This inspection took place on 20 January 2015 and was unannounced.

Tigh Bruadar specialises in the care of people who have a learning disability. It provides accommodation for up to 13 people who require personal and nursing care. The home is divided into two separate units. On the day of our inspection there were 13 people living at the home.

At the time of our inspection 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.

On the day of our inspection staff interacted well with people and people were cared for safely. The provider had systems and processes in place to safeguard people and staff knew how to keep people safe. Risk assessments were in place and accidents and incidents were monitored and recorded. Medicines were administered and stored safely.

The provider acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).If the location is a care home Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.

We found that people’s health care needs were assessed, and care planned and delivered to meet those needs. People had access to other healthcare professionals such as a dietician and GP. Staff were kind and sensitive to people when they were providing support. Staff had a good understanding of people’s needs and used innovative ways to involve people in their care and understand their choices. People had access to leisure activities and excursions to local facilities.

People had their privacy and dignity considered. Staff were aware of people’s need for privacy and dignity.

People were supported to eat enough to keep them healthy. People had access to drinks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

There were sufficient staff available to care for people appropriately. Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs.

Staff felt able to raise concerns and issues with management. We found relatives were clear about the process for raising concerns and were confident that they would be listened to. The provider recorded and monitored complaints.

Audits were carried out on a regular basis and action put in place to address any concerns and issues.

Due to the complex needs of the people who used the service we used a number of different methods to help us understand their experiences when we undertook our visit. Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with two people who used the service and asked them for their views. We also spoke with two care workers, two team leaders, the registered manager and the service manager. We also looked at some of the records held in the service including the care files for five people. We observed the support people who used the service received from staff and carried out a brief tour of the building.

We found where people were able to they gave consent to their care and support. Staff were provided with the leadership they required to protect the rights of people who did not have the capacity to consent. People received care and support that met their needs and this was regularly reviewed to ensure it was up to date. A person who used the service told us, “I have my review.”

We found that suitable arrangements were in place to manage people’s medication and ensure they received any medication they needed. There were sufficient staff to meet people’s needs and the provider maintained records that were accurate and fit for purpose. A person who used the service told us, “There is always staff around. I was a bit upset last night and someone came and helped me.”

Due to the complex needs of the people who lived at the service we used a number of different methods to help us understand their experiences.

During our visit we observed how staff interacted with, and supported people with their care and activity needs. We looked at records. These included care records and information about how the service operated.

We spent some time in communal areas of the home. We also spoke with two people who lived at the home, two staff members and the registered manager.

We saw that people were cared for and treated with dignity and respect. We observed that staff were able to communicate with people by speaking with them direct, and through the use of non verbal actions. This helped to ensure people were able to express their views and be involved with any decisions that needed to be made.

Wherever possible people were able to make choices about the activities they undertook both inside and outside the home.

One person told us, “I am having Carbonara for my tea. I cook it myself with any help I might need. I like it that way” and “I go to college to do hair and beauty. We like to go on Holiday. We went to Whitby last year and it was great.”

Where appropriate we found evidence that relatives of people who used the service were involved in reviews about peoples care and treatment.

We also found that the provider monitored the service and gained views on the service from relatives and from people who used the service.

People told us there were lots of activities to do for example; horse riding, bowling, cinema and games to play in the home.

Other people said they liked living in the home. They got on well with the staff there.

On person told us they liked their bed room, they could change it around to how they wanted to.