We inspected Vincent House on 17 December 2018 and 15 January 2019. The inspection was announced. When we last inspected the service in February 2017 we found the provider was meeting the legal requirements in the areas that we looked at and rated the service as 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.

Vincent House 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.

Vincent House is a large terraced house which is registered to accommodate a maximum number of six people with a learning disability. There is a dedicated male and female unit, each with three en-suite bedrooms. At the time of the inspection there were four people using the service.

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. Registering the Right Support CQC policy.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place. Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring.

Medicines were managed safely with an effective system in place. Staff competencies around administering medicines were regularly checked.

The home was clean and tidy and communal areas were well maintained. Appropriate personal protective equipment and hand washing facilities were available. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained.

There were enough staff employed and on duty to meet people’s needs. We found safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff started work.

People were supported by a team of staff who were knowledgeable about people’s likes, dislikes and preferences. A training plan was in place.

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

Staff were aware of people’s nutritional needs and people were protected from the risk of poor nutrition. Care records contained evidence of people being supported during visits to and from external health care specialists.

People told us staff were kind and caring. Care plans detailed people’s needs and preferences. Care plans were reviewed on a regular basis to ensure they contained up to date information that was meeting people’s care needs. People had access to a range of activities. The service had a clear process for handling complaints.

Staff told us they enjoyed working at the service and felt supported by the registered manager. Quality assurance processes were in place and regularly carried out by the registered manager, senior staff and nominated individual, to monitor and improve the quality of the service. Feedback was sought from people who used the service through meetings and surveys. This information was analysed and action plans produced when needed.

Vincent House is a large terraced house which is registered to accommodate a maximum number of six people with a learning disability. There is a dedicated male and female unit each with three en-suite bedrooms. The property is within walking distance of the beach, town centre and many local amenities, including transportation links to nearby towns. There were five people using the service at the time of inspection.

At the last inspection in January 2015, the service was rated 'Good'. At this inspection we found the service remained 'Good'.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place. Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. Medicines were managed safely with an effective system in place. Staff competencies, around administering medication, were regularly checked. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained.

There were sufficient staff on duty to meet the needs of people who used the service. Staff were available to provide one to one support and with visits out in the community. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. A comprehensive training plan was in place and all staff had completed up to date training. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were able to choose meals of their choice and staff supported people to maintain their health and attend routine health care appointments.

Care plans detailed people’s needs and preferences and were person-centred. Care plans were reviewed on a regular basis to ensure they contained up to date information that was meeting people’s care needs. People were actively involved in care planning and decision making. People who used the service had access to a wide range of activities and leisure opportunities. The service had a clear process for handling complaints.

Staff told us they enjoyed working at the service and felt supported by the registered manager. Quality assurance processes were in place and regularly carried out by the registered manager and registered provider, to monitor and improve the quality of the service. The service worked with various health and social care agencies and sought professional advice to ensure individual needs were being met. Feedback was sought from people who used the service through regular meetings. This information was analysed and action plans produced when needed.

We inspected Vincent House on 7 January 2015. This was an announced inspection. We informed the provider at short notice (the day before) that we would be visiting to inspect because the location was a small care home for people who are often out during the day; we needed to be sure that someone would be in.

Vincent House is a terraced property located in Redcar. Vincent House is a residential care home that provides care and support for up to six people with a learning disability. The property consists of two units each with three en-suite bedrooms. There is a dedicated male and female units.

The home 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.

There were systems and processes in place to protect people from the risk of harm. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

Risks to people’s safety had been assessed by staff and the records of these assessments had been reviewed.

We saw that staff had received supervision on a regular basis. We saw that staff had received an annual appraisal.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. People told us that there was enough staff on duty to provide support and ensure that their needs were met. Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

There were positive interactions between people and staff. We saw that staff treated people with dignity and respect. Staff were attentive, showed compassion, were patient and gave encouragement to people. When people became anxious staff supported them to manage their anxiety and also provided reassurance.

We saw that people were involved in planning the menus and were provided with a choice of healthy food and drinks. However, staff had not undertaken nutritional screening to identify specific risks to people’s nutrition.

People were supported to maintain good health and had access to healthcare professionals and services. People told us that they were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments. We found that people did not have a hospital passport. The aim of a hospital passport is to assist people with a learning disability to provide hospital staff with important information they need to know about them and their health when they are admitted to hospital.

Assessments were undertaken to identify people’s health and support needs as well as any risks to people who used the service and others. Plans were in place to reduce the risks identified. Person centred plans were developed with people who used the service to identify how they wished to be supported.

People’s independence was encouraged and their hobbies and leisure interests were individually assessed. Staff encouraged and supported people to access activities within the community.

The provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take action to support them.

There were effective systems in place to monitor and improve the quality of the service provided. Staff told us that the service had an open, inclusive and positive culture.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

During this inspection we looked at the care records for two people, spoke with the acting manager and two members of staff. We also spoke with two people who used the service. We observed the interactions between staff and people who lived at Vincent House. We saw people moving freely around the home, making their own day-to-day decision and being supported by staff where necessary.

People we spoke with told us that they were always treated with dignity and respect by the staff. Comments included, “Staff are all lovely, they are really caring.” “Loving it here, can talk to the staff and they listen.”

We found that in the main care plans provided staff with the information they needed to meet people's needs. We found that there was the need for further development in one person’s care plan.

We found that information was available for protection of vulnerable adults and that staff were clear about the actions they would take.

We saw that the environment was clean and generally well maintained. We found the systems in place were effective to ensure people's safety.

Records were accessible to staff and had been stored securely.

We found that before people received any care or support they were asked for their consent and that staff acted in accordance with their wishes. We found that people who used the service experienced care and support that met their needs and that this was provided in a clean and hygienic environment.

One person who used the service told us that they like to come and go as they please. When asked how they found the service they said "It's good I go out on my own but they are here (if I need them)".

One person who used the service was continuing to be supported by other healthcare professionals. They had supplied detailed and comprehensive assessments and care plans in relation to this persons care. However, we found that these were not followed or corroborrated by the service care records and that the service had adopted overly restrictive practices that were not suggested by these professionals. This included not allowing the person to go out independently and installing internal security measures that restricted the rights of the people who used the service and were disproportionate to the risks identified.

During our visit we observed how people were treated and spoke to people who used the service. We saw that people were enabled to make choices about how they live their lives.

One person we spoke to said that they were invited to monthly review meetings but they often chose not to attend. They said they had a key worker that they felt they could talk to at any time.

During our visit people told us they chose what they wanted to eat and were supported to make decisions regarding their food. One person told us that they were supported to do their own food shopping and cooking and told us about their favourite food.

People showed us their rooms and told us they had been involved in choosing how they were decorated.

One of the people we spoke to told us that they felt safe living at Vincent House.