Three Sisters and Bronte View is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Three Sisters and Bronte View accommodates up to 17 people with a learning disability across two separate units, each of which have separate adapted facilities. One of the units specialises in providing more independent care to people living in one bedroomed apartments.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

It was clear from what people and the relatives we spoke with said that the service met their needs. People who lived at the home were happy with the support they received and told us they felt safe.

Medication was managed safely and people received the medicines they needed to keep them well. People had access to a range of health and social care professionals and people had health passports in place which gave staff clear information about their physical and emotional needs and the support they required.

Staff received appropriate support and training to do their job role and staff spoken with told us the registered managers were supportive and managed the service well. People and the relatives we spoke with agreed with this. Staff were recruited safely and sufficient staff were deployed to meet people’s care and support needs.

People’s care records were person centred, detailed and gave clear information about people’s care and support needs including assessed risks and personal preferences.

It was clear people felt relaxed and comfortable in the company of staff. Staff knew people’s care and support needs well and good relationships had developed. The atmosphere at the home was relaxed and inclusive. People and their relatives told us staff and the registered manager were kind, caring and supportive.

We observed and people told us they got enough to eat and drink and that they had a choice of what food they wanted to eat.

People had access to a diverse range of person centred activities which were social and educational in nature. This enabled people to develop or maintain life skills and independence at the same time as having good fun.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

During our visit, we had no concerns about people's care or the service itself. We found the home to be well-run with a committed and caring staff team.

There were a range of effective mechanisms in place to monitor the quality and safety of the

Service. The views of people and staff were regularly sought by the registered managers to check and improve the quality of the service.

Further information is in the detailed findings below.

On the 19 and 26 May 2016 we inspected Three Sisters and Bronte View. At the time of our inspection, there were 16 people living at the service. This was an unannounced inspection.

The service was last inspected in October 2014 and was fully compliant with the outcome areas that were inspected against.

Three Sisters and Bronte View is a care home for up to 17 younger adults with a learning disability who may also have challenging behaviours. Three Sisters can accommodate up to 10 people in en-suite bedrooms and Bronte View can accommodate seven people in self-contained flats. There is a small farm and training facility for the people who live at the home and in the local area. The home is in easy reach of Haworth and the local facilities.

The service had a registered manager in place at the time of our inspection. 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.

Potential risks to people were assessed and recorded. There was full guidance on how to safely manage risks in each person’s support plan so that people received the interventions they needed to keep them as safe as possible. The assessments identified people’s specific needs, and measures were in place to reduce the risks, without restricting people’s activities or their lifestyles.

People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns, both within the organisation and to the local authority safeguarding team.

Accidents and incidents were reviewed and action was taken to reduce the risk of re-occurrence. Each person had a personal emergency evacuation plan in the event of an emergency.

Health and safety checks on the equipment and the environment were carried out regularly to make sure the premises were safe. Routine maintenance was carried out on a regular basis as part of maintenance plan.

Some people living at the service needed one to one staffing support and there were appropriate levels of staff on duty and deployed throughout the service to meet people’s needs. Additional staff were on duty throughout the day to ensure that people were supported to enjoy activities of their choice.

There were safe recruitment practices in place and appropriate recruitment checks were conducted before staff started work.

New staff were given a detailed induction, and completed a probationary period to make sure they were suitable to work with vulnerable adults. The on-going training programme ensured that staff had the right skills, knowledge and competencies to carry out their roles.

Staff received regular one to one supervision from their line manager, together with an annual appraisal, to discuss their training and development needs and for any support required.

Care and support plans were designed around people’s individual interests and needs. These were written in a way people could understand, and included pictures and photos.

Deprivation of Liberty Safeguards (DoLS) authorisations were in place for people as required. Guidelines were being followed by staff to ensure there were no unnecessary restrictions to people’s lifestyles.

Staff supported people with their health care needs and when it was necessary, health care professionals were involved to make sure people remained as healthy as possible.

People were supported to eat and drink suitable healthy foods and sufficient amounts to meet their needs and ensure well-being.

Medicines were managed safely and stored securely, and people’s medicines were reviewed regularly by their doctor to make sure they were still suitable.

There was a strong emphasis on person centred care and care records covered people’s preferred

We set out to answer our five questions:

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during

the inspection, discussions with people using the service, the staff supporting them and

looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Was the service safe?

We found the service was safe.

People told us they felt safe in the home. We found systems were in place to investigate people’s concerns to ensure people were kept safe. Staff had received training in safeguarding and understood how to identify and raise concerns.

Recruitment practice is safe and thorough. All staff had a Disclosure and Barring Service (DBS) check prior to starting work at the home. Policies and procedures were in place to make sure that unsafe practice is identified and people are protected.

Was the service effective?

We found the service was caring.

Care was effective as people had their current needs assessed. Care plans were person centred and included specific information around their likes and dislikes.

People told us they had choices with regards to their daily lives and praised the staff in the home. We observed the lunchtime meal which showed people were given appropriate support and choice.

Was the service caring?

We found the service was caring.

People told us staff were kind and caring. For example one person told us, “Staff treat us well,” and another person said, “I like the staff.” We observed staff displayed patience and compassion when caring for people and treated them with dignity and respect.

Was the service responsive?

We found the service was responsive.

People completed a range of activities in and outside the home on a daily basis. The home completed audits on a regular basis and we found that actions had been taken to repair shortfalls.

There was evidence that people were referred to healthcare professionals such as district nurses and doctors to ensure the service responded to any health concerns.

Was the service well-led?

We found the service was well-led.

The manager had identified shortfalls in the home robust quality assurance systems. There was a clear sense of direction and commitment from the manager to ensure these improvements were achieved. Staff told us they knew their roles and responsibilities in the home.

Incidents and complaints were fully investigated and there was evidence that lessons were learnt to ensure continuous improvement.