This inspection was completed on 20 February 2108 and was unannounced.

Tomlen is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Tomlen primarily supports people with a learning disability and accommodates six people in one adapted building. There were six people living at Tomlen at the time of the inspection.

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.

There was a registered manager in post at the home. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The previous comprehensive inspection was completed in June 2015 and the service was rated ‘Good’ overall. At this inspection, the service was rated ‘Outstanding’.

The service remained outstandingly responsive to people’s needs. People received care from staff who were highly motivated to providing excellent levels of personalised care. People and their relatives were positive about the care and support they received. They told us staff were very caring and kind and they felt safe living in the home.

The service was exceptionally responsive to people’s individual interests and how they chose to lead their lives. People had access to an excellent range of activities which maximised their potential and enabled them to learn new life skills. The registered manager and staff had a ‘can do’ attitude and were creative in enabling people to overcome any perceived limitations and live a rewarding and fulfilling life. The registered manager and staff had an excellent understanding of people’s emotional well-being and provided appropriate support to people.

The service benefitted from excellent leadership. The registered manager was highly driven to ensure best practice was sustained. The registered manager was a member of various forums which were focused on promoting best practice and driving improvements in social care. We saw several examples of how people had benefitted from the registered manager’s involvement in these initiatives. People, staff and relatives spoke positively about the registered manager. Quality assurance checks were in place and identified actions to improve the service. The registered manager sought feedback from people and their relatives to continually improve the service.

Staff had been trained in safeguarding and had a good understanding of safeguarding policies and procedures. The administration and management of medicines was safe. There were sufficient numbers of staff working at the service. There was a robust recruitment process to ensure suitable staff were recruited. Risk assessments were updated to ensure people were supported in a safe manner and risks were minimised. Where people had suffered an accident, themes and trends had been analysed, and action had been taken to ensure people were safe and plans put in place to minimise the risk of re-occurrence.

Staff had received training appropriate to their role. People were supported to access health professionals when required. They could choose what they liked to eat and drink and were supported to prepare their own meals. People were supported in an individualised way that encouraged them to be as independent as possible. People were given information about the service in ways they wanted and could understand.

This inspection took place on 5 June 2015 and was announced. Tomlen provides accommodation for up to four people with a mental health condition or a learning disability. At the time of the inspection four people were 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.

People living in Tomlen received highly individualised care which reflected their personal aspirations, wishes and preferences. People had access to a range of social and health care professionals to help them to stay healthy and to monitor their well-being. Staff worked closely with professionals keeping them informed of changes in people’s mental or physical health and following their advice or recommendations. People’s medicines were administered safely and appropriately. Staff had a really good understanding of people’s needs and anticipated their moods or emotions. They received the training and support they needed to achieve this.

People were helped to maintain and develop independence in areas of their life such as moving on to other types of living arrangements, having a job or helping around their home. They enjoyed a range of activities of their choice such as fishing, gardening, going to day centres and colleges and going on holiday . People were supported to stay safe whether in their home or when out in the community. Staff knew how to keep people safe from harm and what action to take if they had safeguarding concerns.

People benefitted from a home which was well managed and from staff who focussed on them as individuals. People were supported to live a calm and fulfilled lifestyle. A healthcare professional stated, “Each person has been allowed to develop to their full potential and sometimes exceeded what we would have thought achievable initially.” Staff were complementary about the openness of the registered manager and the support they received to develop professionally and within the home.

People’s experience of care was monitored through a range of quality assurance processes which included their feedback and views as well as those of staff. Checks were maintained to keep a safe environment and ensure people’s care records reflected the care they received. Service improvements were made where needed. People knew how to raise concerns whether with the registered manager, staff or other professionals. People said they were happy living at the home. A health care professional commented, “The people are cared for to a high standard.”

There were three people living at this service at the time of our visit. We viewed care records and observed staff supporting people in their daily lives.

One person we met said they liked living at this service. They told us "it's very nice here because I have my own room just how I want it". They then showed us how they had personalised it with various personal belongings and photos. People we met said they felt involved in their care and welfare, and regularly talked to staff about their support needs. One person told us that "staff do things right".

One person told us how they spent their time. They told us they went to college, visited friends and went shopping each week. Another person said they liked to "cook meals".

There was a calm atmosphere in the service and we were made to feel very welcome. People were relaxed in staff's company.

Staff were professional, respectful and positive. People told us they felt safe and were well supported by staff. One person said "the staff are all very good and know what I want".

The service had a quality monitoring system in place that checked for feedback from a number of sources and looked to make improvements whenever possible.

We spoke with two people using the service and observed another person receiving support and care. One person told us they liked staff and were supported to go out and do activities such as shopping, college and walking. We observed another person helping out around their home for instance doing the recycling. Another person told us they were happy living at the home. They said they talked to staff about their care and that staff understood them.

We observed people responding positively to staff and with good humour. They were treated professionally and respectfully.

Visitors told us they were made to feel welcome and had no concerns about the service provided. They told us "people are looked after wonderfully".

We spoke with four people living in the home. One person told us, “it’s great living here” and another said, “I love it here, I have been here for four years.”

People told us they made choices and decisions about their day to day lives. They said they went to college, a day centre, swimming, skittles and for walks. One person told us they liked to go out for coffee with friends. People said they had recently been to a party and to the cinema. They were busy planning their holiday for this year and were looking forward to going away together.

People said staff were "ok" and they liked staff. We observed them talking animatedly to staff. Staff were respectful and friendly in response.

People said they had regular meetings with senior staff to discuss the service they receive and talk about any concerns they may have.