About the service: Rowland House provides accommodation, care and support for up to seven people who may have complex physical needs as well as brain injury and other neurological conditions. There were six people using the service at the time of the inspection.

People’s experience of using this service:

• Staff had received training for safeguarding and this was updated regularly. The service was well-staffed and people received their medicines when they needed them. Risk assessments were in place to manage potential risks within people's lives, whilst also promoting their independence. Whilst we noted some people were using bedrails, the risks of these had not been suitably explored in people’s care files. The registered manager sent us this information following our visit. Recruitment processes protected people from the risk of being supported by staff who were not suitable for the role. The service was clean and fresh throughout.

• People's needs were assessed prior to them moving into the service to help ensure they were cared and supported effectively. Staff received training to be able to meet people's needs. People were supported with their nutritional needs and healthy diets were promoted. Staff worked well with external health and social care professionals and people were supported to access health services when required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

• Staff at the service ensured people were at the heart of their care and support. The staff team were reported to be kind, caring and considerate. Staff treated people with dignity and respect and helped to maintain people's independence where possible.

• People's individual communication needs were known by staff, and the provider had used assistive technology to help support people's communication needs. People received personalised care and participated in activities, hobbies and events they enjoyed. People told us they knew who to complain to and would feel confident in doing so.

• Audits and quality checks had been completed and had identified where improvements were needed. Risks were known by staff and aware of the steps to take to reduce these risk. Care records were up to date and person centred.

Rating at last inspection: Rated Good (Report published 15 September 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained Good overall.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Rowland House provides accommodation, care and support for up to three people who may have complex physical needs as well as brain injury and other neurological conditions. There were three people living in the service when we carried out an announced inspection on 11 August 2016. The provider was given 24 hours’ notice because Rowland House is a small service where people are supported to attend day care centres and other activities outside of the service and we needed to know that someone would be available.

There was a registered manager in post. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People received care and support that was personalised to them and met their individual needs and wishes. Support workers respected people’s privacy and dignity and interacted with people in a caring, compassionate and professional manner. They were knowledgeable about people’s choices, views and preferences. The atmosphere in the service was friendly and welcoming.

People were safe and support workers knew what actions to take to protect them from abuse. The provider had processes in place to identify and manage risk. Assessments had been carried out and personalised care records were in place which reflected individual needs and preferences.

Recruitment checks on staff were carried out with sufficient numbers employed who had the knowledge and skills to meet people’s needs.

Appropriate arrangements were in place to ensure people’s medicines were obtained, stored and administered safely. People were encouraged to attend appointments with other health care professionals to maintain their health and well-being. Where people required assistance with their dietary needs there were systems in place to provide this support safely.

People and or their representatives, where appropriate, were complimentary about the care and support provided. They confirmed they were actively involved in making decisions about their ongoing care and support arrangements. As a result people received care and support which was planned and delivered to meet their specific needs. Support workers listened to people and acted on what they said. They understood each person’s way of communicating their needs and anxieties and responded appropriately.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Support workers understood the need to obtain consent when providing care. Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice.

There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the care they received. People’s feedback was valued and acted on. There was visible leadership within the service and a clear management structure. The service had a quality assurance system with identified shortfalls addressed promptly which helped the service to continually improve.