The inspection visit took place on 5 June 2017. The visit was unannounced.

Ryedale House is a residential home which provides care to people with mental health needs. It is registered to provide care for up to seven people. At the time of our inspection there were six people living at the home.

There was 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 and associated Regulations about how the service is run.

People using the service and relatives we spoke with said they thought the home was safe. Staffing levels were sufficient to ensure people's safety. Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area.

Staff were subject to checks to ensure they were appropriate to work with the people who used the service. People's risk assessments provided staff with information on how to support people safely, though some assessments were not fully in place.

People using the service told us they thought their medicines were given safely and on time and this had been the case when we checked.

Staff had been trained to ensure they had the skills and knowledge to meet people's needs. Staff understood their main responsibility under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives.

People had plenty to eat and drink and everyone told us they liked the food served.

People's health care needs had been protected by referrals to health care professionals when necessary.

People told us they liked the staff and got on well with them. We saw many examples of staff working with people in a friendly and caring way. People and their representatives were involved in making decisions about their care, treatment and support.

Care plans were individual to the people using the service and covered their health and social care needs. Activities were organised to provide stimulation for people and they took part in activities in the community if they chose.

People and their relatives told us they would tell staff if they had any concerns and were confident these would be followed up.

People, staff and most relatives we spoke with were satisfied with how the home was run by the registered manager. Management carried out audits and checks to ensure the home was running properly to meet people's needs, though not all essential issues had been audited.

The inspection took place on 7 and 8 June 2016. The visit was unannounced.

Ryedale House is a residential home which provides care to people with mental health needs. It is registered to provide care for up to seven people. At the time of our inspection there were seven people living in the home.

There was 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 and associated Regulations about how the service is run. The registered manager responsible for nursing was managing the service at the time of the inspection.

People using the service we spoke with said they thought the home was safe. Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area.

People's risk assessments provided staff with information of how to support people safely.

People using the service told us they thought medicines were given safely and usually on time.

Staff were not always subject to checks to ensure they were appropriate to work with the people who used the service. The registered manager was following up a reference to obtain more detail to be able to properly assess risk to people living in the service.

Staff had been trained to ensure they had the skills and knowledge to meet people's needs though more training was needed so staff were in a position to meet people's needs.

Staff were not always aware of their responsibilities under the Mental Capacity Act 2005 (MCA) so that people had an effective choice about how they lived their lives. The service had not always obtained legal approval for limiting people's choices when necessary for their best interests. There was no system in place to assess people's capacity to make their own decisions which meant people's choices to follow their own lifestyles could be limited.

People had plenty to eat and drink, everyone told us they liked the food served and people were assisted to eat when they needed help.

People's health care needs had been protected by referral to health care professionals when necessary.

People we spoke with told us they liked the staff and got on well with them, and told us of many times where staff supported them in a friendly and caring way.

People and their representatives were involved in making decisions about their care, treatment and support.

Care plans were individual to the people using the service and covered their health and social care needs.

There were sufficient numbers of staff to ensure that people's needs were responded to in good time.

Activities were available to provide stimulation for people though this provision needed to be reviewed to offer more community activities for people.

People told us they would tell staff if they had any concerns and were confident they would be followed up to meet people's needs.

People, staff and professionals were satisfied with how the home was run by the registered manager.

Statutory notifications of incidents had not been submitted to allow us to assess risk to the welfare of people living in the service

Management had carried out audits and checks to ensure the home was running properly to meet people's needs, though not all essential systems and been audited to provide assurance that people's needs had always been met.

We inspected Ryedale House in April 2013 and returned to the service to check compliance with the regulations. We inspected two outcomes: management of medicines and requirements relating to workers. We found the service had made improvements and were compliant. We saw safe use of management of medicines, and found effective recruitment and selection procedures. We spoke briefly with one person who used services and saw people were busy with daily living activities during our visit. We saw one person leave to attend a computer class, another person went for a morning walk. We saw a relative arrive and was warmly greeted and spoken with by staff. We saw another person spend time quietly in the back garden area.

We spoke with two people who uses the service. We observed people and their interactions with each other and with staff. One person played her electric guitar to us during our visit. We saw people undertaking daily activities and engage positively with staff throughout our visit.

People told us,

" I had egg on toast for breakfast."

" It's a nice place with nice staff."

" I like my keyworker."

"I am going fishing with staff."

We inspected five outcomes areas during this two day inspection. These included: care and welfare, medication management, staff recruitment, quality assurance and complaints. We found compliance for three outcome areas expect for medication management and staff recruitment where we found minor shortfalls around record keeping. We spoke with three people who used services. They told us they were well supported by staff at the home and felt staff were friendly and listened to them. They liked the garden area and felt the home was kept very clean. One person told us." I had two bacon and cheese rolls for my breakfast and I can help myself to drinks. I have privacy in my bedroom and they clean my room everyday."

We inspected parts of the home with the manager. We saw the decor was clean and fresh and the premises well maintained. We saw the outside garden area was attractive with a small pond, bedding plants, various seating areas, and chickens in an enclosed area. One person told us they had helped staff build a chicken run outside and enjoyed feeding the chickens. Staff told us a number of people regularly smoked and were able to smoke in the garden in a covered area.