This inspection took place on 23 January 2019 and was unannounced which meant the provider did not know we would be visiting.

Sutherland Court is a care home and registered to provide a service to seven adults with learning disabilities. The service comprises of two large adjoining bungalows located in a residential area of Lightcliffe, Halifax and is close to shops, cafes, and leisure facilities. People in care homes receive accommodation and personal care under a contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. At the time of the inspection seven people were using the service.

A registered manager was 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 2008 and associated Regulations about how the service is run.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we rated the service as requires improvement; it is the first time the service has been awarded this rating. The provider had not breached regulation but improvements were required.

Staff understood safeguarding and whistle blowing procedures which included their responsibility to report any safeguarding concerns to the management team. Systems were in place to manage most medicines safely but staff were not following safe medicine practice when managing topical creams, nutritional supplements and fluid thickener. Checks were carried out by staff and external contractors to make sure the premises and equipment were safe although some environmental issues needed attention. Risks to people had been identified, assessed and effectively managed. Staffing arrangements ensured people were safe and the same workers provided support so people received consistent care.

Staff received training and support which equipped them with the skills to do their job well. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People accessed services which ensured their health needs were met. People enjoyed the meals but the variety of food served was limited. There was a lack of information to show how people’s nutritional needs were met.

Staff knew people well and had a good understanding of how to provide person centred care. They used different approaches to meet people’s needs. We observed people looked clean and tidy in their appearance. People’s rights were promoted and systems were in place to ensure people were not discriminated against.

People received personalised care. Care plans were detailed and guided staff on how to deliver care and support. People had opportunity to engage in leisure activities. The provider had a formal procedure for dealing with complaints although none had been received. Some people had complimented the service.

The registered manager knew people who used the service well and worked closely with the staff team. They were responsive and took prompt action when issues were highlighted at the inspection. The provider had systems and processes in place for checking people received safe quality care. However, these were not always effective. People were encouraged to put forward suggestions and ideas to help improve the service.

The inspection took place on 19 May 2016 and was unannounced.

Sutherland Court provides personal care to seven adults with complex physical needs and learning disabilities. The home is comprised of two large adjoining bungalows known by staff as house one and house three. The home is located in a residential area of Lightcliffe Halifax close to shops, cafes, and leisure facilities. At the time of the inspection there were seven men living at the home.

The last inspection was in January 2014 and at that time the provider was compliant with all standards and regulations inspected.

The home 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.

People told us they felt the service was safe. Staff understood how to recognise and report any concerns about people’s safety and welfare. Before new staff started work the required checks were done to reduce the risk of people being supported by staff unsuitable to work with vulnerable adults. Staff were trained and supported to understand people’s needs and provide them with safe and appropriate care and support.

People received their prescribed medicines safely. However, the home did not have the correct storage facilities for certain types of medicines. As these medicines were not currently prescribed or in stock for people who used the service there was no risk to people. We recommended the provider reviewed the storage arrangements for medicines to ensure they complied with current guidance and legislation.

There were enough staff to provide people with the support they needed and to make sure people were supported to take part in leisure activities in the local community. The home had their own transport which made it easier for people to go out regularly.

The home was clean, odour free and well maintained. Some parts of the home were in need of redecoration. Risks to people’s safety and welfare were identified and action was taken to reduce or manage the risks. There were procedures in place to make sure staff knew what to do in the event of an emergency to keep people safe.

People were supported to have a healthy and varied diet which took account of their likes, dislikes and cultural needs. People’s weight was checked regularly and action was taken in response to any unplanned weight loss or gain.

Staff obtained people’s consent before providing support, care and treatment. When people were unable to give informed consent decisions were made in their best interests. Best interest decisions were clearly recorded and showed appropriate consultation had taken place.

People were supported to access the full range of NHS services to meet their health care needs. There were procedures in place to make sure hospital staff were provided with information about people’s support needs as well as their health care needs in the event of them admitted to hospital.

People told us the staff were kind and compassionate and this was confirmed by our observations during the visit. Staff knew about people’s individual likes, dislikes and abilities. They supported people to exercise choice, make decisions and be as independent as possible.

People’s support plans were person centred and included detailed information about their individual needs, preferences and abilities. People living in the home and their relatives were involved in planning and reviewing how care and support was delivered.

There was a complaints procedure in place and people’s relatives told us they were confident they would be listened to if they had any concerns. There had not been any complaints about the service in the last twelve months.

The registered manager provided strong leadership a

People who used the service could not communicate clearly so we observed staff providing support and we spoke with staff about the people who used the service. We spoke with two relatives of people who used the service. This gave us assurances that staff knew the needs of people and knew how to deliver the care and support effectively.

Our observations of the service showed that care staff spoke with and interacted with people who used the service in a patient and pleasant manner. Care staff supported people in a sensitive way using differing methods of communication to ensure that people understood what was going to happen.

The people who used the service appeared happy and comfortable with the surroundings. They appeared to be relaxed with the staff in their interactions with them. We noted that people who used the service had access to a wide range of activities, which were personalised to their individual needs.

Relatives we spoke with after our visit were very satisfied with the care. They told us ‘I can’t say enough about their care’ another said ‘it’s always very clean and the staff are very good.’

In this report we have been asked by the provider to refer to people using the service as clients.

People living at Sutherland Court had complex needs which meant they were unable to talk to us. We used different methods, such as observing clients and staff interacting, to help us understand their experiences. During our visit we spoke with the Registered Manager, the Deputy Manager, two members of staff and two relatives.

The relatives we spoke with told us the staff at Sutherland Court regularly updated them about their relatives’ health and they felt the care was good. They said they were involved in care decisions and signed consent forms relating to care and treatment needs. One of the relatives told us “The staff are very good, they really are” another relative said “He’s really settled there, staff are good to them all and look after them. They take them out quite a bit, including holidays.” They told us they felt their relatives lived in a safe environment.

We spoke with two care workers who told us St Anne’s was a good company to work for and they felt confident the service provided was good. Care workers received appropriate training for their role and told us they felt well-supported by their managers.

We were unable to communicate with people living at Sutherland Court however; through our observations we saw that people seemed comfortable and confident in their surroundings and in their interactions with staff.