This was an unannounced inspection which took place on 06 and 07 March 2018. This was the first comprehensive rated inspection of the service since it changed ownership in 2017. A previous inspection in April 2016 under the previous ownership identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations (2014) in that some equipment and parts of the premises were not adequately maintained or suitable for their required purpose, and staff did not always receive mandatory training and supervision in line with the provider’s policies and procedures. At this inspection we found improvements had been made and the service is no longer in breach of the regulations.

The Mews is a service which provides accommodation, personal care and nursing care and provides care and support to young people with disabilities. It comprises of three units situated over four floors. It is built on the side of a hill and terraced, which means all floors have direct access to outside areas. Nursing care is provided by qualified nurses who are supported by care assistants. The service has 50 single bedrooms and at the time of our inspection there were 48 people living in the service.

There was a culture of openness and transparency at the service. Although the service supported people with a variety of extremely complex needs the environment was more homely than clinical. Imaginative furniture arrangements minimised the risk of accidental injury, and the non-clinical environment did not detract from the high quality of care and support provided. Care was provided in a calm and relaxed environment. There was a real sense of community throughout the service; people who used the service were stimulated with a wide range of activities, their needs were addressed and they appeared content. They told us that they got on well with staff and were well supported. They had made friends and enjoyed living at the Mews. The staff we spoke with enjoyed working at The Mews and told us they felt a sense of fulfilment. Most of the people working there had done so for a long time, with very little staff turnover.

People felt they had a stake in the service and a say in how the service was managed. Staff were extremely positive ¿about the people they supported and management and leadership inspired them to deliver a high quality service.

People were safe. There were few allegations of abuse, and those that were raised were taken seriously and fully investigated. Accidents and incidents were recorded and analysed for trends, with a view to preventing repeat occurrences.

The service took a proactive approach to risk and risk taking. Staff worked collaboratively and with mutual respect for other professionals and agencies so that people's social, emotional and physical needs were met. This helped them to lead an exceptionally high quality of life. People’s care and support was planned proactively with them and whilst areas of potential risk had been continually assessed lifestyle choices were respected. Whilst recognising their rights to live their lives the way they chose, staff worked closely with people to consider ways of reducing the risk their choices might incur.

Privacy and dignity were respected, and people were supported by very kind, caring and compassionate staff who routinely went above and beyond what was expected of them to ¿provide people with excellent, high quality care.

People told us that they were well cared for in a welcoming and inclusive environment. Nothing seemed to be too much trouble for the staff.

We saw that there were enough staff to meet people’s needs across all three units of The Mews. Recruitment systems in place ensured staff shared a similar value base and reflected the local population. We saw staff had access to good face to face training and a programme of ongoing learning and development.

People told us that they enjoyed the food on offer and we saw mealtimes were a merry and social occas