Pinecroft provides accommodation and personal care for four people. People who live at the home have autism and mental health needs. There were four people living at the home at the time of the inspection. Pinecroft is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This was an unannounced inspection, which meant the staff and provider did not know we would be visiting.

In addition, the service provides personal care as part of an outreach service to people in their own homes. This service was situated in a separate self sufficient office in the back garden of Pinecroft. It provides a service to older adults and young adults who have a diagnosis of autism.

Not everyone using Bristol Outreach Service receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of the inspection the Outreach service was supporting 18 people. However, only one person was receiving the regulated activity of personal care. The person’s package of care had started on the 6 June 2018 and was a temporary arrangement until the Outreach Office in Plymouth was registered.

There were two registered managers in post. One was responsible for Pinecroft and the other for the Bristol Outreach Service. 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.

At our last inspection, we rated the service good. At this inspection we found the evidence had shown the service continues to be good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

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 citizen. This was the vision of the manager and staff working at Pinecroft. People were very much part of their local community and care was tailored to the person.

There was enough staff to support people living in Pinecroft and those receiving a service in the community and to respond to their changing needs. Some staff worked in both Pinecroft and the Outreach Service. This was seen as positive by the management of the service as some people had previously lived in Pinecroft and it offered them some consistency and familiar staff.

People were being supported and enabled to take more control over their lifestyle choices. People were being encouraged to shop and prepare their own meals, look after their own finances and take some responsibility for their medicines. This was in preparation should people chose to live more independently. Risk assessments were carried out to enable people to receive care with minimum risk to themselves or others. People received their medicines safely.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management, checks on the equipment, fire systems and safe recruitment processes.

People received effective care because staff had the skills and knowledge required to effectively support them. People's healthcare needs were monitored by th

Pine Croft provides accommodation and personal care for four people. People who live at the home have autism and mental health needs. There were two people living at the home at the time of the inspection. This was an unannounced inspection, which meant the staff and provider did not know we would be visiting.

In addition the service provides personal care as part of an outreach service to people in their own homes. This service was situated in a separate self-sufficient office in the back garden of Pine Croft. At the time of the inspection they were supporting seven people however, none of these people were receiving assistance with personal care. The Care Quality Commission therefore did not inspect this part of the service as they were not carrying out any regulated activities.

There were two registered managers in post. One was responsible for Pine Croft and the other the Outreach Service. 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 were receiving care that was responsive and effective. Care plans were in place that described how the person would like to be supported. This included the early warning signs that a person’s mental health was changing and how the person’s autism impacted on their day to day lives. The care plans were tailored to the person and provided staff with information to support the person effectively. People had been consulted about their care needs and their views sought about the service. People were supported to make decisions and take proportionate risks. Systems were in place to ensure that complaints and any concerns in respect of abuse were responded to.

Staff were caring, supportive and demonstrated a good understanding of their roles in supporting people with autism. Staff received training and support that was relevant to their roles. Systems were in place to ensure important information was shared amongst the team and other health and social care professionals to ensure a consistent approach to people’s care.

People had access to other health and social care professionals. Feedback received from visiting professionals was that they were made to feel welcome and were kept informed about any changes enabling them to adjust any treatment and support for the person. People confirmed they could access an advocacy service if they wanted. At the time both people had declined an advocate, saying they could speak out for themselves. Safe systems were in place to ensure people received their medicines as prescribed.

There was enough staff to support people both in the home and the community and to respond to their changing needs. Staff worked in both Pine Croft and the Outreach Service. This was seen as positive by the management of the service as some people had previously lived in Pine Croft and it offered them some consistency and familiar staff.

People were being supported and enabled to take more control over their lifestyle choices. People were being encouraged to shop and prepare their own meals, look after their own finances and take some responsibility for their medicines. This was in preparation should people chose to live more independently.

The service was well led. There were systems to monitor the quality and seek the views of people to improve the service.

The service was advised to review the name of the service as currently it does not acknowledge the service provided in the community, the Outreach Service.

Three people were living in the home at the time of our inspection. They were told by staff why we were visiting and they were asked if they would like to speak with us. All three said that they would like to be introduced to us but that they didn’t want to be part of the inspection. People greeted us when we were being shown around their home and said goodbye when we were leaving. All three people were ‘happy’ and relaxed in their surroundings.

The registered manager had recently been promoted within the organisation and was currently inducting the newly appointed manager. We were assisted throughout the inspection by both managers and support team. They were knowledgeable about people they supported and provided us with information about their experience and views about the quality of service provided. It was evident they enjoyed working in the home and supporting the people who lived there.

People experienced effective, appropriate care, and support that met their needs and was person centred. They were provided with a choice of suitable and nutritious food and drink. People lived in a suitable environment that was safe and promoted their well-being.People were made aware of how to express any concerns they had and were supported by staff when they needed assistance to do this.

We met the two people living at Pine Croft. We talked with one person about their experiences while we met the other person briefly as they were going out with a family member. People told us they were happy living at Pine Croft and that they were well supported by staff. We spoke to the family member about the care of their relative. We were told some very positive views about the care and support that people had received.

We spoke with staff during our visit. We saw that they had developed good relationships with people and were knowledgeable about their individual care needs.

We looked at peoples' care files and saw that peoples’ care and support was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw through staff rotas that there had been sufficient staff to support people with their care needs and activities.

We looked at various records kept at the home including peoples' care plans, the records of how people were being kept safe and records of how staff were being trained to meet peoples' needs. It was evident that people had been empowered to make decisons about their care and had been supported in being independent.