This inspection took place on 7 June 2017 and was unannounced which meant the provider and staff did not know we would be visiting. The service was last inspected on 26 March 2015 and the service was rated good.

50 Belle Vue Grove is a large detached house situated within a suburb of Middlesbrough. It is within walking distance of local amenities. The property has a large garden and patio and bedrooms across both floors. There are also a number of bathrooms, one of which is a wet room. Belle Vue Grove provides accommodation for people who have learning disabilities, broad spectrum autism and mental health needs. There were five people living there at the time of our inspection

Risks to people arising from their health and support needs as well as the premises were assessed, and plans were in place to minimise them.

There were systems in place to ensure that people received their medicines as prescribed.

There were enough staff to meet people's needs. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Staff told us they received training to be able to carry out their role. Staff received effective supervision and a yearly appraisal.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

Staff understood the importance of ensuring people agreed to the care and support they provided and when to involve others to help people make important decisions. The registered manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS).

People were cared for by staff that were trained in recognising and understanding how to report potential abuse. Staff felt confident to raise any concerns they had in order to keep people safe.

People enjoyed a good choice of meals and were supported to maintain a healthy diet.

The service worked with external professionals to support and maintain people’s health.

Throughout the inspection there was lots of laughter between people and staff. The interactions between people and staff showed that staff knew the people well.

Care was planned and delivered in way that responded to people’s assessed needs. Care plans contained detailed information about people’s personal preferences and wishes

Staff showed us that they knew the interests, likes and dislikes of people and people were supported to enjoy various activities. We saw that staff ensured that they were respectful of people's choices and decisions.

The service had a clear complaints policy that was applied when issues arose.

The registered manager was actively involved in monitoring standards and promoting good practice. The service had quality assurance systems in place which were used to drive continuous improvements.

Further information is in the detailed findings below.

The inspection visit took place on 26 and 27 March 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.

We last inspected the service on 4 June 2013 and found the service was not in breach of any regulations at that time.

50 Belle Vue Grove, also called Cinnamon House is a large detached house situated within a suburb of Middlesbrough. It is within walking distance of local amenities. The property has a large garden and patio and bedrooms across both floors. There are also a number of bathrooms, one of which is a wet room. Belle Vue Grove provides accommodation for people who have mental health needs, learning disabilities, and broad spectrum autism. There were four people living there at the time of our inspection.

There is 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.

Four people we spoke with told us they felt safe at 50 Belle Vue Grove. We discussed safeguarding with staff and all were knowledgeable about the procedures to follow if they suspected abuse. Staff were clear that their role was to protect people and knew how to report abuse including the actions to take to raise this with external agencies.

There were policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005 and Deprivations of Liberty Safeguards (DoLS). The registered manager had the appropriate knowledge to know how to apply the MCA and when an application should be made and how to submit one. This meant people were safeguarded.

Staff had received a range of training, which covered mandatory courses such as fire safety, infection control, food hygiene as well as condition specific training such as working with people with mental health problems and providing person centred support. We found that the staff had the skills and knowledge to provide support to the people who lived at the home. People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that two staff routinely provided support to four people.

There was a regular programme of staff supervision in place and records of these were detailed and showed the home worked with staff to identify their personal and professional development. We also saw a regular programme of staff meetings where issues were shared and raised. We saw that staff were recruited using procedures to check they were safe to work with vulnerable people.

The service encouraged people to lead a safe and active lifestyle. People were supported to be involved in the local community as much as possible. People were supported to access facilities such as the local G.P, gym, shops and leisure facilities as well as to use the facilities in the service such as the kitchen for cooking meals.

There was a system in place for dealing with people’s concerns and complaints. Three people told us they would talk to staff if they were unhappy with anything. The staff we spoke with all told us they could recognise if people they supported weren’t well or were unhappy and what measures they would take to address any concerns.

We saw staff treating people with dignity and respect and observed staff caring for people in a gentle and polite manner.

People were encouraged to help prepare menus and food with staff support and on the day of our visit people prepared their lunch independently. People were encouraged to follow a healthy eating programme and staff worked with people to plan menus and to shop using budgeting skills.

We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create care plans which were detailed and person centred. Care plans were regularly reviewed and involved the person as much as possible. We observed one person who had just moved to the service, writing their own care plan with the support of the registered manager.

We reviewed the systems for the management of medicines and found that people received their medicines safely and there were clear guidelines in place for staff to follow.

We found that the building was clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. We found that all relevant infection control procedures were followed by the staff at the home and there was plenty of personal protective equipment to reduce the risk of cross infection. We saw that audits of infection control practices were completed.

We saw that the registered manager utilised a range of quality audits and used them to critically review the service. They also sought the views of people using the service and their families on a regular basis and used any information to improve the service provided. This had led to the systems being effective and the service being well-led.

Accidents and incidents were also reviewed by the registered manager and appropriate measures taken to reduce the risk of any further re-occurrence.

