This inspection took place on 19 November 2016 and was unannounced. The service was previously inspected in October 2015. During that inspection breaches of legal requirements were found because care and treatment was not always provided with the consent of the relevant person and the provider did not have robust systems in place to monitor the quality of the service. In addition the systems in place to assess and monitor risks relating to the health, safety and welfare of people was not effective. After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. The provider took action and at this inspection we found improvements had been made.

The home was registered to provide residential care and accommodation for up to four people who may have a learning disability or mental health support needs. At the time of our inspection three people were living at the home.

The registered manager was present during our inspection. 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 who used the service told us they felt safe and we saw people looked comfortable in the presence of staff. Staff we spoke with knew how to protect people from avoidable harm and abuse. Systems in place to ensure agency staff were suitable to work with adults was not robust to minimise the risk of unsuitable staff working at the home. There was enough staff to support people in a timely manner. There were systems in place to ensure the storage, disposal and administration of medicines was effective.

People were supported by staff who knew them well. Staff understood the principles of the Mental Capacity Act (2005) and people received care in line with their best interests. Staff supported people with their nutrition and dietary needs to promote their health and well-being. People had regular access to health professionals to ensure their health needs were met.

People were supported by staff who were kind and compassionate. People were involved and supported to make their own decisions about their care and support. Advocacy services were available to people, if required. Staff respected people’s dignity and privacy and supported people to maintain their independence.

People and their relatives had been involved in the development of their care plans and were supported to express how they wanted their care delivered. People had the opportunity to participate in activities that they enjoyed. Systems were in place for people and their relatives to raise concerns or complaints.

People, relatives and staff were happy with how the service was managed. People and their relatives had the opportunity to express their opinions on the service that was provided although feedback was not always recorded. Staff told us they felt well-supported by the registered manager. There were systems in place to monitor the quality of the care and support provided to people; however some systems had not identified the shortfalls we found during our inspection. Feedback received had not been analysed to identify trends and to prevent re-occurrence of negative experiences for people.

This inspection took place on 19 November 2016 and was unannounced. The service was previously inspected in October 2015. During that inspection breaches of legal requirements were found because care and treatment was not always provided with the consent of the relevant person and the provider did not have robust systems in place to monitor the quality of the service. In addition the systems in place to assess and monitor risks relating to the health, safety and welfare of people was not effective. After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. The provider took action and at this inspection we found improvements had been made.

The home was registered to provide residential care and accommodation for up to four people who may have a learning disability or mental health support needs. At the time of our inspection three people were living at the home.

The registered manager was present during our inspection. 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 who used the service told us they felt safe and we saw people looked comfortable in the presence of staff. Staff we spoke with knew how to protect people from avoidable harm and abuse. Systems in place to ensure agency staff were suitable to work with adults was not robust to minimise the risk of unsuitable staff working at the home. There was enough staff to support people in a timely manner. There were systems in place to ensure the storage, disposal and administration of medicines was effective.

People were supported by staff who knew them well. Staff understood the principles of the Mental Capacity Act (2005) and people received care in line with their best interests. Staff supported people with their nutrition and dietary needs to promote their health and well-being. People had regular access to health professionals to ensure their health needs were met.

People were supported by staff who were kind and compassionate. People were involved and supported to make their own decisions about their care and support. Advocacy services were available to people, if required. Staff respected people’s dignity and privacy and supported people to maintain their independence.

People and their relatives had been involved in the development of their care plans and were supported to express how they wanted their care delivered. People had the opportunity to participate in activities that they enjoyed. Systems were in place for people and their relatives to raise concerns or complaints.

People, relatives and staff were happy with how the service was managed. People and their relatives had the opportunity to express their opinions on the service that was provided although feedback was not always recorded. Staff told us they felt well-supported by the registered manager. There were systems in place to monitor the quality of the care and support provided to people; however some systems had not identified the shortfalls we found during our inspection. Feedback received had not been analysed to identify trends and to prevent re-occurrence of negative experiences for people.

We inspected this service so we could consider our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Two inspectors carried out this inspection.

There were two people living in the home at the time of our inspection. One person started using the service two months before the inspection. Below is a summary of what we found. The summary is based on speaking with two people who lived in the home and a relative. We also spoke with the manager of the service, a member of staff and one health professional.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People, a relative and a health professional confirmed that they believed that the service was safe. Their comments included: "Do I feel safe? Yes I do," "I saw another place where people were acting silly, I feel safe here, I like it that my friend is here too," "I think that my relative has settled in wonderfully. They would tell me if they didn't feel safe" and "I have no concerns about the care of the person I see at the home."

People had an initial assessment and visited the home before they decided to live there. This meant that the manager could determine if they could safely meet people's needs before they arrived.

There were appropriate arrangements in place to ensure that medication was administered safely.

New staff were recruited appropriately and checks on applicants' previous employment and their safety to work with vulnerable people were undertaken.

CQC monitors the operation of Deprivation of Liberty Safeguards. There had been no applications to deprive any people of their liberty at the time of our inspection. However, the manager had yet to be aware of the changes to the interpretation of the law in this area and had not assessed if some restrictions amounted to a deprivation of liberty or whether people had the capacity to understand these restrictions.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Is the service effective?

People's healthcare had been reviewed and, where necessary, appointments were changed to meet the needs of people living in the home. People had access to health professionals as needed. The manager discussed with people their healthcare needs and this had resulted in a person understanding how to keep well.

People, a relative and a health care professional told us that people received the support they needed. Their comments included: "I am confident that the manager is doing everything right" and "The manager had followed up the health care issues for (relative's name). I think she is competent."

Is the service responsive?

People told us that they were able to keep in touch with their friends and maintain interests and activities they had before they lived in this home. The manager told us about people's individual routines and we saw that people were able to maintain these.

A relative told us that they had been able to contact the manager on a weekly basis and the manager contacted them so they could support the care provided. A health professional told us that the manager had responded well to the demands of a person's healthcare needs.

Is the service well-led?

The service was led by a manager who had the qualifications, skills and experience to provide a good, well led service.

Although people had not lived in the home long there were systems in place to monitor people's views of the service and a complaints policy. There had been no concerns or complaints recorded.