This inspection took place on 03 April 2017 and was unannounced. When we last inspected Moti Willow on 27 January 2016 and 08 February 2016 we found that the service required improvements in some areas such as risk management, staffs knowledge about the signs and symptoms in case people had a relapse in their mental health conditions and governance systems. At this inspection we found that improvements had been made. However some of the governance systems were still being developed and further improvements were needed to ensure people`s care plans were a true reflection of the care and support people needed and received.

Moti Willow is registered to provide accommodation and personal care for up to seven people with Mental Health needs. At the time of our inspection six people were living at the home.

There was a registered manager in post who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

People told us they felt safe at the home and they appreciated the support they received from staff which met their needs. People received support from staff who had been appropriately trained and were knowledgeable in how to protect people from abuse. Staff knew how to report concerns and were able to tell us when they would report under the whistleblowing policy to the local safeguarding authority or the CQC.

People, if they were able to independently organised their leisure activities, where people were not able to staff helped people do the activities they liked. People were also visited by a `service user empowerment team` employed by the provider to support people who lacked motivation to engage in any social activities on a one to one basis.

Risks associated with daily activities and people`s mental health needs were well known by staff who were able to effectively support people and mitigate risks. However care records needed further development to evidence all the risks identified and the care and support people needed. This had been identified by the registered manager and the provider and there were plans in place to address this issue.

People were involved in review meetings with their key worker where they discussed different aspects of their care needs. The care plans contained personal information about people, medical history and appointments, care reviews and incident reports. People, if they were able to signed their care plans and reviews to show they agreed with the care and support they received.

There were sufficient staff to meet people`s needs at all times. The registered manager was recruiting to build a permanent staff group, however the agency staff used to cover the available staffing hours worked at the home on a regular basis and had a very good understanding of people`s needs.

Recruitment processes were thorough and helped to ensure staff employed were of good character and fit to support people with complex mental health issues. Permanent and agency staff working at the home received an induction and on-going training and had regular supervision with the registered manager.

Accidents and incidents were recorded and information was sent to the provider`s head office as well. The registered manager told us they investigated incidents or accidents and they looked for trends or patterns.

People were supported to have their medicines safely by appropriately trained staff who`s competency to administer people`s medicines was regularly checked.

People were supported to cook their own food and they were encouraged to eat a varied and nutritious diet and to drink sufficient amounts to maintain their health. People were able to access health care professionals, such as GPs as and when require

This inspection took place on 27 January 2016 and 08 February 2016 and was unannounced. The service had not been inspected previously since it was registered 19 February 2015.

Moti Willow is registered to provide accommodation and personal care for up to 7 people with Mental Health needs. At the time of our inspection 7 people were living at the home.

There was a manager in post who was in the process of registering with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

People were independently organising their leisure activities, they had regular visits to local shops and their family. There were also activities provided in the home or other locations owned by the provider for people to participate in. The manager told us they were discussing with people what activities they wanted the service to organise and support them with. There were workshops organised for people to learn about their rights, hygiene and healthy eating.

Risks associated with daily activities and people`s mental health needs were identified however there were no clear plans how to manage and mitigate these. Agency staff working regularly at the service were not knowledgeable about the signs and symptoms in case people had a relapse in their mental health conditions.

People were involved in review meetings with their key worker where they discussed different aspects of their care needs. The care plans contained personal information about people, medical history and appointments, care reviews and incident reports, there were no detailed plans about how people communicated, risk assessments and personalised plans around the support needs for people`s mental health needs.

Accidents and incidents were recorded and information was sent to the provider`s head office as well. The manager told us they were investigating incidents or accidents and they were looking for trends if it was a need for it.

The manager told us they were encouraging people to be independent and in control of their life. People told us they were encouraged to participate and help in daily tasks, cooking, setting tables, laundry, keeping their bedroom tidy, however there were no plans developed to ensure staff had a systematic and consistent approach when supporting people to become more independent. People had no clear goals for them to achieve and monitor their progress.

People received support from staff who had been appropriately trained and were knowledgeable in how to protect people from abuse. Regular staff knew how to report concerns and were able to tell us when they would report under the whistleblowing policy to the local safeguarding authority or the CQC. However agency staff who was regularly working at the service had not received training about the mental health conditions people lived with.

People were supported by appropriate numbers of staff, some of which were agency staff. The manager had been recruiting to build up a permanent staff team to ensure people were supported by a permanent staff and received consistent support.

Recruitment processes were thorough and ensured staff employed were of good character and fit to support people with complex mental health issues. They received an induction and on-going training and had regular supervision with the manager.

People were supported to have their medicines safely by appropriately trained staff who`s competency to administer people`s medicines was regularly checked.

People were supported to cook their own food and they were encouraged to eat a varied and nutritious diet and to drink sufficient amounts to maintain their health. People were able to access health care professionals, such as GP’s as and when requi