We inspected this service on 12 December 2017. It was an unannounced inspection. Priory Highfields is a care home that provides accommodation and personal care. Priory Highfields is registered to accommodate eight people. At the time of our inspection eight people were using the service. Priory Highfields accommodates people in two adapted houses and a detached bungalow, converted from a former garage. Each house and the bungalow has a lounge, kitchen and dining area and provides access to enclosed gardens. The home also provides a day care facility for one person.

The service had a registered manager 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was absent from the service. The provider had appointed an acting manager who was working at the service during our inspection visit.

At the last inspection, the service was rated as Good. At this inspection, we found the service had improved their rating to outstanding in Responsive by demonstrating they provided tailored, flexible support that consistently met people’s individual needs and preferences and the service remained Good overall. People were supported to live full lives and received care that was personalised to their individual needs. Staff used innovative and individual ways of involving people in making decisions about their care and support and supported them to engage in varied activities which were personalised to meet their individual needs and wishes. Staff worked collaboratively with other professionals to ensure people received care based on best practice. People’s support plans reflected their views and were reviewed when their needs changed. People’s diversity was recognised and promoted by the staff and people were supported to follow their religious beliefs and to maintain important family relationships. People were supported to raise any concerns or complaints. The staff and acting manager were approachable and were confident any concerns they raised would be listened to an acted on.

People continued to receive safe care. People were protected from the risk of avoidable harm by staff who understood their responsibilities to identify and report any signs of potential abuse. We saw that concerns were taken seriously and investigated thoroughly to ensure lessons were learnt. Risks associated with people’s care and support were managed safely and relatives were confident their family members were safe and well cared for. People received their medicines when needed and there were suitable arrangements in place in relation to the safe administration, recording and storage of medicines. There were sufficient, suitably recruited staff to meet people’s needs. Staff felt valued and supported in their role.

People continued to receive effective care. Staff received training and support to meet the needs of people at the service and were supported and encouraged to develop their skills by the acting manager and professionals working with the service. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported to have a varied and healthy diet and to access other professionals to maintain good health.

The care people received remained good. People looked relaxed and happy in the company of staff and had formed positive, caring relationships. Staff were kind and caring, understood how people communicated and supported them to make choices about their care. People’s privacy and dignity were maintained at all times.

The service remained well led. There were suitable

We inspected this service on 30 December 2015. This was an unannounced inspection. Priory Highfields is a residential care home that provides care for up to eight people who have learning disabilities and autism. When we visited, eight people were living at the service. Our last inspection took place in May 2013 and at that time we found the provider was meeting the regulations we looked at.

The home had a registered manager in place. 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.

We found that people were supported in a way that protected them from harm and abuse. Risks to individuals were managed to keep people safe. This was done in a way that respected their choices and promoted their independence. Staff had a good understanding and knowledge of safeguarding people and understood what constituted abuse or poor practice. They knew how to report concerns and were confident in doing this. There were sufficient staff available to meet people’s needs which enabled people to achieve individual outcomes. People’s medicines were managed in a safe manner.

People received care from staff that knew them well and understood how to support them in the best way. Staff received a range of training which developed their skills and understanding. People were supported to make choices and decisions. When they were not able to, decisions were made in their best interests involving people who were important to them. Where restrictions had been placed upon people these had been assessed, and applications made to ensure any restrictions were lawful.

We saw that people were supported to maintain a balanced diet and were encouraged to take part in the preparation of meals. The kitchens were open for people to access when they wanted to, with support when needed. People received support from health care professionals when needed and staff enabled people to attend appointments.

Positive caring relationships had been developed and we found that people were treated with respect and dignity. People were supported to express their views about their care and we saw that they were encouraged to be actively involved in making decisions about their day to day lives.

Each person had a staff member available to them which provided flexibility, enabling people to make choices about what they did and when they wanted to do it. We saw that the support people received was individual to them and responsive to their needs. The environment had been changed so it was suitable for the people who lived there. People who used the service and their relatives were listened to and changes were put into place following this.

Staff felt supported by the manager and provider. They told us they were approachable and responsive. Staff received a range of training to develop their skills and they showed how they put this knowledge into practice. Systems were in place to assess and monitor the quality of the service and the provider was keen to continue to make improvements.

We inspected Priory Highfields on a planned unannounced inspection, which meant the service did not know we were coming.

At our previous inspection in January 2013 we had concerns that people who used the service were not being involved in their care planning, care and welfare needs were not being met and that the quality monitoring systems that were in place were ineffective. At this inspection we found that improvements had been made in all of these areas.

We were unable to speak to people who used the service as they were all participating in community activities supported by staff.

We spoke with the manager and three members of staff, looked at care plans and risk assessments for two people that used the service and checked that the services quality systems had been up dated.

We found that Priory Highfields was compliant in the three outcome areas we looked at.

We inspected Priory Highfields on a planned unannounced inspection which meant the service did not know we were coming.

We looked to see if improvements in the involvement of people who used the service had been made since our last inspection. We found although plans were in place to improve the situation for one person who used the service the standard was still not being met.

We had concerns over the care and welfare of people who used the service. Risk assessments and care plans were not up to date following recent incidents and staff were unsure as to how to care for one person at certain times in their day. This meant the care being delivered was inconsistent.

Safeguarding procedures were in place and readily available for staff to use if they suspected abuse. We had previously been made aware of safeguarding referrals the service had made when they had suspected abuse.

Staff we spoke with told us they liked working at Priory Highfields and they felt supported by their manager. They told us and we saw that they had sufficient training to complete their role effectively.

The service had implemented quality monitoring systems. We saw that these were relevant but had proved ineffective.

People who use the service may have special communication needs and use a combination of words, sounds, signs and objects to express themselves. Where people were not able to express their views to us we observed interaction between people and staff and how people chose what activities to do and how to spend their time.

We observed staff providing support in the home and saw people were treated with respect. Personal care issues were discussed sensitively and discreetly. There was information about people’s care needs including their preferences and how they wanted care provided.

People were dressed in a style of their choosing and were supported by staff to take a pride in their appearance.

People were able to participate in everyday activities in the home and the community. People were responsible for completely household chores including cooking, laundry and cleaning. During our visit people visited a local theme park and attended college. College course available included developing skills required for independence and arts and crafts.