The inspection took place on 15 August 2018 and was unannounced. St Peter’s Hall provides residential accommodation and support for up to 12 adults with mental health needs. People were supported to living independently with each of the 12 units having its own kitchen, bathroom and bedroom areas. At the time of our inspection 12 people were living at the home. At the last inspection on 21 August 2015, the service was rated as Good. At this inspection we found the service remained Good.

There was a registered manager 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 registered manager for this service is also the registered provider.

At the last inspection in August 2015 we rated the key question ‘Is this service well led?’ as ‘Requires improvement.’ At this inspection the service had improved to now be rated as good. The provider had systems in place to review and update people’s care and to assure themselves of the quality of care being delivered. Where areas had been identified for improvement, actions had been taken. People said the service was well managed and staff felt supported by the management team to provide good care.

People continued to receive care and support from staff who understood how to keep them safe. Staff were available to meet people’s needs and understood how to best support people and the risks to their health. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe. People were supported by staff to have their medicines as prescribed and checks were made to ensure staff supported people with their medicines appropriately.

The service continued to be effective. Staff said training helped them do their job and gave them the right skills to meet the needs of the people they supported. They were supported by the management team through regular supervisions and staff meetings. Staff understood they could only care for and support people who consented to being cared for. People were supported to prepare their own meals which reflected their individual preferences. People told us staff responded when they were unwell and arranged health appointments on their behalf if they asked.

The service remained caring towards people. People said staff were caring and treated them with dignity and respect. People were involved in how their care and support was received; they were given choices and said their wishes were respected by staff.

The service remained responsive. People received care that met their needs. Staff provided care that took account of people’s individual needs and preferences and offered people choices. People said staff listened to them and they felt confident they could raise any issues should the need arise and action would be taken.

Further information is in the detailed findings below.

The inspection took place on 21 August 2015 and was unannounced. At the last inspection on 11 July 2013, we found that the provider was meeting the requirements of the Regulations we inspected.

St Peter’s Hall provides residential accommodation and support for up to 12 adults with mental health needs. At the time of our inspection, 11 people were living there.

There was a registered manager 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.

People who lived at the home felt secure and safe in the knowledge that staff was available to support them, when they needed to be supported. The provider had systems in place to keep people safe and protected them from the risk of harm and ensured people received their medication as prescribed.

There were safe and robust recruitment procedures in place to help ensure that people received their support from staff with the correct skills and knowledge. We found that there were enough staff on duty to meet peoples’ identified needs. Staff received the necessary training to continue meeting the support needs of people.

The provider took the appropriate action to protect people’s rights and staff were aware of how to protect the rights of people, in line with current legislation.

People were supported to make choices and could prepare their own food and drink at times to suit themselves, in their own individual kitchens. People made their own choices about what food to eat. Staff supported people to go shopping and encouraged them to consider healthy options.

People were supported to access health care professionals to ensure their health care needs were met.

People and relatives felt staff were supportive and caring. Staff were respectful and encouraged people to be as independent as possible.

We found that people’s health care and support needs were assessed and regularly reviewed. People and relatives had no complaints about the service and were confident if they did, that they would be listened to and their concerns would be addressed quickly.

The registered manager demonstrated a good understanding of the importance of effective quality assurance systems and sought feedback from people and relatives. There were processes in place to monitor quality and understand the experiences of people who used the service. Although some audits were not always completed on time and action plans not always updated to reflect when actions were completed. Care Quality Commission had not received required information from the provider, although appropriate contact had been made with other agencies to protect and prevent harm to people who used the service.

We looked at three care plans we saw that they were up to date. We saw two care plans had been signed by people using the services to confirm they agreed with the plan of care. One person said, ‘’I know what’s in my care plan because I agreed it.’’ One person had discussed their plan with the manager but had refused to sign their care plan.

All of the staff spoken to were able to tell us about people's needs so that they received care in a way that they wanted. One staff told us, ‘’People always choose what they want to do and we help them.’’ Both relatives told us they were consulted about their relative's care and kept informed about their relative's health so they felt involved in their care.

We saw that people are protected against the risks associated with the unsafe or inappropriate use of medication.

We found that people were supported by, suitably skilled and experienced staff.

There were systems in place to monitor how the home was run and to ensure people received a quality service.

There were 11 people living at the home on the day of our visit. No one knew we would be visiting. We spoke with three people who lived at the home, briefly met three other people who lived at the home and spoke with two staff and three managers.

We saw that staff treated people with respect and dignity and understood their individual needs. We saw that people had built up good rapports with the staff. One person said “I have lived here for five years and I would like to stop here”.

Staff spoken to were able to tell us about people's needs so that they were supported to receive care in a way that they prefer, whilst maintaining their independence. One person said “With the staffs help I am almost back to normal”.

People who lived at the home were supported to take part in activities that were interesting and stimulating so that they have a meaningful lifestyle.

We saw that people were relaxed in their environment and that systems were in place to keep people safe from harm.

Staff received a range of training so that they have up to date knowledge and skills in order to support the people who lived there. People told us that “Most of the staff are very good, they help you” and “The staff are ok”.

There were systems in place to monitor how the home is run, to ensure people received a quality service. People’s views were sought and acted upon.