This inspection took place on 25 January 2017 and was unannounced.

The Pines is a care home which provides care and support for up to six people. People living at the home had learning disabilities and physical disabilities. At the time of our inspection there were six people living at the home.

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.

Our last inspection was in October 2015 where we identified concerns with infection control, staff approach to dignity and respect and the quality of records and audits. At this inspection we found actions had been taken to ensure the regulations had been met and the service had improved.

People’s rights were protected under the Mental Capacity Act (2005). We did note one instance where documentation was not in place for one person. We recommended that the provider ensures that information regarding people’s capacity was clearly recorded.

The home environment was clean and systems were in place to maintain cleanliness as well as the environment. People were involved in decisions about their home, including recent improvements and refurbishment works.

There were sufficient staff present to meet people’s needs. The provider undertook checks to ensure staff were suitable. Staff had access to a wide range of training to support them in their roles.

Staff understood their roles in protecting people from abuse. Risks to people were routinely assessed and where incidents had occurred, actions were taken to prevent a reoccurrence. Staff were trained in managing medicines, which they administered safely.

People were supported by caring staff who supported them to make choices. People made choices about activities they took part in and what food they were prepared. People’s dietary needs were met. People had access to healthcare professionals.

Staff knew the people they supported well and had built positive relationships with them. Staff promoted people’s privacy and dignity when providing support. Staff had access to person-centred care plans which highlighted what was important to people. People’s needs were regularly reviewed in order to identify any changes.

Systems were in place to measure the quality of the care that people received.The provider took action where they identified improvements. People and relatives provided feedback, which the provider acted upon. Staff responded to complaints. Staff felt supported by management and had input into how the home was run.

The Pines is a care home which provides care and support for up to six people. No one living in the home is able to communicate verbally as each person has a profound learning disability. At the time of our visit there were six people living at the home.

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 and associated Regulations about how the service is run. The registered manager was not present during our inspection as they were due to leave the organisation. We were assisted by the deputy manager at the inspection who was joined by the new manager who informed us they were about to start the process of registering.

People lived in an environment that was not well maintained or clean and staff did not always display behaviour that may show they respected people or had considered them.

People were encouraged to take part in a range of activities however we found that some external activities were cancelled meaning people did not go out as often as they could. Records held for people did not always record sufficient information to provide staff with information about care or activities provided for people.

Quality assurance audits took place although we found some areas identified from the providers audit had not been acted on. Regular medicines audits were undertaken to ensure staff were following best practice in medicine administration and we found medicines were administered and stored in a safe way.

People were not prevented from doing things they enjoyed as staff had identified and assessed individual risks for people. For example, those people who liked animals. Staff had followed legal requirements to make sure that any decisions made or restrictions to people were done in the person’s best interests. Staff understood the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS).

There were enough staff deployed each day to enable people to either stay indoors or go out to activities. Staff had a relaxed, easy-going relationship with people. It was evident they understood people’s individuality and needs and respected people’s when they wished to have time alone.

If an emergency occurred or the home had to close for a period of time, people’s care would not be interrupted as there were procedures in place.

Staff were provided with training specific to the needs of people which allowed them to carry out their role in an effective way. Staff met together regularly and felt supported by the deputy manager. They told us they felt, “Valued” by the provider. Staff were able to meet their line manager on a one to one basis regularly.

Staff were aware of their responsibilities to safeguard people from abuse and were able to tell us what they would do in such an event. We found appropriate checks were carried out to help ensure only suitable staff worked in the home.

Staff helped people be independent when they could and supported people to keep healthy as a range of nutritious foods individualised to people’s requirements was provided. People had access to external health services and professional involvement was sought by staff when appropriate.

A complaints procedure was available for any concerns and relatives and people were encouraged to feedback their views and ideas into the running of the home. This included any compliments people had.

During the inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We looked at feedback surveys carried out by the provider. People’s relatives said that they were satisfied with the care.

People appeared relaxed and content, confident and free to express themselves. For example, one person felt confident to join us at the inspection feedback where we were meeting the manager and service manager.

We found that care and treatment was planned and delivered in a way that ensured people’s safety and welfare.

We saw that people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We saw records to confirm that people were protected from unsafe or unsuitable equipment.

We saw that staff received appropriate professional development and support.

All the people we met appeared happy, relaxed and free to choose to be involved in things that they wanted to do. For example, people felt free to indicate they wanted us to move out of the chair they like to sit in when we observed office activity.

People’s relatives told us that they had no concerns, they felt their relative was safe and that they knew how to make a complaint. One person’s relative told us how they had made a minor complaint and they felt listened to when they raised it. One person’s relative said they were concerned about the activities reducing now that the previous day centre contract was ending. Another person’s relative said the staff were terrific people and some of them had been there over ten years and knew the people well.

We found it confusing to find all of people’s information in the different files and we found no link to direct us where to look for missing information. There was no sufficient arrangements in place to provide continuation of appropriate care during foreseeable emergencies.

We saw that the provider minimised risk and the likelihood of abuse by making sure all of the policies and procedures to promote safeguarding were in place. There were enough qualified, skilled and experienced staff to meet people’s needs.