Tunhill is registered to provide accommodation and personal care for up to four people with a learning disability or autistic spectrum disorder. The home is situated in Sheffield, South Yorkshire near local shops and public transport.

There was a manager at the service who was registered with CQC. 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.

Our last inspection at Tunhill took place on 8 June 2015. At that inspection we found two breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in regulations 17: Good Governance and 18: Staffing. We found evidence on this inspection to show improvements had been made to meet the requirements of regulation 18, staffing, as staff were being provided with regular supervisions and an annual appraisal for development and support. We also found improvements had been made to meet the requirements of regulation 17, Good Governance, as monitoring visits to audit the running of the home had increased in frequency.

This inspection took place on 15 November 2016 and short notice was given. We told the registered manager two days before our visit that we would be coming. We did this because the manager is sometimes out of the office at the two other small care homes they manage, and people are often out. We needed to be sure the manager, people and staff would be available. On the day of our inspection there were four people living at Tunhill.

We spoke with three people living at Tunhill. Their comments about Tunhill were positive. We saw people freely approach staff and have conversations and interactions with them.

We spoke with two relatives who had no concerns regarding the support their family member received.

We found systems were in place to make sure people received their medicines safely.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. Staff understood their role and what was expected of them. They were happy in their work, motivated and confident in the way the service was managed.

The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves.

People had access to a range of health care professionals to help maintain their health. A varied and nutritious diet was provided to people that took into account dietary needs and preferences so that health was promoted and choices could be respected.

People living at the home, and their relatives said they could speak with staff if they had any worries or concerns and they would be listened to.

We saw people participated in a range of daily activities both in and outside of the home which were meaningful and promoted independence.

There were systems in place to monitor and improve the quality of the service provided. Checks and audits were undertaken to make sure full and safe procedures were adhered to. People using the service and/ or their relatives had been asked their opinion via questionnaires. The results of these had been audited to identify any areas for improvement.

Tunhill is registered to provide accommodation and personal care for up to four people with a learning disability or autistic spectrum disorder. The home is situated in Sheffield, South Yorkshire near local shops and public transport.

There was a manager at the service who was registered with CQC. 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.

Our last inspection at Tunhill took place on 27 January 2014. The home was found to be meeting the requirements of the regulations we inspected at that time.

This inspection took place on 8 June 2015 and short notice was given. We told the provider two days before our visit that we would be coming. We did this because the manager is sometimes out of the office at the two other small care homes they manage, and people are often out. We needed to be sure that the manager and staff would be available. On the day of our inspection there were four people living at Tunhill.

We spoke with three people living at Tunhill. Their comments about Tunhill were positive. We saw people freely approach staff and have conversations and interactions with them. People commented, “I can talk to the staff here, they know what I like to talk about, what I like to do” and “It’s good. I’m all right.”

We spoke with three relatives who had no concerns regarding the care their loved one received.

We found systems were in place to make sure people received their medicines safely.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. Staff understood their role and what was expected of them. They were happy in their work, motivated and confident in the way the service was managed. The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves. However, some staff did not have a clear understanding of the MCA and DoLS and would benefit from further training so that they had the knowledge needed for their role and to make sure people’s rights were upheld.

People had access to a range of health care professionals to help maintain their health. A varied and nutritious diet was provided to people that took into account dietary needs and preferences so that health was promoted and choices could be respected.

People living at the home, and their relatives said that they could speak with staff if they had any worries or concerns and they would be listened to.

We saw people participated in a range of daily activities both in and outside of the home which were meaningful and promoted independence.

There were some systems in place to monitor and improve the quality of the service provided. Some checks and audits were undertaken to make sure full and safe procedures were adhered to. However, visits by the registered providers ‘locality manager’ to audit and assure themselves of the quality of service delivery had not taken place at the frequency identified by the registered manager. In addition, people using the service and their relatives had not been asked their opinion via surveys and staff had not been asked to complete a survey within the last 18 months as part of the quality assurance process. Some policies available at the home were out of date and required reviewing. Staff meetings had not taken place on a regular basis to share information and provide and encourage an open culture in the home.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Project workers said they knew the people well and they followed the home’s procedures to gain valid consent from people. One of the people who lived at the home told us, “I don’t give consent. I let staff know what my needs are. That’s what happens here and staff help me.” Staff knew the people well and had a good rapport with the people who lived at the home.

Care and support was delivered in a way that protected people from unlawful discrimination. People assured us that staff respected them and helped them with their daily life. One person said, “There is mutual respect between staff and myself. We sometimes have disagreements but that is all about our opinions and expectations. I know that.”

The provider worked in co-operation with other providers to maintain continuity of service for the people.

There were effective systems in place to reduce the risk and spread of infection. The home looked clean and smelt fresh.

People were protected from unsafe or unsuitable equipment.

The provider had a system to monitor the quality of service.

We carried out an unannounced inspection on 14 August 2012 where we found that the provider was not fully meeting the essential standards relating to care and welfare of people who used services, staffing and supporting workers. The provider submitted an action plan. This inspection was to check that the provider had taken action to address the non-compliance.

During this inspection we spoke with staff and the people who used the service and also the new manager and other senior staff within the organisation.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We observed how staff interacted with people who used the service and checked their care records to see the links between what was planned and what was delivered on the day. We noted that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

There was enough qualified, skilled and experienced staff to meet people’s needs. We were informed by the new manager that they had had recently recruited a care worker and had a full complement of staff.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Staff were confident in what they did and they said they had training and supervision to support them.

We carried out an inspection as a response to information we received about the service. We were informed that the registered manager had left the service in May 2012 and there was a high turnover of staff. The staffing levels were not sufficient and the staff were not supported by the management.

There were three people living at the house and we spoke with two of them during our inspection. This was due to one of the people was asleep.

People said they liked living at Tunhill. “I like the staff and they are lovely.” They also made the following comments. “I wish there were more staff so that I can go out.” “I find it difficult to sleep since I am kept awake by the noise of others.”

People said they were encouraged by staff to get involved in exercise and to eat healthy food. They also told us that they felt safe at the service and most staff were approachable.

We did not speak with people who used the service during this inspection.

People who used the service said that they liked living at Tunhill House. They said it was spacious, comfortable and everyone had their own room with en suite facilities.

People told us that the care workers who supported them were good and understanding. They were able to talk to the manager on a daily basis.