Sylvanhurst House is a residential care home that offers housing and personal support for up to six adults who have a range of needs including mental health and learning disabilities. The service has a lounge with dining room, a well-kept garden and six bedrooms all of which are en-suite. Bedrooms are situated on the ground and first floor and the first floor is accessed by stairs. At the time of our inspection six ladies were using the service.

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 ongoing 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.

Systems were in place to safeguard people from abuse and staff knew the procedure and guidance to follow if something went wrong.

Risks relating to people’s care were identified and staff knew how to manage these risks to help keep people safe but still encourage people’s independence. Staff spoke to people about the risks they faced to help people understand how to keep safe. People’s medicines were managed safely by staff.

There was enough staff to care for people and they received adequate training, induction and supervision to support them to do their jobs. The recruitment process ensured staff were suitable to work with people.

People’s needs and preferences were assessed by the service before they began receiving care. People had a choice of food and planned their weekly menu. Staff encouraged people to make healthy choices when they needed to.

Staff promoted the healthcare needs of people and worked well with healthcare professionals, they took on board recommendations to help make sure individual health needs were met. Specialist dietary needs such as those associated with diabetes were provided for.

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 encouraged to be as independent as they could be. Staff treated people with dignity and respect.

People were supported to be involved in hobbies and activities that interested them. This included access to the community and involvement with clubs and outside social events when people wanted to.

People’s care plans were sufficiently detailed to inform staff about people’s needs and to guide staff in caring for them.

The service had a complaints procedure which addressed any complaints within the agreed timescale. Systems were in place to make sure managers and staff learnt from events such as accidents, incidents and complaints. This reduced the risk to people and helped the service continually improve.

The service had a range of audits in place to assess, monitor and drive improvement.

Further information is in the detailed findings below.

This inspection took place on 4 March 2016, the visit was unannounced. Sylvanhurst House is a residential care home that offers housing and personal support for up to six adults who have a range of needs including mental health and learning disabilities.

The service was last inspected in April 2014, it met all the regulations we inspected it against.

The service had a registered manager in post; they were not available at the time of the inspection.

‘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 had suitably numbers of skilled staff on duty to protect people from harm and to meet their care and support needs, staffing levels were flexibly arranged according to need. Staff employed were appropriately supervised and supported. They had the skills and experience needed to care for and support the people living there. There was an on-going training and development programme available so that staff continued with their professional development.

Policies and procedures were in place to make sure that unsafe practice was identified and people were protected from the risk of harm. Staff understood the procedures and the need to follow these to make sure that people were safe and protected from avoidable harm. Appropriate recruitment checks were undertaken before staff started work.

Staff promoted the healthcare needs of people and worked well with healthcare professionals, they took on board recommendations to help make sure individual health needs were met. Specialist dietary needs such as those associated with diabetes were provided for. Staff understood the importance of sharing with people important information about their prescribed medicines including any side effects. Medicines were managed safely and regular audits were completed to make sure people were having their medicines as prescribed.

Staff identified individual needs and together with the person developed an appropriate care and support plan. People consented to the care and support they received. Staff supported people in line with the principles of the Mental Capacity Act (MCA) 2005, holding best interest meetings when required. People’s preferences and choices were known and respected; they received care and support as planned. Staff knew the people they cared for well and could respond to their individual care needs and preferences. Staff were kind and patient, they were mindful to take into account people’s privacy and dignity consider their individuality.

People were offered structure to their day which promoted their well-being, and were able to participate in a range of activities both in the home and local community. The variety of structured activities ranged from going for daily walks and swimming sessions to listening to music and following hobbies such as knitting. Staff responded to what people wanted to do on a daily basis.

People attended weekly resident’s meetings which gave them an opportunity to discuss issues about the service, plan meals and events, and influence the development of the service. The home had a complaints system which addressed any complaints within the agreed timescale. Systems were in place to make sure managers and staff learnt from events such as accidents, incidents and complaints. This reduced the risk to people and helped the service continually improve.

The service had developed a quality assurance system; this was driven by the views of people, and combined with quality audits to make improvements.

On the day of our inspection there were six people living at Sylvanhurst House on a permanent basis. We spoke with four of the people who used the service, two care workers, the deputy manager and the new registered manager. We also spoke with the operational director for the organisation. During the inspection we worked to answer five key questions; is the service safe, effective, caring, responsive and well led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and staff told us.

Is the service safe?

The staff we spoke with understood the procedures they needed to follow to ensure that people were safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

We saw that Sylvanhurst House was clean and well maintained.

Systems were in place to make sure managers and staff learnt from events such as accidents, incidents and complaints. This reduced the risk to people and helped the service continually improve.

Recruitment practice was safe and thorough. The provider could demonstrate that that the staff employed to work at the service were suitable and had the skills and experience needed to support the people living there.

Policies and procedures were in place to make sure that unsafe practice was identified and people are protected.

Is the service effective?

People all had an individual care plan which set out their care needs. People told us they had been involved in the assessment of their health and care needs and we saw how they had contributed to developing their care plan.

It was clear from our observations and from speaking with staff that they had a good understanding of the people’s care and support needs and that they knew them well.

Is the service caring?

We saw staff always treated people with respect and dignity and people were supported to make informed decisions about how they lived their lives. One person told us “The staff treat me well, I get on well with them”. Another person explained they had gone for a walk that morning and told us what they had chosen to eat for lunch.

Staff were aware of people’s preferences, interests, aspirations and diverse needs. Our observation of the care provider, discussions with people and records we looked at told us that individual wishes for care and support were taken into account and respected.

Is the service responsive?

People told us they were able to participate in a range of activities both in the home and local community. One person told us ““We are going out to the café now” and another person said “It’s nice here I can go out when I want”. We saw how staff encouraged people to help clean their rooms, do their own laundry and how they assisted people to prepare and cook their own meals. One person told us “I go shopping for my food so I can choose what I want but staff help me cook.”

People told us they had weekly residents meetings which gave them an opportunity to discuss issues about the service. We saw people were involved in the review of their care plans.

Is the service well led?

The home had a system to assure the quality of service they provided. The way the service was run had been regularly reviewed. Prompt action had been taken to improve the service or put right any shortfalls they had found.

Information from the analysis of resident’s surveys had been used to identify any areas for improvement.

We saw changes and improvements had been made following incidents and accidents at the service to minimise the risk of them happening again.