The inspection took place on 7 December 2016 and was unannounced. SeeAbility- Applewood Residential Home is registered to accommodate up to 5 people who require support with personal care. They specialise in caring for young adults with a learning disability or difficulties with their mental health and also have a visual impairment. On the day we visited five people were living in the service.

The service had a registered manager. 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 met and spoke to all five people during our visit. People were not all able to fully verbalise their views and used other methods of communication, for example pictures and symbols. We therefore spent some time observing people. One person said; I enjoy it here.” And another said; “Staff support me when I get upset.” A staff member said; “Good company to work for.”

A relative wrote to the service and said; “The support and help given to my relative at Applewood is outstanding and has given him more independence than we ever thought possible. We fought hard for his place there and are continually surprised by his achievements. Well done and thanks to all at Applewood.”

People’s medicines were managed safely. Where errors had been found, action had been taken to reduce the risk of recurrence. Medicines were stored and disposed of safely. Staff received appropriate training and understood the importance of the safe administration and management of medicines. People were supported to maintain good health through regular access to health and social care professionals, such as psychiatrics.

People who were able said they were happy with the care the staff provided. People were encouraged and supported to make decisions and choices whenever possible in their day to day lives.

People’s care records were detailed and personalised to meet their individual needs. Staff understood people’s needs and responded when needed. People were not all able to be fully involved with their care plans, therefore family members supported staff to complete and review the care plans. People’s preferences were sought and respected.

People had their privacy and dignity maintained. Staff were observed supporting people with patience and kindness.

People’s risks were well documented, monitored and managed to ensure people remained safe. People lived full and active lives and were supported to access local areas and activities. Activities reflected people’s interests and individual hobbies. People were given the choice of meals, snacks and drinks they enjoyed while maintaining a healthy diet. People had input in preparing some meals and drinks.

Staff understood their role with regards to ensuring people’s human and legal rights were respected. For example, the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS) were understood by the registered manager and staff. They knew how to make sure people, who did not have the mental capacity to make decisions for themselves, had their legal rights protected and worked with others in their best interest. People’s safety and liberty were promoted.

Staff had completed safeguarding training and had a good knowledge of what constituted abuse and how to report any concerns. Staff described what action they would take to protect people against harm and were confident any incidents or allegations would be fully investigated.

Staff described the registered manager as being very approachable and supportive. Staff talked positively about their roles.

The registered manager and registered provider had an ethos of honesty and transparency. This reflected the requirements of the duty of candour. The duty of ca

People's needs were assessed and care and treatment was planned and delivered in accordance with their individual care plan. Care plans seen were covered all aspects of people’s care and support needs and provided guidance for staff, to ensure that people’s identified current and on-going care and support needs could be met consistently and safely. People who live at the home told us they were very happy with the support they were provided. Records confirmed people’s health care needs had been monitored.

One person told us “Staff never shout. I feel safe here”.

Another person told us they had a key worker and said “I talk to my key worker about all sorts of things, about everything really”.

Staff members we spoke with told us that as part of their recruitment they had been interviewed by management and people who lived at the home. They told us they had provided references and identity and security checks had been completed before they started work. They told us they were happy working in the home and they had received the training they needed to meet diverse needs of the people who lived there.

The staff at the home worked in co-operation with others. We saw that each person’s care had been reviewed annually and that relevant health care and social care professionals had been involved in this process.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

The equipment provided at the home promoted peoples comfort, safety and independence. It was safe to use and had been well maintained.

People living in the home spoken with during the inspection expressed satisfaction with the home, the care workers and the service provided:

One person who lived at the home told us

“I like living here and I like my key worker”

“I chose the paint colour in my room”

Another person told us

“I am very happy living here thank you, very, very happy”.

A review of a satisfaction questionnaire completed by another person who lived at the home included the comments

“I really enjoy living at Applewood” ,

“the staff help me and listen to my needs”

“I can learn new things”.

We were told that, in accordance with their identified wishes and individual support plans, people are encouraged and enabled, as far as practicable, to make choices about their daily lives.

During our visit, we found that people living in the home were settled and content, their assessed needs were being met and they were clearly well cared for. This was reinforced by positive comments received and also evident from direct observation of effective interaction of individuals being supported in a professional, sensitive and respectful manner.

Care workers we spoke with told us that they felt supported by the manager and that they were listened to. They told us that they had completed a comprehensive induction and that the training they had received had provided them with the skills they needed to meet the diverse needs of the people living there.