West Dean Care Home is registered to provide accommodation and personal care for 16 people who need support in order to maintain their mental health or who have a learning disability. At the time of our inspection visit there were 12 people living in the service all of whom lived with problems with their mental health.

The service was run by a company that was the registered provider. 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

At the last inspection on 27 January 2015 the service was rated Good.

At this inspection we found the service remained Good.

This inspection was announced and was carried out on 26 April 2017. We gave the registered persons a short period of notice. This was because the people who lived in the service had complex needs for care and benefited from knowing in advance that we would be calling.

Care staff knew how to keep people safe from the risk of abuse. Suitable steps had not always been taken to reduce the risk of avoidable accidents. However, in practice people had not experienced direct harm as a result of this oversight. Medicines were safely managed and there were enough staff on duty. Background checks had been completed before new care staff had been appointed.

Care staff knew how to support people in the right way. People enjoyed their meals and they had been helped to obtain all of the healthcare assistance they needed.

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

People were treated with compassion and respect. Care staff recognised people’s right to privacy and promoted their dignity. Confidential information was kept private.

People had been given all of the care they needed and they had been supported to pursue their hobbies and interests. There was a system for quickly and fairly resolving complaints.

People had been consulted about the development of their home. Quality checks had usually been effective in ensuring that people received safe care. Care staff were supported to speak out if they had any concerns and good team work was promoted. People had benefited from care staff acting upon good practice guidance.

Further information is in the detailed findings below.

We inspected West Dean Care Home on 27 January 2015. The inspection was unannounced. The last inspection took place on 12 December 2013 during which we found there were no breaches in regulations.

The service is located near to the centre of the city of Lincoln. It provides accommodation for up to 16 younger adults who have support needs associated with their mental and physical health. At the time of our inspection there were 15 people living at the service.

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.

People’s rights were protected by staff who understood the Mental Capacity Act 2005 Code of practice and the Deprivation of Liberty Safeguards, and followed the correct procedures.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find.

DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect themselves. At the time of our inspection no-one who lived at the home had their freedom restricted.

People were supported to maintain their privacy and dignity. Staff had a good understanding of people’s needs and they were kind and respectful to people when they provided support.

The registered manager and staff promoted an open and inclusive culture within the home. People had the opportunity share their views and opinions and were involved in planning and reviewing their care. People also understood how to raise any complaints or issues they had and were confident the right actions would be taken to resolve issues.

We found that people’s health care needs were assessed, and met. People had access to other social and healthcare professionals such community psychiatric nurses and social workers when they needed them.

People were given choices about what they wanted to eat and about when and where they had their meals. They were supported to eat and drink enough to keep them healthy and where people had special dietary requirements we saw that these were provided for.

Staff were recruited, trained and supported to meet people’s needs appropriately. There were enough staff on each shift to meet people’s needs. Staff had a good understanding of how to manage risks and protect people from avoidable harm. They also knew how to raise any concerns they may have and report them appropriately. The registered manager ensured there were clear arrangements were in place for ordering, storing, administering and disposing of medicines.

People had been consulted about the development of the service. The provider had completed quality checks to make sure that people received the care they needed in a consistent way.

The service encouraged people to maintain their community hobbies and interests. However, they did not always enable people to carry out person-centred activities within the home on a regular planned basis. We have made a recommendation about providing more meaningful activities within the service.

We used a number of different methods to help us reach a judgement on the quality of service provision. These included talking with five people who used the service, the registered manager and four members of staff.

We looked at records. These included care plans and information about how the service was managed.

We conducted a tour of the building and observed the interactions between the care staff and people who resided at the home.

People were supported to be as independent as possible and were fully involved in the planning and delivery of their care and support.

We found that people were provided with a choice of suitable and nutritious food and drinks in sufficient quantities to meet their individual needs and preferences. One person who lived at the home told us, "The food's brilliant. They ask what we want and we get it.”

We saw that the building was well furnished and in good decorative order. It was light, airy and spacious and was free of any unpleasant odours.

People’s health and welfare needs were met by the provision of sufficient numbers of suitably experienced staff.

We found the service was well led and managed and responded to people’s changing needs.

We talked to four people who live at West Dean Care Home and one visitor who is a relative of an individual who lives there. The people who live there told us that they feel safe and value the service they receive. One person told us that they “feel really secure” another person told us that “this is where I feel safe and “I realise I won’t be hurt here.”The people we talked to were very positive about the staff who provide support. One person told us “they’ve always got time for you”. Another person told us “I think all the staff are very good.” People we spoke to told us that the care they received was helpful and geared to respond to their individual needs. One person told us about how the staff have helped with their aspiration to prepare and plan for an increasingly independent life.

The relative of a person who uses the service described care planning work around personal safety as “brilliant”. The people we talked to told us that they feel consulted and involved in the life of the home and in shaping services. One person who has recently been involved in the recruitment of staff told us that “they try and get you involved with things.”

One person we spoke with told us “I like it here. It’s very nice and I can come and go as I please.” Another person said “I am happy here. It would be nice to be able to live on my own but until then, this place is ok.”

We spoke with four people who told us that West Dean was a good place to live. They said they thought the staff were good to them and helped them.