About the service:

Tamar House provides accommodation, care and support for up to 13 people who experience learning disabilities or autistic spectrum disorder. There were 12 people living at Tamar House at the time of the inspection.

The registered manager and staff worked within the principles and values that underpin Registering the Right Support and other best practice guidance. This ensured that people could live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

People’s experience of using this service:

People continued to receive a safe service and were protected against abuse, neglect and discrimination. Staff were trained to recognise signs of potential abuse and how to manage and report any situations in which people may be at risk.

There were enough staff with the right skills and knowledge to provide person centred care for people. People were supported with good nutrition and were able to access appropriate healthcare services when they had need.

People were treated with dignity and respect and their privacy was maintained. They were supported to make choices and decisions for themselves and encouraged to express their views and opinions.

The registered provider maintained systems to monitor and continuously improve the quality of services provided for people.

Rating at last inspection:

Tamar House was last inspected on 20 July 2016 (published 15 August 2016) and was rated as good overall.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. Tamar House remained rated good overall. The rating of requires improvement for the safe section applied at our last inspection had been increased to a good rating.

Follow up:

We will continue to monitor intelligence we receive about Tamar House until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 20 July 2016 and was announced.

Tamar House specialises in the care of people who have a learning disability. It provides accommodation for up to 13 people who require personal and nursing care. On the day of our inspection there were 13 people living at the home.

At the time of our inspection 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.

On the day of our inspection we found that staff interacted well with people and people were cared for safely. The provider had systems and processes in place to safeguard people and staff knew how to keep people safe. Risk assessments were in place and accidents and incidents were monitored and recorded. Medicines were administered and stored safely.

The provider acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).If the location is a care home the Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.

We found that people’s health care needs were assessed, and care planned and delivered to meet those needs. People had access to other healthcare professionals such as a dietician and GP. Staff were kind and sensitive to people when they were providing support. Staff had a good understanding of people’s needs. People were supported to pursue leisure activities and access local facilities.

Staff were aware of people’s need for privacy and dignity and made arrangements to provide this.

People were supported to eat enough to keep them healthy. People had access to drinks and snacks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

There was not always sufficient staff available to meet people’s needs. Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs.

Staff felt able to raise concerns and issues with management. A process for raising concerns was in place. People and relatives knew how to complain and the provider recorded and monitored complaints.

Audits were carried out on a regular basis and action put in place to address any concerns and issues.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time. An acting manager was in post who was managing the home.

As part of this inspection we spoke with four people who used the service .We also spoke with the acting manager and a senior support worker. We looked at service information, care plan files for three people and did a tour of the home. We also looked at records.

People we spoke with told us they were happy with the care and support they received and felt their needs were well met. One person told us, “It’s alright here. We have all been to Blackpool on holiday.”

We saw that people were involved in the planning of and consented to their care and support.

We asked people about their experience of the meals provided. Comments included, “The food’s alright. We get what we want.”

The provider had taken action to protect people from the risks associated with unsafe or unsuitable premises.

People who used the service and others were well informed to enable them to make a complaint about the service if they so wished.

We carried out an inspection of Tamar House to follow up on an area of non-compliance identified in a previous inspection. We reviewed the evidence that demonstrated the provider's compliance in this area.

Due to the complex needs of the people using the service we used a number of different methods to help us understand their experiences when we undertook our visit.

We spoke with three people living at Tamar House, together with the registered manager and two members of staff.

We also looked at records. These included care plans, records of meetings and information about how the service operated. We also looked at information from surveys undertaken by the provider to assess the quality of service.

The people we spoke with said they were happy with the care and support they received.

One person living at the home told us, “It’s alright.” Another said, “Food is good”

A member of staff that we spoke with said, “I gave up a well paid job in hospitality to go back into care. I don’t regret it a bit.”

One person we spoke with told us, “I like living here. My family visit and take me out.”

Another person said “I go out most days to college.”

People also told us “The staff are nice. I like them.” And “I like the food. There is a lot to eat.”

A relative we spoke with said “It’s always clean and the staff are great. They are cheerful and friendly.”