their relatives knew how to raise any concerns, should they have any and felt assured that they would be dealt with appropriately. Where concerns had been raised we saw that the registered manager had taken action and acted promptly.

People and their relatives were confident in how the service was led. There were systems in place to monitor the safety and quality of the service and we saw that plans were in place to develop the service further.