About the service: Marsh House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had 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 and their relatives made positive comments about the care provided at Marsh House.

¿ Personal and environmental risks in the service had been identified and mitigated by the provider, registered manager and staff. Positive risks were encouraged and supported by the service.

¿ Staff were competent and had the training required to support people.

¿ Staff were recruited safely, were visible in the service and responded to people quickly.

¿ People were given choice and supported to be independent. They were treated with dignity and respect.

¿ Staff knew people well and had developed meaningful relationships with them.

¿ People could take part in a range of activities internally and externally to the service and were actively encouraged to do so.

¿ People's health was well managed. They were supported to maintain healthy and make choices about what they ate and drank. Individual health and nutritional needs were met.

¿ People received their medicines when they needed them.

¿ End of life planning was in place to support people at the end of their life.

¿ People, their relatives and professionals made positive comments about the management team at Marsh House.

Rating at last inspection: Good (report published (2 November 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained good overall.

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 we receive any information of concern, we may inspect sooner.

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

Marsh House is a care home that provides accommodation and personal care for up to six people who have a learning disability or are living with a mental health illness. There were four people in the service when we inspected on 25 August 2016. This was an unannounced inspection.

There was a registered manager in post. The manager was also the provider of 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 were at the heart of the service and there was a positive, inclusive and open culture. The ethos of care was person-centred and valued each person as an individual. People were consistently treated with kindness, dignity, respect and understanding.

People, relatives and healthcare professionals gave consistently positive feedback about the staff and management team. People received person centred care from staff who had an in-depth knowledge and understanding of each person, about their life and what mattered to them. There were sufficient numbers of staff to meet people’s needs and recruitment processes checked the suitability of staff to work in the service.

Care plans were unique, person centred and reflected the care and support that each person required and preferred to meet their assessed needs, promote their health and wellbeing and enhance their quality of life.

People, relatives, staff and healthcare professionals expressed high levels of confidence in the leadership of the service. The registered manager encouraged a multidisciplinary approach to people’s care and support, with a continued and strong involvement from a range of healthcare professionals and people important to them. Staff were encouraged to be involved all aspects of people’s care which helped to promote a positive culture within the service and ensured staff were always aware of people’s current needs.

People were empowered to have choice, independence and control. The continued review of people’s support needs by all those involved in the delivery of their care showed that the service was continually striving to improve on the support they provided, in order to enhance people’s quality of life. The result of this was that people and their relatives could be reassured that they were receiving responsive and effective care which was always provided with compassion, dignity and respect.

People presented as relaxed and at ease in their surroundings and told us that they felt safe. Staff knew how to minimise risks and provide people with safe care. Procedures were in place which safeguarded the people who used the service from the potential risk of abuse. People knew how to raise concerns and were confident that any concerns would be listened and responded to.

People were provided with their medicines when they needed them and in a safe manner. People were prompted, encouraged and reassured as they took their medicines and given the time they needed.

Staff understood the importance of gaining people’s consent to the support they were providing. The management team and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Lack of capacity to make decisions was not assumed and was continually reviewed.