The inspection took place on 14 January 2016 and was unannounced.

Netherlands is registered to provide accommodation and personal care for up to 11 people living with a learning disability. There were 11 people living at the service on the day of our inspection.

There was a registered manager in post at the time of our inspection. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act, 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect them. The management and staff understood their responsibility and made appropriate referrals for assessment. Two people currently had their freedom restricted under a DoLS authorisation and the registered provider had made a further five applications to the local authority and was waiting on assessments.

People felt safe and were cared for by kind, caring and compassionate staff. People were kept safe because staff undertook appropriate risk assessments for all aspects of their care inside and outside of the service. Care plans were developed to support people’s individual needs. Staff knew what action to take and who to report to if they were concerned about the safety and welfare of the people in their care. People received their prescribed medicine safely from staff that were competent to do so. The registered provider ensured that there were always sufficient numbers of staff on duty to keep people safe.

People were cared for by staff that were supported to undertake training to improve their knowledge and skills to perform their roles and responsibilities. People were given a nutritious and balanced diet and hot and cold drinks and snacks were available between meals. People had their healthcare needs identified and were able to access healthcare professionals such as their GP. Staff knew how to access specialist professional help when needed.

People were at the centre of the caring process and staff acknowledged them as unique individuals. People told us that staff were kind and caring and we saw examples of good care practice. People were always treated with dignity and respect and enabled to follow their hobbies and pastimes and be involved in the local community. People were supported to make decisions about their care and treatment and maintain their independence. People had access to information about how to make a complaint in an easy read format.

The registered provider had robust systems in place to monitor the quality of the service and make improvements. Staff had access to professional development, supervision and feedback on their performance.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We saw staff spoke with people in a respectful manner and protected their privacy.

We spoke with five people about living at Netherlands. They all said they liked living at Netherlands. One person told us, “I like it here. I'm going out later ”.

We observed a mealtime and saw staff asked people what they wanted and gave assistance where required. Meals were prepared by staff who had been trained in food hygiene.

The environment looked clean and tidy. There was a cleaning schedule in place which was monitored by the manager.

There was an appropriate and safe system in place for the recruitment of staff. We were told by staff we spoke with they felt well supported by the manager.

As well as talking with people who lived at the home, we used a number of different ways to help us to understand people’s experiences.

We looked at records including personal care plans. We spoke to the manager and staff who were supporting people and we observed how they provided support. We saw people were enabled to make choices and decisions for themselves, for example, how they spent their day. A person said, ”I can spend time in my room listening to music if I want to.”

We saw people were treated with respect and dignity and had a good rapport with staff. People told us they would feel comfortable to tell staff if they had any problems or complaints and we saw there was information displayed which told them how to do this.

People told us their bedrooms were comfortable. We saw they were individually decorated and furnished to people’s own taste and preferences. People told us, “It’s nice here.” Other areas of the home we saw were also clean and tidy.

People felt their needs were being met by the current staffing arrangements in place and they felt safe. They made comments such as, “I like the staff.”

We were concerned however that staffing levels at night were insufficient to ensure people’s safety should they need to be evacuated in an emergency. We told the manager and provider about this and they have since confirmed the action they took to address this matter.

One person we spoke with told us, “I like it here. I’m going on holiday.”

Another person told us that they had felt poorly and had stayed in bed. “They brought me lots of drinks and kept me warm.” And “I can have what I want to eat and I like the food they make for me.”

Another person said, “I like doing jigsaw puzzles and sometimes the staff help me when I get stuck