The service worked closely with other healthcare professionals to ensure people’s mental health needs were supported and monitored.

The inspection visit took place on 26 and 27 March 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.

We last inspected the service on 4 June 2013 and found the service was not in breach of any regulations at that time.

50 Belle Vue Grove, also called Cinnamon House is a large detached house situated within a suburb of Middlesbrough. It is within walking distance of local amenities. The property has a large garden and patio and bedrooms across both floors. There are also a number of bathrooms, one of which is a wet room. Belle Vue Grove provides accommodation for people who have mental health needs, learning disabilities, and broad spectrum autism. There were four people living there at the time of our inspection.

There is 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.

Four people we spoke with told us they felt safe at 50 Belle Vue Grove. We discussed safeguarding with staff and all were knowledgeable about the procedures to follow if they suspected abuse. Staff were clear that their role was to protect people and knew how to report abuse including the actions to take to raise this with external agencies.

There were policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005 and Deprivations of Liberty Safeguards (DoLS). The registered manager had the appropriate knowledge to know how to apply the MCA and when an application should be made and how to submit one. This meant people were safeguarded.

Staff had received a range of training, which covered mandatory courses such as fire safety, infection control, food hygiene as well as condition specific training such as working with people with mental health problems and providing person centred support. We found that the staff had the skills and knowledge to provide support to the people who lived at the home. People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that two staff routinely provided support to four people.

There was a regular programme of staff supervision in place and records of these were detailed and showed the home worked with staff to identify their personal and professional development. We also saw a regular programme of staff meetings where issues were shared and raised. We saw that staff were recruited using procedures to check they were safe to work with vulnerable people.

The service encouraged people to lead a safe and active lifestyle. People were supported to be involved in the local community as much as possible. People were supported to access facilities such as the local G.P, gym, shops and leisure facilities as well as to use the facilities in the service such as the kitchen for cooking meals.

There was a system in place for dealing with people’s concerns and complaints. Three people told us they would talk to staff if they were unhappy with anything. The staff we spoke with all told us they could recognise if people they supported weren’t well or were unhappy and what measures they would take to address any concerns.

We saw staff treating people with dignity and respect and observed staff caring for people in a gentle and polite manner.

People were encouraged to help prepare menus and food with staff support and on the day of our visit people prepared their lunch independently. People were encouraged to follow a healthy eating programme and staff worked with people to plan menus and to shop using budgeting skills.

We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create care plans which were detailed and person centred. Care plans were regularly reviewed and involved the person as much as possible. We observed one person who had just moved to the service, writing their own care plan with the support of the registered manager.

We reviewed the systems for the management of medicines and found that people received their medicines safely and there were clear guidelines in place for staff to follow.

We found that the building was clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. We found that all relevant infection control procedures were followed by the staff at the home and there was plenty of personal protective equipment to reduce the risk of cross infection. We saw that audits of infection control practices were completed.

We saw that the registered manager utilised a range of quality audits and used them to critically review the service. They also sought the views of people using the service and their families on a regular basis and used any information to improve the service provided. This had led to the systems being effective and the service being well-led.

Accidents and incidents were also reviewed by the registered manager and appropriate measures taken to reduce the risk of any further re-occurrence.

The service worked closely with other healthcare professionals to ensure people’s mental health needs were supported and monitored.

People who used the service told us that they received the support they needed to help them lead fulfilling lives. They were able to engage with the local community and were helped to develop the skills they would need to live more independent lives in the future.

Staff were knowledgeable about people’s physical and mental health needs and were aware of the support networks in place for people who used the service. Where people were being supported by a number of different health professionals or organisations it was clear that staff communicated with each other to make sure that people were safe and supported appropriately.

Staff received the training they needed to enable them to carry out their role effectively and safely. They underwent regular supervision sessions, had annual appraisals and told us that they felt supported by the manager of the service.

There were quality monitoring procedures in place and people were aware of their responsibilities in relation to maintaining and improving quality. The service had recently named a member of staff the infection control champion.

Records were stored securely, contained up to date, relevant information and were fit for purpose.

People who lived at Belle Vue Grove were supported in a way which improved their independence and encouraged them to integrate within the local area. People were encouraged to take part in activities and supported in doing so. They were also supported to express their opinions both about the support they received within the service and support they received from other service providers. Where they had expressed concerns, these had been documented and investigated fully by the manager of the service or forwarded to the service they related to.

The health and welfare of people was promoted and where people needed intervention from health professionals such as GPs, dentist, and mental health specialists they had been involved. People were also encouraged to live a health lifestyle.

People were supported by staff who were aware of their responsibilities relating to safeguarding vulnerable adults. Staff had undergone training and there was information about who to contact about safeguarding and concerns about abuse readily accessible to staff. Staff had also undergone a robust recruitment process and people were supported by staff who had the skills and qualifications to support people appropriately.