The inspection took place on the 21 September 2016 and was announced.

Strawberry Field provides care for up to 4 people. The home supported people who had a range of learning disabilities. One person lived in a self-contained flat within the service. The home was an extended bungalow in rural Norfolk.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. During this report we will refer to the registered manager as the manager. The day to day running of the service was carried out by one senior member of staff.

People benefitted from being supported by staff who were safely recruited, trained and who felt supported in their work by their colleagues and by the manager. There was consistently enough staff to safely meet people’s individual needs.

Staff understood how to protect people from the risk of abuse and knew the procedure for reporting any concerns. Medicines were administered safely and adherence to best practice was applied. People received their medicines on time, safely and in the manner the prescriber intended. The service regularly audited the administration of medicines, although we found a delay in responding to an issue with one person’s medicines. The manager was aware staff needed further training with administering people’s medicines. Medicines were stored securely.

Staff knew and understood the needs of people living at Strawberry Field. Staff also knew what was important to each person and how to help them achieve this.

Staff received yearly appraisals. Staff also had regular supervisions. However the supervisions and testing of staff knowledge was not robust. The manager told us they were aware of this and were looking into ways to improve this. The manager observed practice and was involved in the daily running of the service.

Staff told us they enjoyed working at Strawberry Field. We saw that staff assisted people with kindness and compassion. People’s dignity and privacy was maintained and respected. People were treated as individuals.

The Care Quality Commission (CQC) is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service was depriving some people of their liberty in order to provide necessary care and to keep them safe. The service had made applications for authorisation to the local authority DoLS team. The service was working within the principles of the MCA.

People’s care plans contained important, relevant and detailed information to assist staff in meeting people’s individual needs. People had been involved in making decisions around the care they received. People’s needs had been reviewed on a regular basis. People’s care was person centred.

People were supported to maintain good health and wellbeing. The service was proactive in dealing with changes to people’s physical and mental health.

The service had links with the local community and the manager planned to continue developing these. The service encouraged people to maintain relationships with people who were important to them. There were planned activities on a daily basis to support people to maintain their interests and fulfil their goals. There was a positive, open culture and a homely atmosphere at Strawberry Field.

There were some systems in place to monitor the quality of the service. However, these were not always robust. We found some short falls in the monitoring of the safety of the premises. We also found that although issues had been identified in some of the audits the management team had completed, there was no plan of action in place to address these. We made a recommendation that the service improved it

On the day of this inspection there were 4 people living at Strawberry Field. We looked at written records, which included people's care records, staff personnel files and quality assurance documentation. We spoke with three of the people who used the service and we also spoke at length with the manager, the administration manager and two members of care staff.

We considered our inspection findings to answer the five questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? This is a summary of what we found based on our observations during the inspection.

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

Is the service caring?

We spoke with three people who used the service. One person said to us, "I like living here." Another person said, "It's good here. I've got my own flat and I like doing my own cooking. I'm really good at making stews and stir fry meals." Another person told us they liked living with the other people. All of people we spoke with spoke highly of the staff members who supported them.

People's privacy and dignity was respected, and people were encouraged and supported to maximise their independence.

Is the service responsive?

People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Where people did not have the capacity to give consent, we found the provider acted in accordance with legal requirements. Care plans and risk assessments were informative, up to date and regularly reviewed.

Staff told us that the manager and other senior staff were approachable and they would have no difficulty speaking to them if they had any concerns about the service. The manager responded in an open, thorough and timely manner to complaints. Therefore people could be assured that complaints were investigated and action was taken as necessary.

Is the service safe?

The accommodation was adapted to meet the needs of the people living there, was suited to caring for people with limited mobility and was properly maintained. The service was warm, clean and was personalised to the people who lived there.

People were protected by effective staff recruitment systems. There were proper process in place in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

Is the service effective?

People we spoke with were satisfied with the care and support they received. No one raised any concerns with us. This was consistent with positive feedback from people reported in the provider's own annual quality assurance survey. All of the staff we spoke with were knowledgeable about individual people's care needs, and this knowledge was consistent with the care records.

Is the service well led?

Staff said that they felt well supported by the manager, there was a good team ethic and they were able do their jobs safely. The provider had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

There were four people living at the service at the time of our inspection. All four people were at home. The people we spoke with told us they were happy living at the service and were happy to show us round the house. One person told us: “I couldn’t wait to come back here and have the same staff look after me, they know me and help me decide what I want to do. I like cooking and I am doing the tea for everyone today.” Another person told us: “I go to a keep fit class, although I need new trainers I am going to buy some new one’s this afternoon.”

We saw that people had a care plan that met their needs and encouraged them to be as independent as possible. We saw people preparing their own meals and drinks during our inspection.

People had their health needs met and were supported to manage their own hobbies, household tasks and lifestyle activities. We saw one person mowing the lawn and another person preparing to go to their keep fit class during our visit.

The majority of people attended day care or worked at the farm within the company grounds, although go out to social activities, visited family, arranged their own holidays and are supported with shopping trips by the staff to ensure people have a balanced and varied choice.

People were supported by skilled and experienced staff and the service was regularly checked for people’s comfort and safety needs.

We spoke with two people living at Strawberry Field and two members of staff during their shift changeover. One person showed us their care plan and discussed how they enjoyed living there. They told us what they did during the week and they had just been on a camping trip. They showed us round the cottage and told us about the new building work to be carried out within the following three months. "I am busy packing all my stuff into boxes because we are moving into another cottage while the builders are here. The staff are helping me to do this." Staff told us the three people currently living at Strawberry Field were moving into a cottage within the grounds of The Rookery, with the staff team continuing supporting them during three months the building work would take to complete.

Both people told us they were happy living at Strawberry Field and that all the staff were kind and supported them very well. One person showed us their paintings they had done telling us they had displayed their paintings in a local gallery.

People were very positive about living in Strawberry Field, They told us they "Had the best of both world's, they lived in their own house and had the day centre and farm across the road."

We spoke with people regarding their experience of living in the home. One person told us, "I decide what I want to do in my free time and the staff come out with me. I do the shopping when we've all decided what we want for our meals."

Two people told us they attended the day centre to join in with activities and crafts, with one developing their woodwork skills in their own time. Another person told us that they enjoyed their 'keep fit' classes and working two days on the farm.

We spoke with one person about their care and welfare within the home. They said, "My key worker talks with me about what changes I want and if I have ideas I'd like to plan for, I would like to go to an extra art class."