The Sheiling is a care home providing accommodation, personal care and support for up to ten adults who have a learning disability, physical disability or mental health conditions.

When we carried out our unannounced inspection on 15 January 2018, there were ten people living at the home at the time of our inspection.

There was a registered manager in place. 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.

People were treated by staff who were kind and caring. Staff treated people with respect and maintained their dignity. People were able to make their own choices and encouraged to be independent. People received care that was personalised to their individual needs. Support plans reflected people’s needs and preferences

People were supported by sufficient numbers of staff to meet their needs and keep them safe. Good recruitment procedures were followed to ensure only suitable staff were employed. Staff understood their responsibilities in safeguarding people from abuse and knew how to report any concerns they had. The provider did not have robust processes that had ensured people finances were managed appropriately which was subject to an investigation. However, we had no concerns about the processes within The Sheiling in relation to people’s finances.

Risks to people’s safety were identified and action taken to keep people as safe as possible. Accidents and incidents were analysed and discussed within the team so lessons were learnt. Regular checks were carried out at the service to ensure the home was safe and well maintained and the provider had a contingency plan to ensure that people’s care would continue in the event of an emergency.

There were good medicine management processes in place and where people lived was clean and hygienic. The home was adapted to help ensure it was suitable for people and their needs.

People’s needs had been assessed before they moved into the home. Staff had the training and support they needed to carry out their roles effectively. All staff attended an induction when they started work and were required to undertake a nationally recognised set of care standards.

People’s rights under the Mental Capacity Act 2005 were respected. Where people lacked capacity the legal requirements were followed to help ensure decisions were made in their best interests.

People were able to make choices about the food they ate and where people had a specific diet this was provided to them. People were supported to maintain good health and to obtain treatment when they needed it. Each person had a health action plan which detailed their health needs and the support they needed.

People had opportunities to take part in activities that reflected their interests. People were supported to access the local community which enabled them to meet people outside of the service. There were appropriate procedures for managing complaints.

People, relatives and staff felt the service was well managed by the registered manager. There was the opportunity for everyone to give their feedback and suggestions and these were reviewed and the registered manager responded positively to feedback.

The staff and provider’s quality monitoring systems were effective in ensuring people received good quality care and support. Staff had established effective links with external agencies and health and social care professionals to ensure people received the care they needed. The standard of record-keeping was good. People’s care records were kept up to date and stored accessibly yet securely.

This inspection was carried out on the 11 October 2016. The Sheiling is registered to provide accommodation for up to 10 people who have a learning disability including autism. Some of the people who live at the service also have physical disabilities. At the time of our inspection the service provided care to 10 people.

There was a registered manager in post at the time of the 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff informed us and we saw from records that there were not always enough staff to support the needs of people that required one to one support. However on the day of the inspection people received support from staff when they needed.

The provider did not have robust processes that had ensured people finances were managed appropriately which is subject to an investigation. However the registered manager was fully aware of the processes to follow in house.

People were protected from the risk of abuse and staff understood their roles and responsibilities. People told us that they felt safe and relatives had peace of mind that their family members were looked after in a safe environment. Appropriate recruitment checks were undertaken before staff started work. There were appropriate plans in place in the event the service needed to be evacuated.

Staff understood the risks to people. Staff encouraged and supported people to lead their lives as independently as possible whilst ensuring they were kept safe. People’s medicines were managed in a safe way and those that could were encouraged and supported to manage their own medicines.

Staff receiving appropriate training and supervision to provide effective care to people.

People's human rights were protected because the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty (DoLS) were being followed. MCA assessments were completed where needed. Staff understood MCA and why it was important to understand if people had capacity to make decisions.

People enjoyed the food at the service. Staff supported people’s nutritional and hydration needs and people accessed health care professionals when needed.

Staff were caring and considerate to people’s needs. People said that staff were caring and kind to them and treated them with dignity. People and relatives were involved in their care planning and the care that was provided was person centred.

Care plans were detailed and provided guidance to staff on how best to support people. Staff communicated with each other the changes to people’s care.

People were supported to follow their interests and take part in social activities, education and work opportunities. People said that they enjoyed going out and lived their lives to the fullest.

Complaints and concerns were taken seriously and used as an opportunity to improve the service.

The provider had systems in place to regularly assess and monitor the quality of the care provided.

The provider actively sought, encouraged and supported people's involvement in the improvement of the service.

People told us the staff were friendly and management were always approachable. Staff were encouraged to contribute to the improvement of the service. Staff told us they would report any concerns to their manager. Staff felt that management were very supportive and staff felt valued.

The registered manager had informed the CQC of significant events. Records were accurate and kept securely.

People's care plans contained information about how their personal care needs were to be delivered by the staff supporting them.

We conducted a random telephone survey of the family of the people who used the service. They said that they were happy with the care and support provided to their family members at The Sheilling. They said that were kept informed of any changes in their family members care and support.

The service had a set of safeguarding and whistle blowing policies and procedures in place. Incidents were reported promptly to the local authority and notifications were supplied to the Care Quality Commission.

We looked at the staff training records and we saw some evidence that staff had attended training in safeguarding vulnerable adults.

The provider has taken steps to provide care in an environment that was adequately maintained to safeguard the people who used the service.

We found that there was an effective recruitment and selection processes in place. We saw checks were undertaken before staff began work. These included a fully completed application form, health check, two written references and a criminal record check.

Quality Assurance (QA) checks are carried out by the provider on a regular bases to ensure that the service was meeting the needs of the people who used the service. The QA for the staff and people who used the servie was completed after our inspection but was since then the manager has confirmed that they were competed.

The people who live at the service all attend activities within the community, on the day of the visit only one person was at home.

Staff stated that the person who was present was unable to communicate verbally. As a result we were unable to ask the opinion of the people who use the service in regards of the care and support they receive at The Sheiling.

We were however able to make limited observations of one person who used the service who was at home during the inspection.

Our observations were that this person, appeared relaxed and at ease in their surroundings and interacted well with staff on duty.

We observed that the staff member who was on duty as a one-to-one was attentive and demonstrated a good understanding of this person’s communication styles or body language.

In order to further ascertain the quality of care and support provided by the service, we undertook a telephone survey of a selection of relatives of the people who lived at the service.

We were told by one person that the home had a “good feel about it” and that their relative had benefited by living at The Sheiling. They told us that staff supported their relatives to participate in community based events and activities. This was supported by a family member from another person who lived at the home. They told us that their relative enjoyed a very active life that was at their pace and they were encouraged to participate in a range of activities.

The home was described as being “proactively responsive” and acted appropriately when changes were suggested or alternatives offered in the care of the people who live at The Sheiling.

One person stated that the placement of their relative into The Sheiling had been very successful. Their relative had developed and reengaged in activities and social outings.

Another person spoke of the improvement in the general well being of their relative since they moved into the service and how they continued to engage effectively with other people and the staff at the home.

Another person told us that they felt supported and that people looked out for each other when they were upset or unhappy.

Overall people were very positive of the respect and dignity their relative was shown by the staff at the service.