This inspection took place on 12 December 2016 and was unannounced.

There is a requirement for Spion Kop to have a registered manager and a registered manager was in place. 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 service is registered to provide residential care for up to six people with mental health needs. At the time of our inspection six people were using the service.

People were supported to manage their own medicines when this was their choice. Where staff administered medicines for people, medicines were stored safely and records were clearly completed and any support provided respected people’s privacy. One bottle of medicine had an illegible prescription label and one liquid medicine had exceeded the recommended ‘use by’ date. The deputy manager told us action would be taken to resolve these issues. Other medicines were labelled clearly and were in date.

Risks to people’s health were identified and well managed, however one person’s care plan and risk assessment did not contain sufficient detail on the observations staff completed regarding potential risks. Other risks to people, such as from the risk of a potential fire had been considered and plans were in place to reduce risks to people.

People felt safe at the service. Staff had been trained in safeguarding and had the knowledge to identify any potential signs of abuse and how to report those. Staff recruitment practices were followed to ensure people were safe to work at the service. Sufficient numbers of staff were available to meet people’s needs and to support people to attend appointments and activities.

The registered manager understood the principles of the Mental Capacity Act (MCA) 2005 and had a policy in place for both the MCA and Deprivation of Liberty Safeguards (DoLS). No applications for a DoLS had been required as no one lacked the mental capacity to make decisions. However there was not a process to record mental capacity assessments and record any best interests’ decision making, should a person lack the mental capacity to make a decision in the future. We brought this to the attention of the registered manager who agreed to put this in place, should this be required. People’s consent was obtained prior to staff providing any care and support.

People were involved in planning and choosing healthy, nutritious food and drink, as such people made choices that suited their own preferences. People were supported to be involved in meal and drink preparation to promote their independence. People were supported to access any other healthcare services they needed in order to maintain good health.

Staff listened to people and spent time talking with them. People described staff as kind and caring. Staff supported people with their dignity and promoted their independence. People’s views were used to identify improvement in the service and people were involved in planning their own care.

People received personalised and responsive care as they were involved in identifying what support they required. People had been asked about their preferences and staff were aware of these. People contributed to their care planning and were asked for any suggestions, comments or complaints at regular meetings.

The registered manager was clear on their role and responsibilities and was supported by motivated staff team. Staff understood their roles and responsibilities. Systems were in place to check on the quality and safety of services provided.

We spoke with four people who used the service.

People told us they were happy with the care and service they received, and felt that their needs were being met. Comments received from people included ‘’the service is fantastic; the staff have helped me to get my life back on track, we are supported to go on holiday and go out regularly for meals and we all get on well; the staff are very good.’’

People also said that they were satisfied with the choice of foods and meals provided, and that they received enough to eat and drink. A planned menu system has been put in place, to ensure that people receive a variety of foods.

People were involved in completing their care records. Care records we looked at showed that people's care and treatment was delivered in a way that ensured their safety and welfare.

The service was flexible and centred around individual needs and preferences. We found that the service was well managed, and that clear lines of responsibility were in place. This meant that people received consistent standards of care and service.

People said they liked the staff that supported them as they were honest and reliable, and they understood their needs. The provider's recruitment procedures have been strengthened to ensure that people are cared for by suitably trained, skilled and experienced staff.

We spoke with two people who use the service.

People told us they were happy with the care and support they received, and felt that their needs were being met. People had agreed to the care and treatment, and had signed their care records to support this.

One person told us ’’the routines are flexible and I do the things I like to do. I feel I am doing well here and I aim to live more independently in the future’’. Another person told us’’ I can’t fault the place or the staff. I have been on two holidays this year, which I enjoyed’’.

People said they liked the staff and felt that they get the help they needed as there was usually enough staff on duty.

People told us they received their medicines at the times they needed them, and in a safe way.

People said they liked living at Spion Kop as it was comfortable, safe and clean and it felt like ‘home’. They particularly liked their bedroom with ensuite facilities.

We spoke to five people who used the service, and three members of staff.

People spoke highly of care and support they received, and felt their needs were being met. One person told us ‘'the staff are great; they listen and involve me in my care’’. Another person said ‘’This is a good place to live; I like the fact it’s small and feels like a family’’.

People said they get the help and support they need as there is usually enough staff on duty. People said their social and leisure interests were supported.

People told us they are given information to help them choices about lives.

People felt that staff treated them with dignity and respected their privacy. People also felt safe and able to raise concerns with staff if they were unhappy