The inspection took place on 1 December 2016 and was announced.

The Old Hall is registered to provide accommodation and personal care for up to 13 people who have a learning disability or autistic spectrum disorder.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act, 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect them. The management and staff understood their responsibility and made appropriate referrals for assessment. Nine people living at the service had their freedom lawfully restricted under a DoLS authorisation and a further two were waiting on assessment.

Staff undertook appropriate risk assessments for all aspects of a person’s care to keep them safe from harm inside and outside of the service. Care plans were developed to support people’s individual needs. Staff knew what action to take and who to report to if they were concerned about the safety and welfare of the people in their care. People received their prescribed medicine safely from staff that were competent to do so. The registered provider ensured that there were always sufficient numbers of staff on duty to keep people safe.

People were supported to have a nutritious and balanced diet and hot and cold drinks and snacks were available throughout the day. People had their healthcare needs identified and were able to access healthcare professionals such as their GP and dentist. Staff knew how to access specialist professional help when needed.

People were at the centre of the caring process and staff acknowledged them as unique individuals. Relatives told us that staff were kind and caring and we saw examples of good care practice. People were always treated with dignity and respect. People were cared for by staff that were supported to undertake training to improve their knowledge and advance skills to enable them to perform their roles and responsibilities.

People were supported to have an active life and were encouraged to take part in hobbies and interests of their choice. Relatives commented that their loved ones were well looked after and their wellbeing had improved since moving into the service.

People where able were supported to make decisions about their care and treatment and maintain their independence. People had access to information in an easy read format about how to make a complaint. Relatives told us that they could approach staff with concerns and knew how to make a formal complaint to the provider.

The registered provider had robust systems in place to monitor the quality of the service and make improvements. Staff had access to professional development, supervision and feedback on their performance. People, their relatives and staff found the registered manager approachable.

On this inspection we saw the care files were all securely stored. We saw there was a designated locked cupboard for care files which were no longer in use.

We saw evidence the home had a deep clean throughout since our last inspection. We saw the home was clean throughout.

We saw the grounds were tidy and people were able to move about them safely.

We saw some areas had been decorated and unsafe furnishings had been replaced.

The people told us they were happy living in the home.

We saw people had access to an advocate provided by the provider. We saw most people had involvement from their family and health professionals to help them make decisions about their care.

We saw people were engaged in a variety of activities in and out of the home. Some people went swimming and others were looking forward to watching a local football match that evening.

We spoke with families. One said, “No concerns, everything is perfect.”

People who lived in the home told us they were happy.

We saw people were cared for, or supported by, suitably qualified, skilled and experienced staff.

All the staff we spoke with said it was a good home, people were safe and the manager was approachable.

We found some records were not securely stored.

We observed care staff were attentive to people’s needs and their interaction with people was friendly, respectful and professional.

We saw members of staff were effectively supported by the manager to deliver a high standard of care.

The home was kept clean. People were encouraged to act independently by helping to keep their rooms tidy and assisting with the preparation of meals.

People enjoyed a wide variety of daily activities ranging from visits to museums to voluntary work at a local hospice café.

We saw the home sought the opinion and comments of the people who lived there and their relatives. One person said, “It’s great living here, everyone’s really nice.”

People who were able to, told us that they were supported in the way that they wanted to be at The Old Hall. They said that they liked living at the home and staff knew how to look after them. They said that they could do all of things they wanted to do.

One person told us that they could talk to staff if they had any concerns, and they felt safe living in the home. They said that they had privacy within the home, and knew about their care plans.