We inspected Wordsley House on 1 June 2017. The inspection was unannounced, this meant the provider and staff did not know we were coming.

Wordsley House provides accommodation for up to eight people who require personal care. The service accommodates adults over the age of 18. The provider is able to support people with mental health needs. The service is over three floors and has a range of communal areas for people to use, including an enclosed garden for people and their relatives. There were eight people using the service at the time of the inspection.

At the last inspection on 15 May 2015, the service was rated Good. At this inspection we found the service remained Good.

The provider had safe and robust recruitment procedures in place. Staff were trained in safeguarding and had a good understanding of how to respond to safeguarding concerns. The registered provider ensured there were sufficient numbers of staff on duty to support people with their assessed needs. Risks to people and the environment were assessed and plans put in place to mitigate any identified risks. Policies and procedures were in place to manage medicines. We saw people were supported to self-administer their medicines. This meant the service was acting appropriately to keep people safe.

The provider had a training plan in place to ensure staff had the correct skills to meet the needs of the people using the service. Staff were supervised in their roles and received an annual appraisal to aide their personal development. People were provided with a healthy and varied menu to meet their nutritional needs. People were supported to have maximum choice and control of their lives and staff supported them to do so. This meant the service was effective in meeting people’s needs.

People were supported by kind and caring staff. People were supported in a respectful dignified manner. Details of advocacy services were given to people in leaflet form and discussed at reviews. Staff knew people’s abilities and preferences, and were knowledgeable about how to communicate effectively with people.

Care plans were individualised and person centred. Plans were reviewed and evaluated regularly to ensure planned support was current and up to date. People had access to health care when necessary and were supported with health and well-being appointments.

The provider had a quality assurance system in place. Meetings with people and staff were held regularly. The service maintained links with the wider community.

Wordsley House was very clean and well-maintained. Relevant checks of the building and maintenance systems were completed to ensure health and safety. We found infection control procedures were followed by the staff at the home. Personal emergency evacuation plans were in place for people and for staff to use as guidance in case of an emergency.

Further information is in the detailed findings below:

At the time of the inspection the people who used the service did not require staff to support them with personal care. We discussed the continued registration of the home with the owner because we found personal care, as defined by the Health and Social Care Act 2008 was not provided. The owner/manager told us the intention of the home was to offer services to people who would require assistance with personal care needs.

During the visit, we met six people who used the service. All were extremely complementary about the staff and the service. People said, “They have been great here, I have learnt so much”, “The owner and staff are like family” and “It is great here.”

We found that staff continually sought people’s views and asked their opinions. We saw they worked in partnership with people and people lived very independent lives. Staff and people who used the service told us the home was run much like a large family. We found that staff had a good understanding of how to best meet each person’s care needs.

We found that there was an effective system in place for dealing with concerns and the complaints procedures were well understood by all.

We found that action had been taken since the last inspection to provide staff with up dated training to make sure they could meet the needs of the people they cared for in a safe and individual way.

We also saw a system was in place to show the service was being monitored for the quality of the support it provided. This was to make sure people who lived at the home received appropriate care and support.

The five people we spoke with were positive about the care and support they received. They said they were satisfied with the food. They also said they had a choice of food at meal times. All people said the home was very comfortable. Two people said they had lived at the home for many years. They also said the staff were excellent. People also said communication was good and they were asked their opinions every day and consulted about any changes in the home.

People we spoke with told us that Wordsley House was their home and that they had lived there for a very long time. They told us that the staff were their family and looked after them very well. They also said that they loved living there and felt safe and supported. One person told us that the “rooms are very nice and always kept immaculately clean’’. Another person told us that if it hadn’t been for Wordsley House, they would have been in trouble, because they had been quite unwell when they went there. Another person said that certain times of the year such as Christmas and birthdays were always made special for them, with cakes and parties if people wanted them.

We inspected Wordley House on 15 May 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.

We last inspected the home on 8 August 2013 and found it met the five outcomes we reviewed.

Wordsley House is a semi detached house with gardens set on the outskirts of Hartlepool. It is within walking distance of local amenities. It provides a residential service for eight people who have mental health needs. The people who live at Wordsley House live independently and require limited support from staff.

The home had a registered manager in place and they are also one of the owners. 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.

At the time of the inspection seven people lived at the home. The people who lived at the home were very independent and did not require staff to support them with personal care. We discussed the continued registration of the home with the provider because we found personal care, as defined by the Health and Social Care Act 2008 was not provided. The provider told us the intention of the home was to continue to offer services to people who would require assistance with personal care needs.

People we spoke with told us they found that the service met all of their needs and ensured that they were kept safe. We saw there were systems and processes in place to protect people from the risk of harm. We found that staff understood and appropriately used safeguarding procedures.

People told us that the staff had supported them to develop the skills they needed to live independently. We found that people were encouraged and supported to take responsible risks and positive risk-raking practices were followed.

We observed that staff had developed very positive relationships with the people who used the service. Staff were kind and respectful, we saw that they were aware of how to respect people’s privacy and dignity. People told us that they made their own choices and decisions, which were respected by staff but they found staff provided really helpful advice.

People told us they were offered plenty to eat and assisted to select healthy food and drinks which helped to ensure that their nutritional needs were met. We saw that each individual’s preference was catered for and people were supported to manage their weight and nutritional needs.

We saw that people were supported to maintain good health and accessed a range of healthcare professionals and services. We found that staff worked well with people’s healthcare professionals such as consultants and community nurses.

We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. The people we spoke with discussed their support plans and how they had worked with staff to create them.

Staff had received a range of training, which covered mandatory courses such as fire safety, infection control and first aid as well as condition specific training such as applying the recovery star model (which is a recognised model for supporting people with mental health needs). Staff had also received training around the application of the Mental Health Act 1983 (amended 2007) and were familiar with the accompanying code of practice.

People who used the service had capacity to make decisions and were consulted about all aspects of their care. The registered manager recognised that in the future this may not be the case so ensured staff received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards training. The staff we spoke with understood the requirements of this Act.

Staff and people who used the service told us the home was run much like a large family. People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that two to four staff were on duty during the day and the owners lived in an annex of the home and provided sleep-in cover overnight.

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

We reviewed the systems for the management of medicines and found that people received their medicines safely.

We saw that the provider had a system in place for dealing with people’s concerns and complaints. People we spoke with told us that they knew how to complain and felt confident that staff would respond and take action to support them. People we spoke with did not raise any complaints or concerns about the service.

We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. We found that all relevant infection control procedures were followed by the staff at the home. We saw that audits of infection control practices were completed.

The provider had developed a range of systems to monitor and improve the quality of the service provided. We saw that the registered manager had implemented these and used them to critically review the service.