This inspection took place on 8 November 2018 and was unannounced.

Petersfield is a ‘care home’ for five people with learning disabilities and/or autism. There were five people living in the home when we visited. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any other citizen.

At our last inspection on 16 April 2016 we rated the service as overall ‘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 ongoing 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 continued to receive a safe service and were protected from harm by well trained staff and effective risk assessment processes. Staff knew how to report concerns and there were sufficient staff on duty to keep people safe. People were given medication as prescribed and lessons were learnt from incidents and accidents to reduce the risk of further harm.

People continued to receive an effective service. Staff received training that was relevant for their role and were vigilant to people’s changing health needs to ensure prompt referrals could be made to external healthcare professionals. Consent was obtained before care and support was given and people enjoyed living in a homely environment.

People continued to receive a caring and compassionate service from staff who took the time to get to know people and make sure their needs were met. People were encouraged to be as independent as possible by contributing to the daily routines in the home.

People continued to receive a responsive service. People had the opportunity to follow their own preferred hobbies and interests and people’s needs and preferences were assessed and planned for. Keyworkers ensured that people were involved in planning and reviewing their own care.

The service continued to be well-led. Staff and relatives were happy with the way the service was led and audits were effective in highlighting where there were areas of practice that needed improvement. The registered manager had created a culture which put people’s needs first and staff and people were encouraged to share their views on how the service was run.

Further information is in the detailed findings below.

Our inspection was unannounced and took place on 09 March2016. The inspection was carried out by one inspector. At our last planned inspection on14 April 2014 the provider was meeting all of the regulations that we assessed.

Petersfield is a care home which is registered to accommodate and deliver care to a maximum of five people. The home specialises in the care of people with a learning disability. At the time of our inspection four people lived at the home.

There was a registered manager in post and they were 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 and their relatives told us they felt safe and that staff treated them well. The manager and staff understood how to protect people they supported from abuse, and knew what procedures to follow to report any concerns.

People were supported by staff that were kind, caring and respectful and knew them well. People were encouraged to pursue their interest and hobbies so that they did the things that they liked.

Staff had a good understanding of risks associated with people’s care needs and knew how to support them. There were enough staff to support people safely in the home and whilst outside of the home. Recruitment procedures ensured that only staff of a suitable character to care for people were employed.

Medicines were stored and administered safely, and people received their medicines as prescribed. People were supported to attend health care appointments when they needed to and received healthcare that supported them to maintain their wellbeing.

The registered manager and staff understood the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), and supported people in line with these principles. People were supported to make everyday decisions themselves, which helped them to maintain their independence.

People were supported to eat and drink food that met their dietary requirements and that they enjoyed eating

Staff felt that they had received adequate training to ensure that they had the skills and knowledge they needed to provide safe and appropriate support to the people who lived at the home.

Arrangements were in place to monitor the service and ensure that people received a caring and personalised service.

On the day of our inspection five people lived at the home. We spoke with three people who lived there, two members of staff and the manager.

At our last inspection in October 2013 we found that improvements were needed in two areas and we set compliance actions in our report for improvements to be made. At this inspection we saw that overall improvements had been made in all of the areas previously identified.

We saw that there were enough staff employed to meet people's needs and ensure their safety. One person told us, “There is always enough staff to support us all the time.” Another person said, "We get the support we need from staff without any problems."

We found that appropriate records were in place that had accurate information which fully reflected people's care needs and was accessible to staff when needed.

On the day of our inspection five people were living at the home, we spoke with three of the people. The registered manager was not available on the day however, we spoke with the unit manager who was involved in the day to day management of the home and two members of staff.

People were asked for their consent and staff acted in accordance with their wishes. One person told us, “I sign all my care plans”.

Care was person centred and delivered according to people's individual needs and wishes. One person told us, "If I need to see the GP, staff will take me".

People were given their medicines as how they had been prescribed by their doctor to ensure their health and wellbeing. This meant that medicines were given to people appropriately as prescribed.

We saw that the provider had an effective recruitment and selection procedures in place which ensured that only staff suitable to work with vulnerable adults were employed. However, we saw that there were not enough staff on duty to ensure people received care in a timely manner.

People were provided with information about how to make a complaint if they were not happy with the service and a system was in place to deal with complaints.

We identified that there were gaps in people's care records which meant that information was not accurate and did not fully reflect people's care needs. This meant that people's care records were not fit for purpose.

There were five people living here on the day we visited. We spoke with three people, the manager and two members of staff. We looked at the records for three people.

We observed how people were cared for to understand their experiences. We saw that people were treated with respect and dignity and were happy and at ease with the staff.

We saw that people had personalised care plans which were regularly reviewed and updated. These included advice form health care professionals involved in their care and treatment. This meant that staff had all the information they needed to support people appropriately and safely in the way they preferred.

People we spoke with told us that the staff had helped them to become more independent. One person told us, “I can make my own drinks and clean my own room, its good here.”

We saw that people could choose what they did and how they spent their time. One person told us, “We can choose when we get up and what we want to eat. We can choose where we go. We go out to the library, the theatre and on holiday. We do shopping, bowling or go to the centre when we want.”

Systems were in place to ensure that people were safeguarded from harm.

Staff were trained to give them the skills and knowledge to know how to meet people’s needs and ensure their wellbeing.

People living here, their relatives, representatives and healthcare professionals were asked for their views about the home and these were listened to.

Five people were living in the home when we visited. Some people had gone out to a centre for most of the day and others went out during the day to take some things to a charity shop and do some shopping.

We met all five people and we chatted with some of them. They all seemed relaxed in the company of the registered provider, the manager and the staff. One person told us “It’s good here.”