We inspected this service on 8 February 2017. This was an unannounced inspection.

Bath Road is a care home run by the National Schizophrenia Fellowship, also known as Rethink Mental Illness. Bath Road supports up to 10 people who experience a mental health crisis by providing support that meets their changing needs. At the time of inspection there were nine people living at the home.

There was not 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. The service had a manager in place who had applied for registration with the Care Quality Commission.

At an inspection in December 2015 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. People were at risk due to unsafe management of medicines. We also found risks to people’s environment that meant people were not protected in the event of a fire. People had not received care and support that was individualised to their needs. After the inspection the provider sent us details of how they would meet their legal requirements relating to the two breaches.

At this inspection we found improvements had been made. People felt safe and were supported by staff that had the skills and knowledge to meet their needs. The service was continuing to work on recruiting to vacant posts and in the meantime took measures to ensure temporary staff were of a good standard. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their roles.

Staff had a clear understanding on how to safeguard people and protect their health and well-being. People received their medicines as prescribed. There were systems in place to manage safe administration and storage of medicines.

People had a range of individualised risk assessments in place to keep them safe and to help them maintain their independence. Where risks to people had been identified, risk assessments were in place and action had been taken to manage the risks. These were regularly reviewed and updated when needed. Staff were aware of people’s needs and followed guidance to keep them safe.

People were supported by competent staff that benefitted from regular supervision (one to one meetings with their line manager). Staff received adequate training and support to carry out their roles effectively.

The manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and applied its principles in their work. Where people were thought to lack capacity to make certain decisions, assessments had been completed in line with the principles of MCA.

People were supported to maintain their health and were referred for specialist advice as required.

People were involved in decisions about their support needs. People had care plans which detailed the support they required and how the support would be provided. These were regularly reviewed and updated. Staff knew the people they cared for and what was important to them. The service recognised that further progress was needed to encourage people to engage with a variety of social activities of their choice to avoid social isolation.

The service looked for ways to continually improve the quality of the service. Ongoing feedback was sought from people to improve their care. People knew how to make a complaint and complaints were managed in accordance with the provider’s complaints policy.

The service had informed us of all notifiable incidents. The manager had applied to become a registered manager and had a clear plan to develop and further improve the service. Staff spoke positively about the support and leadership they received from the management team.

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.

We spoke with six of the people who used the service. One person said “I’m happy here” and that they felt they were listened to by staff. Another person said there was nothing they would change about Bath Road. A third person said they thought Bath Road was “Brilliant”.

We found that people were respected and involved in the planning of their care and the running of the home.

Some of the provider's records were not fully completed.

The home was clean and appropriate stands of hygiene were in place.

The home provided good food and nutrition for the people who used the service.

We could see that staff knew the people who lived at Bath Road very well.

There were enough staff members on duty in order to meet people’s needs and to keep them safe.

People told us that they liked living at the home. They told us that the staff were supportive, helped them with tasks and were very friendly.

We saw that people’s needs were assessed and their care and treatment was planned and delivered in line with their individual support plan. Information in their care records was detailed and identified their preferences and personal wishes.

People in the home we spoke to all said they felt safe living in the home and that the staff looked after them well

We saw that all areas of the home were in a clean and tidy state and that the stair carpet had now been replaced and there was new non slip flooring on the upstairs landing.

Staff we spoke with told us that there were enough staff to ensure people were given a good quality of life there. People’s comments about their care were recorded in the daily handover file

People told us they could choose what to do each day. They met with staff to agree the support they wanted. People did a lot of things independently, but staff were available to provide support when it was needed. One person said the staff helped them with “coping strategies”.

People told us what they liked about the home. One person mentioned the large garden and another person said they liked the meals. People went out regularly and the town centre shops and facilities were within walking distance of the home.

People said they felt safe at the home. They told us the staff were friendly and understood their needs. One person commented: “they (the staff) know what’s going on with me”. People were supported by staff who received training and felt well supported. A staff member told us that training “was a strong point”.

The relationships we observed between staff and the people who used the service were friendly and respectful.

We inspected Bath Road on 7 December 2015. This was an unannounced inspection. We also visited on 8 and 29 December to continue our inspection. Bath Road is a care home run by the National Schizophrenia Fellowship, also known as Rethink Mental Illness, where up to 10 people who are experiencing a mental health crisis can stay with the aim to help people move on to more independent accommodation by providing support that meets their changing needs. At the time of inspection there were eight people living at the home.

There was a registered manager at the service at the time of our inspection. 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 said they felt safe. However, people were at risk due to unsafe management of medicines. We also found risks to people’s environment that meant people were not protected in the event of a fire. Accidents and incidents had been reported and managed appropriately. Staff had received training and understood how to keep people safe from abuse. Staff had been checked to ensure they were suitable before starting work in the service.

Care staff had received training and felt able to request further training required. Staff said they felt supported to deliver their roles and responsibilities. However, records showed staff had not had regular meetings with their managers as often as stated in information received from the service before the inspection. These are important to give staff and managers regular opportunities to discuss people’s roles and responsibilities.

Staff had an understanding of the Mental Capacity Act 2005 and had received training.

People told us the food was good. People were supported to access health professionals or appointments. Staff did not have regular team meetings to enable them to share information and discuss issues collectively.

People in the service felt cared for. We observed friendly interactions between people in the service and care staff. Staff knew people well and talked of their interests, likes and dislikes. Staff spoke of their enjoyment of supporting people in the service and some staff had been there a number of years. Staff supported people to do activities which both people and staff enjoyed.

People had opportunities to do activities and to plan towards choices they had made, for example, organising a coffee morning for charity. Staff had accompanied people on their holiday of choice. People had opportunities to be involved in making changes such as food choices and layout of the dining room and choice of furniture.

People did not receive support that was individualised to their needs. The planning of the support was task focused. Not all people would engage with goal setting and it was not always evidenced whether other ways of supporting a person had been explored. This meant that people did not always have the opportunity to be provided with care personal to their individual needs.

Complaints were managed and monitored and people had access to independent advocates if needed.

There were not effective systems in place to monitor the quality of the service and identify ways to improve the quality of care.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.