This inspection took place on 23 and 31 May 2017 and was unannounced. This meant the staff and provider did not know we would be visiting. We also contacted family members and relevant health and social care professionals on 12 June 2017.

Resolve provides care and accommodation for up to seven people with a learning disability. On the day of our inspection there were six people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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 last inspected the service in November 2014 and rated the service as ‘Outstanding’ overall. At this inspection we found the service remained ‘Outstanding’ and met all the fundamental standards we inspected against.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the safe administration and storage of medicines.

The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

The provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following legal requirements in respect of Deprivation of Liberty Safeguards (DoLS).

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported to attend visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at Resolve. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Person-centred care was at the heart of the service. Health and social care professionals said the service was “highly supportive” of people who used the service and “worked effectively” on people’s behalf.

Management and staff were able to talk in great detail about each person they supported and the best way to support them. People who used the service told us about how they could make choices and do what they wanted to do.

The service was flexible and responsive to people’s individual needs and preferences. Staff planned people’s care and support proactively and in partnership with them.

The provider had developed innovative and creative ways to provide people who used the service with training and education opportunities. People were supported to play a key role in the local community and were encouraged and supported to engage with groups outside of the service.

The provider had an effective complaints procedure in place and people who used the service and family members were aware of how to make a complaint.

The registered manager demonstrated how they had sustained outstanding practice, development and improvement at the service, and the service had a strong emphasis on continually striving to improve. The registered manager said, “We really want to influence national practice” and spoke positively about the service, describing their role as, “Balancing safety with a happy life and a positive outcome” for the people they supported.

The provider worked in partnership with other organisations to make

During the visit, we spoke with six of the seven people who used the service. Everyone said that they were extremely pleased with the service; felt they had made remarkable progress since being at the home; and that staff were really helping them to lead independent lives. People felt that the service had really enabled them to get the best out of life. People told us; “This place is brilliant”, “I am so pleased I was able to come here, as it has the been the best thing ever for me and I have made so much progress” and “The staff know what they are doing and always make sure I know what is going on”.

We found that people were actively supported and encouraged to make decisions about all aspects of their life and this included working with the staff to decide how the home would be developed. From our observations we found that staff worked in ways that effectively supported the people to deal with issues associated with their behaviour and to understand how to reduce any risks that arose from this behaviour. We also saw that staff treated individuals with a great deal of humanity as well as empathy.

We found that the provider had an effective system for monitoring the service and this led to them constantly looking at how to improve what was offered. We found that the home was maintained to a high standard. The people who used the service were supported to learn decorating and gardening skills and they were encouraged to put these into practice in the home.

Everyone told us that the staff treated them with respect, respecting their privacy and right to make choices. One person explained to us how they choose to study at a local college to gain qualifications in Maths and English

People told us they were happy with the care and support they were receiving. One person said "I like it better here, it is much quieter and I go out a lot more now” and another said "I like playing football and I can play for a local team.”

All the people that we spoke with told us they felt safe with the carer's employed by the service. One person said "the staff look after me well here”.

Everyone told us that the staff treated them with respect, respecting their privacy and right to make choices. One person explained to us how they choose to study at a local college to gain qualifications in Maths and English

People told us they were happy with the care and support they were receiving. One person said "I like it better here, it is much quieter and I go out a lot more now” and another said "I like playing football and I can play for a local team.”

All the people that we spoke with told us they felt safe with the carer's employed by the service. One person said "the staff look after me well here”.

This inspection took place on 24th and 25th November 2014 and was unannounced. Low House provides care and accommodation for up to seven people. The home specialises in the care of people who have a forensic learning disability and supported men with a range of criminal offences. Some people who used the service were detained under the Mental Health Act 1983.

On the day of our inspection there were a total of six people using the service.

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.

On the day of the inspection there was a calm and relaxed atmosphere in the home and we saw staff interacted with people in a very friendly and respectful manner. One person told us, “I love living here, I feel very safe and I don’t want to leave.” Another said, “For the first time in my life I feel safe.”

The six staff we spoke with described the management of the home as open and approachable. Throughout the day we saw that people and staff appeared very comfortable and relaxed with the registered manager on duty.

People had their psychological and mental health needs monitored. There were regular reviews of people’s health and the service responded to people’s changing needs. People were assisted to attend appointments with various health and social care professionals to ensure they received care, treatment and support for their specific conditions.

People said staff were, "Great” and “mint”. On three recent surveys we saw a professional reported that the service was “focused on providing a person-centred care and it achieved great results.”

A clinician quoted, “This is an impressive provider that delivers an excellent service.” Another quoted, “People are involved in decisions, and there is a good range of activities and educational opportunities. The ethos of care is very positive.”

We saw people’s care plans were very person centred and clearly described their care, treatment and support needs. These were regularly evaluated, reviewed and updated. The care plan format was easy for people who used the service to understand by using of lots of pictures and symbols. We saw lots of evidence to demonstrate that people were involved in all aspects of their care plans. For example, one person told us, “I help my key worker to keep mine up to date and I am always fully involved when I have my review meeting with my consultant and social worker.”

All staff we spoke with said they received appropriate training, good support and regular supervision. We saw records to support this.

Staff had received training in how to recognise and report abuse. We spoke with four staff and all were clear about how to report any concerns. Staff said they were confident that any allegations made would be fully investigated to ensure people were protected.

Throughout both days we saw staff interacting with people in a very caring and professional way.

We noted that throughout the day when staff offered support to people they always respected their wishes. For example, during lunch, everyone was asked what they would like to eat and were offered various choices for people to choose from.

We saw activities were personalised for each person. People also made suggestions about activities and outings during house meetings. Where necessary additional staff were provided to enable people to access community facilities appropriate to their ages and abilities.

All people received one to one support for their health, personal care and support needs, and this enabled regular community support on a daily basis. For example, work placements, education and leisure. On the day of our inspection, two people were escorted to go football training and others were working in the gardens.

People received a wholesome and balanced diet in pleasant surroundings and at times convenient to them.

We saw the provider had policies and procedures for dealing with medicines and these were adhered to.

The provider had an effective pictorial complaints procedure which people felt they were able to use.

We saw people who used the service were supported and protected by the provider’s recruitment policy and practices.

The home was immaculately clean and well maintained, and equipment used was regularly serviced.

The provider had a quality assurance system in place, which was based on seeking the views of people, their relatives and other health and social care professionals. There was a systematic cycle of planning, action and review, reflecting aims and outcomes for people who used the service.