The inspection was unannounced and took place on 6 & 7 July 2016. The service provides a residential service with an emphasis on rehabilitation for up to 19 people with a variety of mental health problems and the service was full at the time of inspection. People have their own bedrooms many of which are ensuite, there is a shaft lift and a variety of aids and adaptions are in place to aid people with minimal mobility difficulties. This service was last inspected on 8 January 2014 when we found the provider was meeting all the regulations inspected at that time.

There was a registered manager in post who was available in the service Monday to Friday and included in a telephone on call rota at weekends to advise staff if needed. A registered manager is a person who is 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 were provided with a safe, clean environment that was maintained to a high standard, with all safety checks and tests routinely completed. There were enough skilled staff to support people and provide continuity, and the provider implemented recruitment procedures quickly when staff left, with an emphasis on recruiting skilled qualified staff. New staff were inducted appropriately into their role and given opportunities to meet regularly with members of the management team individually and in staff meetings, they said that they felt well supported and listened to.

Staff understood how to keep people safe and protect them from harm, they understood how to respond to emergencies that required them to evacuate the building quickly and safely. It was recognised that some restrictive practices were necessary although there was a clear culture of least restrictive practice and positive risk taking embedded across the service. Risks were appropriately assessed to ensure measures implemented kept people safe.

People were encouraged by staff to make everyday decisions for themselves, but staff understood and were working to the principles of the Mental Capacity Act 2005 (MCA) where people could not do so. The MCA provides a framework for acting and making decisions on behalf of people who lack mental capacity to make particular decisions for themselves.

There was a strong rehabilitation focus helping people to regain a meaningful life. Staff worked in partnership with people to promote and encourage their rehabilitation and skills development and included them in every aspect of their support. People were placed at the centre of the service and their involvement and empowerment was clearly embedded. They were able to contribute to their own care records through regular meetings with their key workers (in this service the keyworker was involved in planning with the person how their care needs were met, and agreeing with them the amount of assistance they required) this may also involve participating in discussions about the persons support with professionals and attendance for example at reviews. They were treated with dignity, respect and kindness and their relationships with staff were positive. People understood how to complain and felt confident of approaching staff with any concerns.

Medicines were well managed. People were encouraged to eat healthily and chose from a selection of food provided for them, they had opportunities to self-cater. Their health and wellbeing was monitored closely and specific staff had the responsibility for doing this each month as a preventative measure; any issues arising from these checks were quickly alerted to health professionals.

People were supported to develop relationships and maintain those that were important to them, there was excellent support for them to use new technology to do so and free access to telephone and intern

We spoke with three of the 19 people using the service. They were positive about the service. They told us “it’s alright” and that they get support from the staff. One person told us they were “happy with the way things are going” and that staff were “approachable if you’ve got problems.” The interactions we saw between staff and people using the service were friendly and respectful.

People had had their needs assessed, and care plans developed to meet these. People’s physical healthcare needs were responded to. The service worked with other health and social care professionals to ensure that people’s needs were met.

People were satisfied with the food provided by the service. Some of the people using the service cooked their own food.

The service was adequately maintained, and was undergoing refurbishment at the time of the inspection.

Staff received adequate training and supervision.

We spoke with 7 of the 19 people who use the service, and they were all positive about it. One person told us the service was “nice and friendly” and “relaxed”, and another that “it’s a nice place to live” and that they felt very settled and safe. One person said “I love it here,” and they always had someone to talk to, which helped them when they heard voices.

The interactions we saw between staff and people using the service were friendly and respectful. The people we spoke with said they liked the staff and found them supportive. One person said “they’re very good” and another “we’re well looked after here.” One person told us “it’s a good place” and that “the people who work here have a lot of respect for me.” The people we spoke with told us what they liked to do, and said they were able to make choices about their lives and pursue their interests.

The service had effective systems in place for the handling of medication. We saw that there were processes for the safe ordering, storage, administration and disposal of medicines.

There were effective recruitment and selection processes in place. The service had processes in place for the recruitment and management of staff, and the staff working there had had the necessary recruitment checks.

Records were kept of people’s care and both these and staff records were updated and kept securely by the service.

People who use services said that the staff treated them with respect, listened to them and supported them to raise any concerns they had. They said that they received the health and personal care they needed and that they were comfortable in their home. One person said, 'the staff here are pretty good to me and I've no complaints really'.