This inspection took place on the 2 November 2016 and was unannounced.

The service is registered to provide accommodation and nursing care for up to 31 people. On the day of our inspection there were 29 people living at the service.

The service provides nursing and personal care support to people who have a neurological condition, such as acquired brain injury or chronic neurological disease and including the care of people living with dementia.

The service 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.

This service was previously inspected in October 2015 and was rated as ‘Requires Improvement’. The provider sent us their action plan describing the action they would take to meet regulatory requirements.

At this inspection we found that improvements had been made. For example, staffing levels had improved. The provider had improved their system for logging all concerns and complaints. The employment of a new clinical lead had meant that staff received the support and clinical oversight they needed. Audits to check that people received safe and effective care had been further improved and managed effectively.

There was a positive, enabling culture in the service. Staff found innovative and creative ways of supporting people to overcome perceived limitations and enable people to take as much control over their own lives as possible. Discussions with the senior management team and staff demonstrated a passionate approach to looking at ways to improve the quality of the service provided.

Staff had extensive understanding of managing risks whilst supporting people to live their lives in a manner which promoted their independence, autonomy and choice with a view to enabling people to reach their full potential despite physical and emotional challenges. People were supported to access healthcare professionals when they needed them.

People were consulted and invited to be involved in the continuous planning to improve the service. For example, through their involvement in setting up and running their own committee meetings, dignity meetings and a regular review of their care and review of support plans.

Staff were caring and committed to providing quality care. People were treated with respect and their dignity was maintained. The atmosphere was friendly and there were positive, enabling relationships between staff and the people who used the service. Staff worked collaboratively as a team with their primary focus meeting the neds of people whilst enabling them to maintain their independence.

There was a strong emphasis on person centred care. People were supported to plan their support, were involved in the pre-admission process and in the planning for all aspects of their care and received a service based on their personal needs and wishes. People’s care was regularly reviewed with their key nurse and involvement of friends and relatives according to their choice.

People had positive relationships with their support staff who knew them well. There were enough staff available to meet people’s needs and people were supported to follow a wide range of interests and hobbies including access and involvement in the local community.

Staff understood their roles and were well supported by the management team. Staff were encouraged to develop their skills further and provided with opportunities to access specialist training which provided them with the skills and knowledge they needed to meet the complex health and communication needs of the people they supported.

The cohesive management team demonstrated outstanding, strong values with a desire to learn about and implement best practice throughout the service. Staf

We did not talk to the people who use this service on this occasion as we concentrated on checking that the service was compliant with an outcome that they were not compliant with on a previous visit: Care and welfare of people who use the service, outcome 4, regulation 9.

When we did visit the service in April 2012, people told us that they liked being at The Chantry, and that they felt well supported and were treated as individuals. They also told us that they felt safe and well cared for.

During this inspection we saw that all the actions in the action plan that had been sent to us after the previous inspection, had been carried out. We sampled the care records of two people and found that they were of a good quality, were detailed, person centred and that all the areas that had caused us concern during our previous inspection had been addressed. The service is now compliant in this outcome.

During our visit we spoke with 10 people who use the service.They all told us that they enjoyed being at 'The Chantry', they felt well supported and treated as individuals, they felt safe and well cared for.

The 5Rs therapy service was a course that provides information and support for people with multiple sclerosis. The people who used this service told us that they found the day extremely helpful and staff treated them as individuals with respect and helped them meet their day’s needs.

This inspection took place on the 22nd, 23rd and 26 October 2015 and was unannounced.

Sue Ryder – The Chantry is a 30 bed service which supports people with complex neurological conditions and physical disabilities. During our inspection there were 26 people living at the service.

There was 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 felt included and listened to by staff. They told us they were involved in the planning of their care and that staff were responsive to their needs. People’s decisions were respected and their dignity promoted.

The service wasn’t completely safe as the provider did not operate safe systems in the audit of medicines and the recruitment of new staff to the service. Gaps in employment were not always identified and references obtained from the previous employer. There were systems in place to ensure people received their medicines as prescribed, however audits were ineffective in identifying when checks of stock had not been carried out and stock carried forward from one month to the next.

Staff knew how to keep people safe from the risk of abuse as they had been trained and knew what to do if they had concerns. They could identify when people were at risk of abuse and what action to take to protect people from the risk of harm.

Staff were kind, caring and promoted people’s privacy and their dignity was respected. People and their relatives were involved in the planning of their care and involved in making decisions about their everyday lives. People’s choices and preferences were respected.

The service was responsive because people’s care had been planned following an assessment of their needs. People were involved in the planning and review of their care and support. They were provided with opportunities to pursue their social interests in the local community and joined in activities provided from within the service.

The service routinely listened and learnt from people’s experiences. Concerns and complaints were addressed. However, work was required to evidence the definition between a concern and a complaint and action taken to determine any emerging trends with planning for improvement.

The service had a positive culture that was person centred, open, inclusive and empowering. The manager said that the vision was to care and support people to live as full a life as possible in spite of their disabilities.