Medihands Healthcare provides accommodation and personal care for up to 17 adults with mental health needs. The care home is owned and managed by a private individual who has another care home in the local area, as well as an independent and supported living service. There were 15 people living at the home on the day we visited.

The home was based in two adjoining houses, linked by internal corridors. Bedrooms are all single occupancy with shared bathrooms on each floor. There are two main sitting rooms and one smaller room. Dining areas are in the sitting rooms and the conservatory. There was a kitchen and a training kitchen, where people could practice home skills.

At our last inspection in February 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were safe at the home. The provider took appropriate steps to protect people from abuse, neglect or harm. Support plans continued to show staff assessed the risks to people's health, safety and welfare. Records showed that these assessments included all aspects of a person's daily life. Where risks were identified, management plans were in place. Records showed that incidents or accidents were thoroughly investigated and actions put in place to help avoid further occurrences.

We observed that there were sufficient numbers of qualified staff to support people and to meet their needs. The provider's staff recruitment process continued to help ensure that staff were suitable to work with people using the service.

People were supported by staff to take their medicines when they needed them. Medicines were stored securely and staff received annual medicines training to ensure that medicines administration was managed safely.

Staff continued to have the skills, experiences and a good understanding of how to meet people's needs. The provider had developed new ways for staff to learn and implement their training in practical ways.

The service had taken appropriate action to ensure the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) were followed. People are 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 support this practice.

Detailed records of the support people received were kept. People had access to healthcare professionals when they needed them. People were supported to eat and drink sufficient amounts to meet their needs.

People were supported by caring staff, in a relaxed and friendly atmosphere. Staff respected people’s privacy and dignity. People's needs were assessed and information from these assessments had been used to plan the support they received. People had the opportunity to do what they wanted to and to choose the activities or events they would like to attend.

The provider had arrangements in place to respond appropriately to people's concerns and complaints. The home continued to be well managed by the provider, registered and deputy managers. The provider had developed new ways to help staff understand the homes policies and procedures.

The provider had systems in place to assess and monitor the quality of the service. Weekly, monthly and annual health and safety and quality assurance audits were conducted by the home.

Further information is in the detailed findings below

This unannounced inspection took place on 23 and 25 February 2016. At the last inspection on 28 April 2014 the service was meeting the regulations we checked.

Medihands Healthcare provides accommodation and personal care for up to 17 adults with mental health needs. The care home is owned and managed by a private individual who has two other care homes in the local area. There were 17 people living at the home on the day we visited.

The home had a registered manager at the time of the inspection. The registered manager was also the provider/owner of Medihands Healthcare. We have referred to them in this report as the provider. 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 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 safe at the home. The provider took appropriate steps to protect people from abuse, neglect or harm. Training records showed staff had received training in safeguarding adults at risk of harm. Staff knew and explained to us what constituted abuse and the action they would take to protect people if they had a concern. We saw that people could speak to the provider or deputy at any time.

Care plans showed that staff assessed the risks to people's health, safety and welfare. Records showed that these assessments included all aspects of a person’s daily life. Where risks were identified, management plans were in place. Records showed that incidents or accidents were thoroughly investigated and actions put in place to help avoid further occurrences. We saw that regular checks of maintenance and service records were conducted.

We observed that there were sufficient numbers of qualified staff to care for and support people and to meet their needs. We saw that the provider’s staff recruitment process helped to ensure that staff were suitable to work with people using the service.

People were supported by staff to take their medicines when they needed them and records were kept of medicines taken. Medicines were stored securely and staff received annual medicines training to ensure that medicines administration was managed safely.

Staff had the skills, experiences and a good understanding of how to meet people’s needs. Staff spoke about the training they had received and how it had helped them to understand the needs of people they cared for.

The service had taken appropriate action to ensure the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) were followed. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is deemed necessary to restrict their freedom in some way, to protect themselves or others.

Detailed records of the care and support people received were kept. People had access to healthcare professionals when they needed them. People were supported to eat and drink sufficient amounts to meet their needs.

People were supported by caring staff and we observed people were relaxed with staff who knew and cared for them. Personal care was provided in the privacy of people’s rooms.

People’s needs were assessed and information from these assessments had been used to plan the care and support they received. People had the opportunity to do what they wanted to and to choose the activities or events they would like to attend.

The provider had arrangements in place to respond appropriately to people’s concerns and complaints. People told us they felt happy to speak up when necessary. From our discussions with the provider and deputy, it was clear they had an understanding of their management role and responsibilities and the provider’s legal obligations with regard to CQC.

The home had policies and procedures in place and these were readily availa

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? The summary describes what people using the service and the staff told us, what we observed and the records we looked at. We looked at the care records of four people, spoke with six people who used the service and four members of staff and the registered manager.

Below is a summary of what we found.

Is the service safe?

People using the service told us they felt safe and they received individualised care. Assessments carried out by the staff ensured that people's needs were identified and met. Risks were assessed and reviewed regularly to ensure people's individual needs were being met safely. People were involved in making decisions about their care and how they wanted to be cared for. The premises were maintained and clean. Staff had undertaken training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and understood how this could impact on the people they cared for. People were supported to take their medicines in a safe way.

Is the service effective?

People received effective care from staff who were trained and supported by the manager. People told us that staff were "nice and sometimes strict". People we spoke with told us that they were provided with clear information which helped them understand the care and treatment choices available to them. People were involved in assessments of their health and care needs and in writing their plan of care.

Is the service caring?

The service was good and caring. This was confirmed by all the people we spoke with. Staff respected peoples' privacy, dignity and their right to be involved in decisions and make choices about their care and treatment. Care plans we viewed detailed people's individual preferences, so that staff knew people's individual wishes. People told us that staff “want the best for me”, “it’s ok here”, “I can go out when I want to” and “they understand me”.

Is the service responsive?

People's needs were reassessed on a regular basis and we saw the service responded to any changing needs. We saw that visiting professionals gave people time to express themselves. The provider organised some activities in the evening and weekends and people commented that these were good. The provider responded to appropriately to peoples complaints.

Is the service well-led?

Medihands Healthcare was privately owned and the provider had two other care home in the local area. The owners were very hands on and we saw that they knew the people who used the service well. People using the service and staff we spoke with said the leadership of the service was excellent and it was a good place to work. Staff felt well supported to raise any concerns and said they were always acted on.

We spoke with eleven people who use the service, three members of staff, the owner manager and two health professionals during this unannounced inspection.

People said "I am happy living here", I'm settled here", "I looked around and chose to come here" and "I have all I need in my room". Comments about the food included "the food is good", "if I don't like what is provided, they will do me something different", "I like the food" and "sometimes I cook for myself". People told us they did things they wanted during the day, saying "I go to the day centre", "I go shopping", "I play cards", "I don't do much", "I see my family" and "I see my friends". People told us that they felt safe and said they would speak with staff if they had any worries or concerns.

Staff told us they had the required checks before they started work and said their induction training gave them all the information they needed. Staff said that they were happy working at Medihands and had regular meetings, supervision and support.

People who use the service told us 'I like living here', saying ' I am settled' and 'it's like a family'. People made positive comments about staff, saying 'staff treat me well', 'staff are available to help when I need them' and 'staff are good'. Comments about the food provided were positive and included 'the food is good', 'I enjoy the food' and 'they cater for my specific needs'.

The owner, manager and staff had a good knowledge of individual's needs and how to best meet them. We saw staff interact positively with people, speaking to them in respectful and appropriate way.