Strensham Hill is a care home without nursing for up to 10 people, all of whom have learning disabilities and some of whom have additional physical disabilities. The property is a large, adapted house and accommodation is on two floors with a passenger lift to facilitate access. At the time of our inspection the service was supporting nine people.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People told us that the home was safe. Staff demonstrated that they were aware of the action to take should they suspect that someone was being abused. Staff knew the risks associated with people’s medical conditions and the actions required in order to minimise the possibility of harm. There were enough staff on each shift to meet people’s care and support needs promptly. People received their medicines safely and when they needed them.

People were supported by staff who had the skills and knowledge to meet their needs. People were supported to have the 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.

Menus had been developed in response to people’s preferences and nutritional needs. When necessary people were helped to eat by staff. People in the home were supported to make use of the services of a variety of mental and physical health professionals.

People told us that the registered manager and staff were caring. People were supported by regular staff who spoke fondly about the people they supported. People had key workers who understood people’s preferred communication styles and assisted them when necessary to express their views. Staff respected people’s privacy and care plans promoted people’s independence.

Staff supported people to engage in activities they enjoyed. People’s care and support was planned in partnership with them so the plan reflected their views and wishes. People told us that the nominated individual, registered manager and staff were approachable and would take action if they were not happy or had a complaint.

Relatives told us that the home was well run. The registered manager and nominated individual were aware of their responsibilities to the commission and they were knowledgeable of the type of events they were required to notify us of. Staff told us that the nominated individual and registered manager were supportive and led the staff team well. People had the opportunity to influence and develop the service they received. The nominated individual and registered manager made checks that the standard of care was maintained and in some instances these checks had led to further improvements.

Further information is in the detailed findings below.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was unannounced. At the last inspection in October 2013 the provider was compliant with the Regulations we looked at.

Strensham Hill Care Home is a home providing accommodation for up to 10 people who have learning difficulties and/or dementia. There were 10 people living in the home when we visited. Not all people could communicate with us verbally, but they were able to understand us and express their feelings through non-verbal communication.

We found there was a registered manager at this location.  A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People who lived in the home told us they felt safe and we saw there were systems and processes in place to protect people from the risk of harm. During our visit we found staff were caring and kept asking people if they needed anything. People told us that staff were nice to them. We saw that people were treated with dignity and respect.

Staff received appropriate training and were knowledgeable about the needs of people living in the home. This meant they provided effective care and support that met people’s individual needs. We found that there were enough staff to meet people’s needs and ensured they could engage in activities they liked such as day trips and attending places of worship.

People were able to make choices about what they did and what they ate. They were supported by communication aids such as pictures and presented with several alternative meals so they could choose which one they wanted. Staff supported people how they wanted because they understood what each person’s gestures and behaviour meant.

People lived in an environment that met their needs. People chose how they wanted their bedrooms decorated and what furniture they wanted. The home had a communal area and quiet room so people had a choice of living area to use. People could also meet their relatives and visitors in private if they wanted.  People also had appropriate beds, chairs and mobility aids which allowed them to remain safe and be independent as much as possible.

Management systems were well established to monitor and learn from incidents and concerns. There were also systems to ensure the quality of the service was regularly reviewed against national standards of good practice. The service had earned accreditation with several organisations by demonstrating compliance with good practice and national regulations.

When we visited we found that the home provided care for nine people. Some of the people using the services had complex needs which meant they were not able to tell us their experiences. We used a variety of methods to help us understand the quality of the care people received. We spoke to four care staff and the manager. We looked at the care records and policies and watched how people received care. We also spoke to relatives of two people who use the service.

Records showed that the people who used the service and their relatives were involved in planning their care. The relative of a person who used the service told us, “It’s absolutely brilliant, they look after [person’s name] very well”.

People received sufficient quantities of food and drink to meet their needs and were supported to make choices about what they ate and drank. A person who used the service told us that their lunch was, “delicious” and “fabulous”.

The provider had robust recruitment procedures in place to ensure that people employed at the service were of good character and had the necessary skills, qualifications and knowledge to meet the needs of the people who used the service.

There were good arrangements for making sure that standards of care and support were monitored and improved, where necessary. We saw that the manager supported the people who used the service and their relatives to comment on the quality of care people received.

When we visited we found that the people using the services had complex needs which meant they were not able to tell us their experiences. We looked at care records, talked with four staff and two relatives of people living in the home to help us understand the experiences of people using the service.

We saw that the provider had made improvements since our last inspection. Care records were up to date, meals were suitable for people who found eating difficult and there were plans to ensure medicines were being given as prescribed.

Throughout the inspection, we found that staff treated people with respect and dignity.

The care provided met the individual health and welfare needs of the people who used the service. A visitor we spoke with was confident their relative’s care was planned, managed and delivered in the way that was promised.

We saw that the provider had made suitable arrangements to ensure that people were safeguarded against the risk of abuse.

We found that care workers were skilled, qualified and competent to provide people with the care they required to meet their individual needs.

The provider was able to protect people from unsafe care and treatment by regularly assessing and monitoring the quality of the service provided.

We noted that one of the registered managers, Maureen Wilmot no longer worked at the location. The provider is aware of the need to formally apply for the registration of this person to be cancelled.

We met all nine of the women who live at 12 Strensham Hill. People found it hard to tell us directly their experience of the home as they had communication needs as part of their learning disability. We sat with people in the lounge areas of the home. We saw people being supported in a kind and friendly way. People had been supported to dress in attractive clothes that were individual to their style. People had warm, smart coats and hats when they went outside. One person we were sitting close to, showed us with gestures that she was proud of her nice clothes.

The first part of the morning was busy as people were getting ready to leave the home to attend day activities. We saw staff support people in a way that was unhurried and calm.

We sat with people as they had the lunch time meal. This had been freshly prepared, and people seemed to enjoy this. Staff support was offered and this was given to people at their own pace.

We looked around the home, and we saw the home was very clean, and extremely well decorated and furnished. People we met seemed proud of this.