This inspection took place on 8 November 2017 and was unannounced. Stubblefields is registered to provide personal care and accommodation for up to ten adults or older people with a learning disability or autistic spectrum disorder. There were ten people living at the service ion the day of the inspection. The service is in Bridlington with good access to the town and surrounding countryside. It is a family run service which promotes family living.

There was a registered manager for this service. 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

We observed that people felt safe with staff and they confirmed this. Staff had been trained to safeguard adults and were aware of how to recognise and report any incidents of abuse.

People who used the service were kept safe because safety checks were carried out within the environment to ensure it was fit for purpose.

Staff were recruited safely and there were sufficient staff on duty to meet people’s needs. Rotas confirmed the numbers were sustained.

People’s health and safety needs were identified and where necessary risk assessments were in place to support people’s safety. Accidents and incidents were recorded.

Medicines were managed safely. We saw that staff checked medicines thoroughly before they were administered. Records were completed properly.

The service was effective because staff used the training they had received to best effect. They knew people well and followed guidance in care plans and from professionals to ensure people received care that met their needs. Staff were supported through supervision.

Staff followed the principles of the Mental Capacity Act 2005 by ensuring that where people could not make their own decisions the best interest decision making process was followed to ensure that people’s wishes were carried out.

People were given a healthy nutritious diet. People were encouraged to be as independent as possible when eating and drinking.

Staff were caring and kind showing people respect. People at this service clearly felt that they mattered and staff reinforced that. They knew how to make a complaint if necessary.

Care plans were person centred and reviewed regularly with any changes noted.

People took part in a variety of activities at the service and in the local community.

The quality monitoring system was effective with regular audits being carried out. Surveys were sent to people to gather their views about the way in which the service was run.

This inspection took place on 18 October 2016 and was unannounced.

We carried out an announced comprehensive inspection of this service on 8 May 2015. At this inspection we identified two breaches of regulation. This was because medication had not been recorded safely and the quality assurance systems had not identified or resolved issues with poor record keeping. We asked the registered provider to take action to make improvements to Regulation 12: Safe care and treatment and Regulation 17: Good governance. After the comprehensive inspection on 8 May 2015 the registered provider wrote to us to say what they would do to meet the legal requirement in relation to the breaches of regulation.

Stubblefields House is registered to offer accommodation and care for up to 10 people. The service supports younger and older adults who have a learning disability or autistic spectrum disorder.

The registered provider is required to have a registered manager in post and on the day of the inspection the manager who was employed at the home was registered with the Care Quality Commission (CQC). 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 that they felt safe living at the home. We found that staff had a good knowledge of how to keep people safe from harm and staff had been employed following robust recruitment and selection processes. Improvements had been made to the management of medicines in the service and people received these on time and as prescribed.

We raised concerns with the registered manager about visitors being able to access the premises without a member of staff being present, as on arrival we were able to walk into the service without staff being aware of our presence for at least 10 minutes.

Improvements were made to the number of staff employed in the service. Recruitment was on-going to ensure enough staff were employed to meet the needs of people who used the service and the registered provider anticipated that this would be completed by November 2016

New staff were given a one-day induction to the service. From the paperwork made available and comments received from the staff we found that this was not in-depth, but did cover the basics of health and safety and working in the home. Work was on-going to embed more robust induction processes in the service.

Staff received a range of training opportunities and told us they were supported so they could deliver effective care; this included some staff supervision and monthly staff meetings. Work was on-going to embed more frequent supervision and appraisal sessions in the service.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. The plans of care were individualised to include preferences, likes and dislikes. People who used the service received additional care and treatment from health professionals based in the community. People had risk assessments in their care files to help minimise risks whilst still supporting people to make choices and decisions.

People received adequate nutrition and hydration to maintain their levels of health and wellbeing. They told us they were satisfied with the meals provided by the service. People had been included in planning menus and their feedback about the meals in the service had been listened to and acted on.

People were able to see their friends and families as they wanted. There were no restrictions on when people could visit the service. People spoken with said staff were caring and they were happy with the care they received. They had access to community facilities and most participated in the activities provided in the service.

We observ

Stubblefields House is registered to offer accommodation and care for up to nine people. The service supports younger and older adults who have a learning disability or autistic spectrum disorder. The service is located in the sea-side town of Bridlington and there is on street parking available outside of the premises.

This inspection took place on 8 May 2015 and was unannounced.

We last inspected the service on 4 March 2014 and the registered provider was compliant with the outcomes we looked at.

The registered provider is required to have a registered manager and 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.

At this inspection 8 May 2015 we found that the registered manager was on leave and the service was being looked after by a care manager who was not registered with the Commission. The registered provider was on site for part of our inspection.

On 8 May 2015 we found there were two breaches of Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3). We also made four recommendations with regard to staff recruitment, staffing levels, staff training and communication.

You can see what action we told the provider to take at the back of the full version of this report.

The registered provider failed to protect people who used the service against the risks associated with the unsafe use and management of medicines. We saw evidence of unsafe recording and handling of medicines in the service.

We found that the quality monitoring system was ineffective and had not been used to ensure the safety of people who used the service and staff.

We had some concerns with regard to the staffing levels in the service. We found no evidence to suggest that people were not receiving the care they required during the day time. However, the lack of a waking night staff increased the risk of harm to people who used the service. We have made a recommendation about this in our report.

The registered provider had a policy on recruitment, but this had not always been followed. We have made a recommendation about this in the report.

No staff had completed training on the Mental Capacity Act 2005 (MCA). This meant there was insufficient evidence that staff understood the principles of capacity and decision making. No staff had completed specialist training on learning disabilities. This meant there was a risk that staff did not have the skills and knowledge to meet the needs of people who used the service. We have made a recommendation about this in the report.

Some people who used the service communicated with others by using Makaton. However, staff had a limited knowledge of this. We have made a recommendation about this in the report.

We found that people were protected from the risks of harm or abuse because the provider had effective systems in place to manage issues of a safeguarding nature. Staff were trained in safeguarding adults from abuse and the staff understood their responsibilities.

We found the premises to be safe and well maintained; people had their own bedrooms and access to a garden area.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. The plans of care were individualised to include people’s preferences, likes and dislikes. People who used the service received additional care and treatment from health care professionals based in the community.

People spoken with said the staff were caring and they were happy with the care they received. They had access to community facilities and most participated in the activities provided within the service and in the community.

People were treated with respect and dignity by the staff. There had been no formal complaints made to the service during the previous twelve months but there were systems in place to manage complaints if they were received.

People told us that they were consulted about their care and were able to make their own decisions about life in the home. People felt staff respected their privacy and dignity.

We observed that there were good interactions between the staff and people, with friendly and supportive care practices being used to assist people in their daily lives. One person told us “I am fairly independent, the staff let me get on with my life but they are around if I need any support.”

Staff had received appropriate training to ensure they could meet the needs of the people who used the service.

The home was designed to meet the needs of people who lived there and the provider ensured the environment was regularly maintained, safe and fit for purpose.

The provider had an effective quality assurance system in place and people’s views and opinions of the service were listened to and acted on where necessary.

The provider had a domiciliary service operating from this location. We spoke to two people who used the service and looked at care records and documentation. People told us “I am very happy with the service”, I can highly recommend this service” and “I find the staff professional and caring.” We have commented on the personal care service at the end of each outcome.