We carried out this inspection on 26 July 2018. The inspection was unannounced. This meant no-one at the service knew we were planning to visit.

Sheffield Crisis House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Sheffield Crisis House is registered to provide accommodation for persons who require nursing or personal care. However, it is a condition of the registered provider’s registration they must not provide nursing care at Sheffield Crisis House. The service provides short-term accommodation for people experiencing a mental health crisis. Staff provide 24 hour emotional and practical support to assist people to resolve their crisis. The service has six beds and is located in a residential area of Sheffield. There is a bedroom on the ground floor of the property suitable for people with mobility difficulties. The remaining floors are accessed by stairs. At the time of the inspection there were four people living at the service.

There was a manager at the service who was registered with the CQC. 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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. We have made four recommendations in our report, which means we expect the registered provider to consider our feedback and make improvements before the next inspection.

People living at the service told us they felt safe. Staff had completed safeguarding adults training and were aware of their responsibilities in protecting people from abuse. We saw systems in place to evacuate people safely in the event of an emergency. However, we identified people’s personal evacuation plans were not always being completed and therefore made a recommendation for the registered provider to prioritise completion of the same. On the day of the inspection we found there were sufficient numbers of staff to meet people’s needs and it was evident that staff had been safely recruited. However, staff told us they sometimes felt rushed. We made a recommendation about the staffing arrangements at the service.

We found very clear evidence that people’s care and support was planned and reviewed with them and not for them. The people we spoke with told us the standard of care they received was good. We made two recommendations about the information recorded in people’s care records.

The service encouraged people to maintain a healthy diet and worked collaboratively with external health services to promote people's wellbeing and positive discharge outcomes. Staff told us they enjoyed working at the service and had received support, training and supervision to help them to carry out their support role effectively. 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 support this practice.

People said they were treated with respect and dignity, and staff supported them in a way which met their needs. People told us staff were caring and kind and as a result of the emotional support they had received they felt more confident. We saw the service promoted people’s independence by supporting people to manage their

The inspection took place on 10 November 2015, and the inspection was unannounced. There were no breaches of relevant legal requirements at the last inspection of the service in March 2014.

Sheffield Crisis House provides short term accommodation for people experiencing a mental health crisis. People can access the service usually for up to a maximum of seven nights, however if treatment plans require a longer period this can be negotiated between the service and their providers. Staff provide 24 hour emotional and practical support to help people through their crisis. The service has six bedrooms (one has been adapted to support the needs of individuals with mobility problems). The bedrooms are provided over three floors of the building.

The home has 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.

The staff of the service had access to the organisational policy and procedure for protection of adults from abuse. They also had the contact details of the authority in which the service is located.

The members of staff we spoke with said that they had received training about protecting children and adults from abuse which we verified on training records and staff were able to describe the action they would take if a concern arose.

We found there were the designated number of staff on during our visit, this helped to ensure that

staff were working with people who they had come to know and could quickly identify any changes to people’s care and support needs.

We saw that risks assessments associated with people’s day to day care, for example if someone was at risk of self-harming behaviour, were compiled and regularly reviewed and included what action should be taken to minimise these risks.

We saw there were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected. However due to the short term placements for people at the service when they are in crisis it may not be appropriate to make any DoLS applications for them.

People were supported to maintain good health. Staff are available and accessible on duty at the service 24 hours a day. Staff told us they felt that healthcare needs were met effectively and this was confirmed by a local GP who regularly visited the service.

The people that used the service praised staff for their caring attitudes. The care plans we looked at were based on people’s personal needs and wishes. They had all been developed to meet the specific needs for everyone that used the service and were very person centred.

People’s views were respected as was evident from conversations that we had with people using the service, relatives, visitors and staff. We saw that staff were involved in decisions and kept updated of changes and were able to feedback their views. The provider carried out regular reviews of the service and sought people’s feedback on how well the service performed and outlined any the areas of improvement that were necessary to maintain the quality of the service

We last inspected Sheffield Crisis House in July 2013 in response to a serious incident at the service. The service was found to be non-compliant in two of the four outcomes we inspected. This inspection was to check that improvements had been made in relation to safeguarding and the safety of the premises.

Information about people’s experience of Sheffield Crisis House was gained by speaking with three people staying at the service and by reviewing questionnaires about the quality of the service which had been completed by people following their stay. Information was also gained by speaking with the registered manager and with the two support workers on duty at the time of our inspection. We also reviewed a range of records.

Each person was positive about the support they received. One person described Sheffield Crisis House as, “nice, friendly and relaxing.”

People said that they felt safe at the service. Each person commented that staff being available at all times had a positive impact upon their sense of safety. Our conversations with staff and our check of records demonstrated that the service were aware of, and followed local safeguarding procedures in order to safeguard people.

People were protected against the risks of unsafe or unsuitable premises. One person described the premises as, "safe and clean." We found that a number of daily and weekly checks were in place to ensure the safety of fixtures and fittings within the property.

We undertook a responsive inspection of Sheffield Crisis House following a recent serious incident at the service. An investigation of this incident is being conducted by Sheffield City Council Environmental Health Office. We will review the findings of this to determine if we need to take further action.

Prior to the inspection we had contacted the service and asked for information about the steps taken following the incident to ensure safe care, treatment and support of people using the service. This information was provided within the required timescale and contributed to our inspection.

We found that people supported by the service at the time of our inspection were positive about the care and support they had received. Comments within completed surveys were also positive, one comment described the service as, "an amazing environment for recovery."

Whilst the provider demonstrated knowledge and awareness of safeguarding, local guidance and reporting procedures had not been followed to ensure that people who used the service were safeguarded from abuse. Observations of the premises and our review of risk assessments identified some areas of concern about the safety and suitability of certain fixtures and fittings within the service. There were effective systems to regularly assess and monitor the quality of service that people received.