This inspection took place on 31 March 2016 and was unannounced.

Tunnicliffe House is a large detached property in a quiet cul-de-sac close to Macclesfield town centre. The people who live there are accommodated on the ground and first floors of the building. There are six single and five double bedrooms. The home has a passenger stair lift to access between the ground and first floor. Staff members are on duty 24 hours a day to provide support for the people who live in the home. At the time of our visit there were 13 people living there. Twelve people had lived there for a long time and one person had recently moved in.

Tunnicliffe House had a registered manager. 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.

Prior to this inspection we contacted the local authority quality monitoring team. They told us that they had visited in March and June last year and had identified some minor issues with the staff supervision system in place. This was addressed and during this inspection we were able to confirm the improvements had been maintained. Full details regarding this are in the main body of the report.

We asked people if they felt safe living at Tunnicliffe House. All the people who commented said that they did and that they were happy living there. Comments included, “Of course I am, [we] have all that we need”, “Staff are good”, “Very safe” and “I am safe here and get on with the staff”. We did observe a relaxed and welcoming atmosphere in the home between the people living there and the staff and owners.

The service had a safeguarding procedure in place. This was designed to ensure that any possible problems that arose were dealt with openly and people were protected from possible harm.

We looked at the files for the two most recently appointed staff members to check that effective recruitment procedures had been completed. We found that the appropriate checks had been made to ensure that they were suitable to work with vulnerable adults.

We asked the staff member on duty about training and they confirmed that they received regular training throughout the year and that it was up to date.

The service had a range of policies and procedures which included guidance on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. .

There was a flexible menu in place which provided a good variety of food to the people using the service.

The four care plans we looked at contained personalised information and they were written in a style that would enable any staff member reading it to have a good idea of what help and assistance someone needed at a particular time. Three of the plans that we looked at were well-maintained and were being reviewed monthly so staff would know what changes, if any, had been made. We did identify one plan that was in need of up-dating. We queried this with the registered manager who explained that a new deputy manager had recently been appointed. She was in the process of reviewing them all and they were being re-written if necessary. We have since received written confirmation that the review process had now been completed and all of the care plans have been up-dated so no further action is needed.

The staff member on duty during our inspection was positive about how the home was being managed and throughout the inspection we observed them, the member of the domestic team on duty and the two owners who were also present interacting with each other in a professional manner.

We found that the providers used a variety of methods in order to assess the quality of the service they were providing to people. These included regular contact with the people living a

Tunnicliffe House provides care for 16 people who have mental health needs.

The care being delivered at the home was person centre because people living there were involved in their care decisions were appropriate whilst respecting the person and their dignity. Reasonable processes were in place to ensure people were protected from harm or risk.

We spoke with people who lived at the home; we asked them to share with us their views and experience of care support they received. One person told us “I have lived here a long time; the care is brilliant; they (the staff) give me my medication on time when I need it.”

We spoke with four people who lived at the home and they told us that staff looked after them well and showed them dignity and respect at all times.

We reviewed four care files and found them to be well organised; the care documents provided staff with detailed information on how to support people’s needs.

We spoke with staff who had an understanding of how to protect vulnerable adults and how to report any concerns.

Systems were in place to review the people’s care needs and dependencies to contribute towards the preparation of the staffing rotas. We were told by staff that they felt the staffing levels were sufficient and managed effectively.

We spoke with staff who told us they felt well supported by the management and colleagues. They (the staff) said they worked well as a team and enjoyed their job.

We asked people living in the home if they were consulted and listened to in respect of their care and treatment. They told us that that they are always consulted and listened to regarding their care and treatment. We were told by two people that they were "very happy with the ways things are" and that "they can come and go as they please" and that they will always have someone to help them and escort them if they need to. We were told that they could always get something to drink or eat when they wanted to and that they have personal items and pictures in their rooms and that they were "happy living here". We also asked people if they knew the names of the staff and they told us that they did and that they were "all very nice".

We spoke to one person who said there had been changes made to the home which included a new assisted shower area and this had made their life alot easier. We spoke to another person who had moved rooms because they needed to be on the ground floor now and they were happy with this.

People also said that the staff were "very good"; one person told us that they were "very lucky to be here". Some people who live at the home have done so for a number of years and said that they "have been very happy here". We also spoke to one person who had moved recently to the home and commented that they were settling in very well and "like it here a lot".

People who use the service told us they were happy with the support and care they received in Tunnicliffe House. They told us that staff listen to any worries, concerns or complaints they may have and that they were confident these would be listened to and acted upon. We were told they were encouraged to take part in planning their care and on how they wish to live their daily lives. One person told us how changes made to the environment helped to improve their quality of life. Another person told us that, because of their healthcare needs, they were receiving specialist support from healthcare professionals.

People who use the service told us they receive the level of support they require to live as independently as possible. They like living in Tunnicliffe House and like the staff who support them and ‘treat them well’. They also told us staff help ensure they were kept safe and that their health and social care needs were being met.

Overall people who use the service told us were very satisfied with service they receive.

Information received from health and social care professionals told us they have no ‘worries or concerns’ about the care and welfare of the people who use the service.