The inspection took place on 5 and 6 January 2017 and was unannounced.

Baytree House is a care home registered to provide accommodation and care for up to nine people with a learning disability and/or mental health needs. At the time of our inspection, the home was fully occupied. Baytree House is a large, detached Victorian House situated close to the centre of Worthing, with easy access to public transport. Communal areas include a sitting room, a dining room and gardens. Accommodation is provided over two floors and all bedrooms are of single occupancy.

A registered manager was 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 told us they felt safe living at Baytree House. Staff had been trained to recognise the signs of potential abuse and knew what action to take. People’s risks were identified, assessed and managed appropriately and clear guidance was provided to staff on how to mitigate people’s risks. Staffing levels were sufficient to meet people’s needs and recruitment processes for new staff were robust. Medicines were managed safely.

People were supported by staff who had been trained in a range of areas. New staff completed the Care Certificate, a nationally recognised qualification. Staff received regular supervision meetings and annual appraisals. Staff meetings took place. Staff understood the requirements of the Mental Capacity Act 2005 and put this into practice. People living at the home were subject to Deprivation of Liberty Safeguards and the provider had completed applications for authorisation under this legislation. People were supported to have sufficient to eat and drink and encouraged to maintain a healthy lifestyle. They had access to a range of healthcare professionals and services. People showed us their rooms which were personalised.

Staff were kind and caring and positive relationships had been developed between people and staff. People were involved in decisions about their care. They were treated with dignity and respect.

Care plans provided staff with comprehensive and detailed guidance and information on how to support people in a personalised way. Care plans were written in an accessible format and reviewed every three months. People participated in a range of activities on a day to day basis and many people attended day centres. The provider had an accessible complaints policy in place; no complaints had been received recently.

People were actively involved in developing the service and monthly residents’ meetings were held. Relatives were asked for their views about the service through formal surveys and people also completed questionnaires to provide feedback. Staff felt supported by management and spoke highly of the service and of their enjoyment in working at Baytree House. A range of audit systems was in place to measure and monitor the care delivered and the service overall. A social care professional endorsed the service provided at Baytree House and spoke positively of the care people received and of the support from staff.

Baytree House is a privately owned care home for people needing personal care and accommodation. It provides care for up to nine people with learning difficulties. We were informed that, at the time of our visit, nine people were being accommodated.

This inspection was carried out by one inspector. We gathered evidence that helped answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with four people using the service, three of the staff supporting them and from looking at records. They included care assessments and care records, staff recruitment and training records, staff rotas and records related to the provider’s quality assurance system.

Although we were unable to have meaningful discussions with people, we spent time with people in communal areas. This enabled us to observe interactions between people and members of staff so that we could understand what it was like to live at Baytree House.

Is the service safe?

Care staff had received training in identifying and reporting possible abuse. This meant that people had been safeguarded against the risk of being abused.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. On the day of our inspection we were told there were no applications made under DoLS that were currently in force. The manager confirmed they understood when an application should be made to deprive someone of their liberty.

The provider had a system in place for gathering, recording and evaluating accurate information about the quality and safety of the care and support the service provides.

Care records had been appropriately maintained to ensure people’s needs had been met safely.

The manager demonstrated that a robust recruitment procedure was in place. This meant that the needs of people were met by care staff who were fit, suitably qualified and capable of doing the job.

Is the service effective?

Where possible, people's health and care needs were assessed with them, and they were involved in writing their plans of care.

When necessary best interest decisions had been made to maintain the health and wellbeing of individuals who lacked capacity to make decisions for themselves.

Is the service caring?

From our observations we saw people were treated with respect and dignity by the staff.

People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Family members who completed satisfaction surveys reported they had no concerns about the care provided. One relative reported, ‘This is a very good example of how it should be done – well done!’

Is the service responsive?

People completed a range of activities in and outside the service regularly. The activities provided have been in response to requests made by people who lived at the care home.

Care staff supported people to talk about their views and experiences and to sort out any problems.

People and their relatives completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Is the service well-led?

Care staff we spoke with were able to describe their roles and responsibilities.

Staff training records we looked demonstrated they had received induction training.

Staff we spoke with confirmed they felt well supported and well led by the manager.

At the time of our inspection there were nine people living at the home.

We looked around the home and found that people had been encouraged to personalise their rooms with their own furniture and ornaments. Some people had their own televisions. The manager told us that people were given a choice or decor when rooms were due to be re decorated.

During the inspection we reviewed the provider's policies and procedures. We found policies in place to support the assessment, delivery and review of care. We also spoke with three people who lived at the home and to one person's relative. One person told us "I love it here, I get to do lots of nice things".

We spoke with two members of care staff. One member of staff told us "It is nice working here. I love my job". Our review of records showed that staff were up to date with mandatory training.

We spoke to three people during our visit.

People said that they take part in a number of daytime activities such as swimming and occupational work schemes. People also said that they like to exercise their own independence in looking after themselves and when going out.

People said that they like the staff at the home and that they have a keyworker who takes a lead responsibility for coordinating their care.

Choice was said to be available in how people can spend their time and in the provision of food. People told us that they have attended meetings to discuss the home’s menu plan.

We found people expressed their views and were involved in their care and treatment. We found people's views were clearly documented and there was a system in place to address unforeseen emergencies which arose at the home.

We found people has personalised care plans and risk assessments. We found for every identified risk there was a plan in place to address the risk. We saw people had daily preference lists that were used to meet their preferences.

People told us "the food is great" and "there's lots to do".

We viewed records relating to staff requirements and found that the provider was not operating effective recruitment procedures.

We found the lack of consistent recording systems meant that there was a risk that information may not be kept up to date and people may not be protected against the risks of unsafe or inappropriate care and treatment.

We found the provider had not submitted the appropriate notifications.