We carried out an unannounced comprehensive inspection on 15 December 2018.

Bidna House provides care and accommodation for up to 12 people. On the day of our inspection there were 12 people living at the service. The home provides residential care for people with a learning disability or autistic spectrum disorder.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager in post who was also a joint owner. 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.

We checked the service was working in line with ‘Registering the Right Support’, which makes sure services for people with a learning disability and/or autism receive services are developed in line with national policy - including the national plan, building the right support - and best practice. For example, how the service ensured care was personalised, how people’s discharge if needed, was managed and people’s independence and links with their community.

At the last inspection on the 11 May 2016, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good:

Not all people were able to fully verbalise their views about their experience of living there. We spent time with people seeing how they spent their day and observing the interactions between people and the staff supporting them.

The provider told us in their provider information return (PIR) that, “We are responsive to the needs of the resident and then as they stay with us for longer, we review and adapt our care packages according to their need.”

People remained safe at the service. People were protected from abuse as staff knew what action they would take if they suspected anyone was being abused, mistreated or neglected. Staff were recruited safely and checks carried out with the Disclosure and Barring Service (DBS) ensured they were suitable to work with vulnerable adults. Staff confirmed there were sufficient numbers of staff to meet people’s needs and to help keep them safe.

People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. Staff assessed and understood risks associated with people’s care and lifestyle. Risks were managed effectively to keep people safe whilst maintaining people’s rights and independence. People had their medicines managed safely, and received their medicines as prescribed. Staff completed training and competency checks were carried out to continually test their knowledge and to help ensure their skills in relation to medicines were up to date and in line with best practice.

People received support from staff who had completed training to meet their needs effectively. Staff meetings, one to one supervision of staff practice, and appraisals of performance were undertaken. Staff completed the Care Certificate (a nationally recognised training course for staff new to care). Staff confirmed the Care Certificate training looked at and discussed the equality, diversity, and human right needs of people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's hea

This unannounced inspection took place on 11 May 2016. We returned on 19 and 23 May as arranged with the registered manager to complete the inspection.

Bidna House is registered to provide accommodation for 12 people who require nursing and personal care. Most people living in the home have a learning disability or autistic spectrum disorder.

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.

People felt safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. They were supported to maintain a balanced diet, which they enjoyed. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were strong, caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate.

There were effective staff recruitment and selection processes in place to protect people. Staffing arrangements were flexible in order to meet people’s individual needs. Staff received a range of training and regular support to keep their skills up to date in order to support people appropriately. Staff spoke positively about communication and how the registered manager worked well with them, encouraged team working and an open culture.

A number of effective methods were used to assess the quality and safety of the service people received.

Our inspection team was made up of a single inspector.

We considered all the evidence we had gathered under the outcomes we had inspected. We used the information to answer the five questions we always ask: 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 to people using the service, staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We know the service was safe because people were treated with dignity and respect by the staff. People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

The Registered Manager set the staff rotas, they had taken people's care needs into account when making decisions about staffing numbers, qualifications, skills and experience required. This helped to ensure that people's care needs were always met.

Is the service effective?

People's healthcare needs were assessed with them. Specialist needs and support had been identified in care plans where required to ensure people could be supported to live their lives the way they wanted.

Is the service caring?

People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people. People commented, "The staff support me when I need it."

People using the service, were involved in regular meetings where shortfalls or concerns were raised these had been addressed. People's preferences, interests, aspirations and diverse needs had been recorded and care support had been provided in accordance with people's wishes.

Is the service responsive?

People regularly completed a range of activities in the home. People enjoyed having trips out. We were told other people were offered the choice of outings but declined.

People's lives and choices were respected and staff worked to ensure that they were accommodated.

Is the service well-led?

The service worked well with other agencies and services to make sure that people received their care in a joined up way.

The service had a quality assurance system, records seen by us showed that identified shortfalls had been addressed promptly. As a result the quality of the service was continually improving.

Staff told us they were clear about their roles and responsibilities.

We spent time talking with people who lived at the home and observed how people’s care and welfare needs were met. People were spending their time planning to go out in the local community, watching television and spending time in their bedrooms. People did not appear rushed and the home was relaxed and homely. Comments included: “I love it here. It’s nice” and “I am happy here.” We spoke with two visiting relatives. They commented: “We think it is brilliant here. They (the staff) treat people as individuals. It’s like a family home. We are always kept informed about things. They (the staff) go that extra mile. X was supported to come to family weddings. X is very well cared for.”

Staff demonstrated a good understanding of the need to provide a nutritious and balanced diet for people, ensuring that health needs were taken into account, for example if a person had diabetes.

We saw that the premises were adequately maintained. We saw that health and safety checks were completed on a daily, weekly, monthly and annual basis by staff employed by the organisation and external contractors.

There were effective recruitment and selection processes in place.

We saw the home’s complaints procedure. It provided people with details about how to make a complaint. It set out the procedure which would be followed by the registered manager and organisation.

Bidna House is a residential care home which provides care and support for up to 12 adults with a learning disability. We talked with the people who lived in the home, seven staff employed by the provider, the manager, two visitors and the provider. We looked at the care records of four people living in the home and the records of three staff.

There were 11 people living in the home at the time of our inspection. All were seen to be able to move freely about the home and were comfortable in each others company as well as with the staff who supported them.

We found that the provider had suitable arrangements in place to gain people’s consent to care and treatment and saw that people agreed to the support offered to them.

We saw that people received safe and appropriate support that met their needs. The staff demonstrated a good knowledge of people’s individual needs and behaviours. We saw that staff had effective skills to manage the changing moods of people living in the home.

People’s medication was generally safely managed and administered by a trained and knowledgeable staff group.

Staff told us they were supported and supervised and received appropriate training to enable them to fulfil their role.

The provider had effective systems in place to routinely audit and monitor the services it provided to reduce the risks to people using the service.

We conducted an unannounced visit to Bidna House on 24 February 2012 as part of our programme of planned inspections. We met most people who used the service and looked closely at the care provided to two people.

We asked two staff questions, observed staff interacting with people and looked at some records. Following the visit we contacted a health care professional with knowledge of the home.

People told us that they felt listened to, could express choices and were respected. We observed that people were offered choice and enabled to take responsibility, which included some work in the home. Interactions we saw were respectful and kind and it was clear that people went to the manager and staff for company and support. Information for people was provided in various formats, such as pictures and graded written text. The use of audio information was being considered.

People's mental and physical needs were addressed and the home worked with specialist health care professionals, one of whom expressed confidence in the staff and service delivered, as required.

People were able to follow various interests through the arrangements and support provided. These included walking, gardening, discos and the dogs living at the home. People were encouraged to improve their skills and gain independence.

People were safeguarded from abuse through the open and relaxed culture at the home, accessibility to the manager and information. The training and knowledge of staff, which included the legal safeguards to uphold people's rights, also protected people.

There were detailed systems in place to monitor the quality of the service provided, although these were not yet fully implemented.