This announced inspection took place on 15 December 2016. BH House provides personal care and support for older people in their own home. At the time of the inspection 23 people were using the service.

This is the first comprehensive inspection of the service by the Care Quality Commission (CQC) since registration in April 2014.

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.

Staff were trained in how to protect people from abuse and harm. Staff knew how to recognise signs of abuse and their responsibility to report any concerns. Staff assessed risks to people’s health and had guidance to ensure they managed the known risks to protect people from harm. Risk assessments were reviewed and updated regularly to ensure they remained effective.

There were sufficient staff on duty to meet people’s needs. Staffing levels were adjusted when people’s needs changed. The provider used an electronic system to monitor staff visits to people’s homes and to minimise the risk of late or missed visits. The provider had robust recruitment processes. Staff were recruited safely and suitable to support people.

People received the support they needed to take their medicines safely. Staff had received training on managing and administering people’s medicines.

Staff were competent to meet people’s needs. Staff received ongoing training and had the skills and knowledge to provide care effectively. Staff had regular supervision to monitor their performance.

People were involved in decisions about their care. Staff understood systems in place to protect people who could not make decisions and followed the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

Staff knew each person well and understood how to meet their needs. The provider tried to ensure the same staff looked after people to promote good working relationships.

Staff assessed each person’s needs and preferences. Care plans were individualised and provided enough information for staff on how to support people. People were involved in the day to day care and support. People’s care plans were reviewed with their involvement and their relatives where appropriate. Care plans were updated as people’s needs changed. People received care that was responsive to their individual care and support needs.

People received the support they required with their eating and drinking. People were supported to access healthcare professionals when needed.

People were treated with dignity and respect. Staff promoted people’s independence and encouraged them to do as much as possible for themselves.

People were provided with information about how to make a complaint. There was a complaints procedure as well as incident and accident reporting. Staff supported people to make their views about the service and wishes known.

There was a positive and open culture at the service. Staff had a clear set of values based on respect and choice for people.

People and staff were encouraged to give their views about the service and their feedback was used to make improvements. The registered manager used audit processes in place effectively to monitor the quality of care people received and used findings to improve care.