About the service: Myland House is a residential care home that provides personal care and support for up to five people with complex neurological needs following a traumatic or acquired brain injury. At the time of our inspection there were five people living at the service.

People’s experience of using this service:

People received care from staff who knew them well. People told us staff were kind, caring in their approach and promoted their independence.

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 were systems in place to monitor the quality and safety of the service provided, and to drive improvements where this was required. The service considered people's feedback and was continuously trying to improve the service.

People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. Sufficient staff were available to meet people's needs and people told us when they needed assistance, staff responded promptly. People received their medicines regularly and systems were in place for the safe management and supply of medicines. Incidents and accidents were investigated, and actions were taken to prevent recurrence.

People received a service which was personalised and met their needs. The care provided enabled them to remain as independent as possible. Care plans contained explanations of the control measures for staff to follow to keep people safe. Support was planned and delivered in a structured way to ensure people's safety and wellbeing. Staff had access to up to date information about how to support people and communication with health and social care professionals was effective in ensuring people received joined up care.

The service continued to be well led. The management team worked well to lead the staff team in their roles and ensure people continued to receive a good service. Staff and the registered manager showed a genuine interest and passion to deliver personalised care based on people's likes, wishes and preferences.

People had access to a variety of nutritious meals and snacks and were supported to learn skills in food preparation and cooking. People’s weights were monitored.

Staff were aware of people's life history and preferences. They used this information to develop positive relationships and deliver person centred care. People’s end of life care was considered, and people supported to express their views.

There was a varied range of social activities on offer. Staff encouraged people to participate in group and one to one activities of interest to the individual.

Rating at last inspection: Good (report published on 21 October 2016).

Why we inspected: This was a scheduled inspection based on the 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.

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

This inspection was unannounced and carried out on 31 August 2016.

Myland House is a residential care home that provides care and support for up to five people with complex neurological needs following a traumatic or acquired brain injury.

At the time of our inspection there were five people using the service.

A registered manager was 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was last inspected on 10 October 2013 and at that time requirements in the Health and Social Care Act 2008 and associated Regulations were met.

Myland House provided a small homely environment and promoted a positive and inclusive culture. People described their care as good and told us that staff were kind and helpful. Staff had developed caring and meaningful relationships with people and knew each person’s individual care and support needs. The service had established firm links with the community and supported individuals to develop and maintain personal relationships with friends and family, which enhanced their wellbeing.

People were protected from avoidable harm and potential abuse. Safeguarding procedures were in place and people were encouraged and supported to raise any concerns.

Potential risks were identified and assessed. Management and staff had a positive attitude towards managing risk and balanced the need for people to have preference and choice with ensuring they were safe, both in the service and in the community. Detailed management strategies were in place to provide guidance to staff on the actions to take to minimise risk and provide appropriate and individualised support.

Safe recruitment practices ensured the suitability of newly appointed staff coming to work in the service. People were supported by sufficient numbers of staff with appropriate experience, training and skills to meet people’s needs. Staffing levels were flexible and supported people to follow their interests, take part in social activities and, where appropriate education and work opportunities.

Appropriate checks of the building and maintenance systems were carried out regularly to ensure people’s safety. Medication was stored safely and administered correctly. Robust systems were in place to ensure medication and people’s finances were managed safely and appropriately.

Management and staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals.

People were supported to maintain good health. They received continuing healthcare support to meet their needs and had prompt access to healthcare professionals when they became unwell. Staff promoted healthy eating. They supported people to balance choice with healthy options and people's preferences contributed to the menu planning.

The provider had arrangements in place to listen and learn from people's experiences, comments and views. There was a strong emphasis on promoting good practice in the service and there was a well-developed understanding of equality, diversity and human rights which management and staff put into practice. The registered manager was knowledgeable, inspired confidence in the staff team and led by example.

Quality assurance systems were robust and helped to ensure the service was of a good quality, was safe and continued to improve.

We observed that the staff were attentive to people’s needs. We saw that staff respected people’s privacy and dignity and sought their agreement before providing any support or assistance. The people we saw were relaxed, engaged with their surroundings and interacted with each other.

We talked with three of the four people who used the service at the time. People told us that they were comfortable and liked living there. One person told us, “I have lived here a long time now, these people are my friends.” Another person told us that staff, “…are always here to help me if I need it.”

We found that staff were supported through supervision and that they received training essential for caring for people living with an acquired brain injury, we found that staff were knowledgeable about the people they supported. We saw that the service managed and recorded medication appropriately and that the organisation had systems in place to monitor the quality of the service.

During our visit, we spoke with two staff, this included the registered manager. We spoke with three of the five people who were living in the service. We contacted two family members of people who used the service. One family member told us, "I cannot praise them (staff) highly enough."

We observed that staff spoke respectfully with people and spent time interacting with people on a social basis as well as meeting their care needs. People told us they were happy with the service provided and that they were supported to make their own choices about their daily living. One person said, ‘’It is very good.’’

We saw that the service had a robust audit system in place and that people were involved in the planning and delivery of their care.

Staff were able to describe different signs of abuse and how they would report any concerns. They were also able to explain how they would respond in different emergency situations. This meant that people were safeguarded from the risk of harm.

People were receiving good nutrition and told us they were happy with their choices of and quality of their meals.

People with whom we spoke confirmed that they were respected and involved by staff. People also confirmed that they felt happy in the home and if they required any assistance staff would respond promptly.

People with whom we spoke confirmed that they were generally satisfied with the care and treatment provided by staff. They felt able to approach staff if they had any concerns and were confident that these would be addressed appropriately.

Two people with whom we spoke said that they liked their bedroom and one person said they enjoyed looking out of the window and watching the world go by.