About the service: Link House is a residential care home. At the time of the inspection, it was providing personal care and support to six young people with learning disabilities. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s experience of using this service: People lived in a safe environment. Staff knew how to protect people from abuse and harm; risk assessments were completed, which helped staff minimise risk whilst ensuring this was not overly restrictive. Staff were recruited safely and there was enough staff deployed to meet people’s needs. Staff managed medicines well to make sure people received them as prescribed.

People’s health and nutritional needs were met. Staff supported people to access health professionals when required. The menus offered people choices and alternatives. Staff received training and supervision, which provided them with the skills and knowledge to support people safely and effectively.

The staff approach was kind and caring. They respected people’s privacy and dignity and supported them to be as independent as possible. Care was planned and delivered in an individual way in line with people’s preferences. The end of life care for people was delivered in a kind and compassionate way, which responded to their needs and the needs of relatives and friends.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There was a quality monitoring system which consisted of audits, meetings and questionnaires to make sure people’s views were obtained and action could be taken when shortfalls were identified. People felt able to raise concerns or make a complaint. Information about how to complain was in an accessible format.

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

Rating at last inspection: Good (the last report was published on 14 October 2016).

Why we inspected: This was a planned inspection based on previous rating.

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

We inspected Link House on 2 August 2016. This was a short notice announced inspection, because the service users take part in activities in the local community. We wanted to ensure they were available for us to speak with on the day. The service provides care and support for up to eight people with learning disabilities and mental health problems. When we undertook our inspection there were seven people living at the home.

People living at the home were of mixed ages. Some people required more assistance either because of physical illnesses or because they were experiencing difficulties coping with everyday tasks.

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.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 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, usually to protect themselves. At the time of our inspection there were two people subject to such an authorisation.

We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe.

People were treated with kindness and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

Staff had taken care in finding out what people wanted from their lives and had supported them in their choices. They had used family and friends as guides to obtain information.

People had a choice of meals, snacks and drinks. Meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual.

People had been consulted about the development of the home and quality checks had been completed to ensure services met people’s requirements.

People who used the service told us they liked living at the home. They told us staff were approachable and they knew staff kept notes on them. One person said," I am able to lock my own bedroom." Another told us, "I speak up at clients meetings each month."

The care plans we looked at included details about each person's medical, social and religious needs. They had been reviewed regularly and included details of visits to and from other health and social care professionals. One person said, "Staff take me to my doctor's and help to explain to me what is being said."

Medicines were stored in a safe place. Records confirmed people received medicines as prescribed.

People who used the service told us there were always sufficient staff about to meet their needs. They said staff were pleasant to them. One person said, "Staff look after me." Another person said, "I can go to staff and speak with them."

The complaints process was on display in words and pictures. People who used the service and staff told us they had every confidence any concern would be looked at quickly and in confidence. One person said, "You should never be frightened of speaking up and I'm not."