We inspected Sunflowers on the 22 May 2018.

Sunflowers is a care home for people living with learning disabilities which provides support for up to six adults. At the time of our inspection six people were using the service. The service is provided in a converted house in a residential location. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection

At our last inspection we rated the service good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service has 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.

The service was safe. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so. There were systems in place to minimise the risk of infection.

The service was effective. People were cared for and supported by staff who had received training to support people to meet their needs. The acting manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to have 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. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to other health professionals were made when required.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed choices.

The service was responsive. People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were supported to follow their interests and participate in social activities. The registered manager responded to complaints received in a timely manner.

The service was well-led. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis.

We inspected Sunflowers on the 16 and 18 March 2016.

The service provides accommodation and support for up to six people with learning disabilities. There were six people living at the service at the time of our inspection.

The service has 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 were cared for by staff that had been recruited and employed after appropriate checks were completed. Staff were available to support people.

People's care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Records were regularly updated and staff were provided with the information they needed to meet people’s needs.

Staff and the manager were able to explain to us what they would do to keep people safe and how they would protect their rights. Staff had been provided with training in safeguarding adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).

People were relaxed in the company of staff. Staff were able to demonstrate they knew people well. Staff were attentive to people's needs and treated people with dignity and respect.

People who used the service were provided with the opportunity to participate in activities which interested them, these activities were diverse to meet people’s social needs.

The service worked well with other professionals to ensure that people's health needs were met. Where appropriate, support and guidance was sought from health care professionals, including people’s G.Ps and specialist nurses.

People knew how to raise a concern or make a complaint, any complaints were resolved efficiently and quickly.

The manager had a number of ways of gathering views on the service including holding meetings with people, staff and talking with relatives.

The manager and provider carried out a number of quality monitoring audits to ensure the service was running effectively. These included audits on care files, medication management and the environment.

On the day of our inspection six people were living in the service. We spoke with people who used the service, two staff members, the registered manager and the compliance manager. We looked at two people's care records. Other records viewed included audits, minutes of meetings, staff training records, personnel records, health and safety checks, compliments and complaints books. We considered our inspection findings to answer questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found:

Is the service safe?

When we arrived at the service the staff asked to see our identification and for us to sign in the visitors book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

We saw records which showed that the health and safety in the service was regularly checked. This included regular checks on such areas as fire safety equipment, as well as checks on the environment. This told us people were looked after safely.

We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

Is the service caring?

People were relaxed in the company of each other and staff. We saw that staff were attentive to people's needs. Staff we spoke with were able to demonstrate they knew people well. We saw staff treated people with dignity and respect.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to. This was demonstrated in minutes we saw which related to meetings with people who used the service. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including a doctor, dentist, chiropodist and optician. This told us that the service worked well with other professionals and that people's needs were met.

Is the service well-led

The service had a number of quality assurance measures in place. We saw the quality of the service had been maintained.

During our inspection on 30 April 2013 we found that there were insufficient systems in place for the assessment and storage of substances that could be hazardous to health, for example, toilet cleaner.

The provider supplied us with an action plan following our last inspection. This inspection was completed to check that the provider was now complying with the regulation.

We did not speak to people using the service during this inspection. We found people and staff were protected against risk associated with hazardous substances because there was now a system in place to assess and safely store substances considered hazardous to health.

We used a number of different methods to help us understand the experiences of people using the service because people using the service had complex needs which meant that some people were not able to tell us their experiences.

We spoke with three people using the service and three relatives. They told us that the care was good and they felt able to speak to staff if they had any queries or problems.

We saw that some capacity assessments were not in place and some care plans needed updating.

We spoke with three staff who told us that they had support and opportunities for their personal development.

We saw that the provider had systems in place to assess and monitor the quality of service provision.

Due to people being out the majority of the day we completed this inspection over two days later in the day.

We spoke with two people using the service who told us that staff are nice and that they felt safe there. They both told us that they chose their room decor and made day to day choices such as, when to get up and what to do during the day.

We found that generally the home was clean but there were areas were attention to detail cleaning was required.

We saw that care records were person specific and detailed and that consent had been obtained prior to support being given.

The premises and decor was in need of some repair however the provider was aware of most of these areas and had a plan in place to address this.