South Highnam provides residential care services for up to eight people with learning or physical disabilities. There were seven people using the service during our inspection.

At the last inspection in May 2015 the service was rated Good. At this inspection we found the service remained Good.

Staff knew how to keep people safe and prevent harm from occurring. Staff were confident they could raise any concerns about poor practice in the service and these would be addressed to ensure people were protected from harm. Recruitment checks were carried out to ensure suitable people were employed to work at the service. Medicines were managed safely and administered by staff trained for this role.

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. People were supported to have enough to eat and drink and attend appointments with healthcare professionals. Staff had undertaken a structured induction and essential training at the beginning of their employment. This was followed by periodic refresher training and on-going support sessions.

Staff provided care and support with kindness and compassion. There were positive interactions between people and staff. People could make choices about how they wanted to be supported and staff listened to what they had to say.

Detailed support plans were in place which guided staff how people wished and needed to be supported. People who received support, or where appropriate their relatives, were involved in decisions and consented to their care. People's independence was promoted and encouraged.

People and relatives spoke positively about the registered manager. The registered manager used a variety of different methods to monitor the quality of the service. A recent audit had been effective in identifying where improvements were needed and generating improvements for the benefit of people who used the service.

Further information is in the detailed findings below.

We inspected South Highnam on 8 May 2015. This was an announced inspection. We informed the provider at short notice (the day before) that we would be visiting to inspect. We did this because the location is a small care home for people who are often out during the day; we needed to be sure that someone would be in.

South Highnam is located close to the centre of Hartlepool and provides personal care and support for up to eight people who have a learning disability and / or complex needs. Additionally the service can support people who have autism, epilepsy and challenging needs.

The service 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.

People were protected by the services approach to safeguarding and whistle blowing. People who used the service told us that staff treated them well. Staff were aware of safeguarding procedures, could describe what they would do if they thought somebody was being mistreated and said that management acted appropriately to any concerns brought to their attention.

Appropriate checks of the building, equipment and maintenance systems were undertaken to ensure health and safety.

Staff told us that they felt supported. There was a regular programme of staff supervision and appraisal in place. Records of supervision were detailed and showed that the registered manager had worked with staff to identify their personal and professional development.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. There was enough staff on duty to provide support and ensure that their needs were met.

Staff understood the requirements of the Mental Capacity Act, 2005 and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who lack capacity to make their own decisions.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

There were positive interactions between people and staff. We saw that staff treated people with dignity and respect. Staff were attentive, showed compassion, were patient and gave encouragement to people.

People’s nutritional needs were met, with people being involved in shopping and decisions about meals. People who used the service told us that they got enough to eat and drink and that staff asked what people wanted.

The care records we looked at showed that people who used the service had regular access with other health and social care professionals. Other professionals who had recently been involved in people’s care included chiropodists, opticians, nurses, doctors, dieticians and dentists.

Assessments were undertaken to identify people’s health and support needs. Person centred plans were developed with people who used the service to identify how they wanted to be supported. We saw that risks identified with care and support had been included within the care and support plans.

People’s independence was encouraged and their hobbies and leisure interests were individually assessed. Staff encouraged and supported people to access activities within the community.

The provider had a system in place for responding to people’s concerns and complaints. People and relatives told us they knew how to complain and felt confident that staff would respond and take action to support them.

There were effective systems in place to monitor and improve the quality of the service provided. Staff told us that the service had an open, inclusive and positive culture.

People who lived at South Highham received the care and support they needed because their support was based on regularly reviewed risk assessments. Records contained detailed information so that staff were able to make sure that people who used the service were happy and content. Staff were knowledgeable about the people they supported and had the training they needed to meet people’s needs.

The service ensured that people’s health and well being were promoted because they involved health professionals in people’s care planning. Staff also contacted health professionals when people were unwell and made sure people attended medical appointments.

Staff were aware of their responsibilities relating to safeguarding vulnerable adults and had access to a comprehensive policy and contact details for the local authority safeguarding team.

Staff received regular supervisions and annual appraisals. Staff told us that they were supported by the whole team to help them carry out their role. New staff had a full induction and were assessed before being able to support people unaccompanied.

Regular checks on the quality of the service took place and changes were made where improvements were needed.

Records used by the service were stored securely, up to date and fit for purpose.

People who lived at South Highham experienced care and support which enabled them to participate in activities in the community and promoted their independence.

Records used by the service were detailed and person centred so they ensured that staff were aware of the needs of people and how they should be supported. However some records had not been reviewed within the last six months and therefore there was a risk that they did not accurately reflect the support people needed.

We saw evidence that family members were happy with the care and support their relatives received. There were a number of different ways that relatives and people who used the service could make their concerns, complaints and compliments known. There had been no complaints made about the service within the last 12 months however the service had a complaints policy and people could be assured that any complaints would be investigated appropriately.

Staff employed by the service had the relevant skills and experience to support people who used the service and pre employment checks had been carried out. Where specialist equipment was used, staff had received training in how to use it and all equipment had been serviced, maintained and checked for wear and tear correctly.

People living at South Highham were unable to tell us what they thought about the care they received. However, we observed that they were clean, nicely dressed and appeared to be happy and relaxed in the company of the staff.

As people could not tell us whether staff were trained to meet their needs, we made observations. We saw that staff supported people appropriately.

We did not specifically speak to people who used the service about their care and support. The people who used the service, whilst they were able to understand what was being said, had difficulty in expressing their views.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives and the staff supporting them, and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We inspected the premises and saw that there were systems and safety precautions in place to protect staff and people using the service. Staff had received safeguarding training and relatives we spoke with told us they thought South Highnam was a safe place for their family member to live. A relative told us, “He is in a safe and loving environment.”

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Whilst no applications had been submitted, relevant staff had been trained to understand when an application should be made.

Is the service effective?

People’s health and care needs were assessed with them and they were involved in writing their plans of care. Relatives we spoke with told us they were also involved in the planning of care and were invited to assessment meetings. We saw that support plans and risk assessments were up to date and reflected people’s individual needs.

Is the service caring?

People were supported by kind and attentive staff. Care records were accurate and up to date. People and their relatives told us they were happy with the care provided at South Highnam. A relative told us, “We’ve had no issues with the staff” and “they are all so dedicated to their jobs.”

Is the service responsive?

People were given the chance to make decisions for themselves. Records showed that people’s preferences, interests and needs had been taken into account and care and support had been provided in accordance with people’s wishes. People had access to activities that were important to them. People and their relatives knew how to make a complaint if they were unhappy. A relative told us, “We have no issues with the place.”

Is the service well-led?

The provider gathered information about the safety and quality of their service from a variety of sources. The manager held regular team meetings with staff and asked people and their relatives their opinions on how the service was run. Regular checks of the premises took place to ensure it was safe and suitable for the people who lived there.