This inspection took place on 25 May 2017 and was unannounced.

Burgess Care is a residential care service and provides accommodation, care and support for up to 20 adults who have a learning disability. People who use the service may also have behaviour that challenges, or autism spectrum conditions that require specialist care and support. At the time of our inspection there were 20 people living at the home. The home is in a rural setting and divided into four houses known as Treetops, Meadows, Acorns and Paddocks. These all provided care for people with differing needs.

A requirement of the service’s registration is that they have a registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. There was a registered manager in post.

At the last inspection in March 2015 the service was rated good. At this inspection we found the service remained good, although we found the responsiveness of the service to people’s needs was now outstanding. Each person who lived at Burgess Care was treated as an individual with their own unique qualities and characteristics, no matter how challenging some of their behaviours could be. Both managers and staff were extremely committed to making things possible for people that others may take for granted.

Staff had an extremely in depth knowledge of each person, their likes and dislikes, their important routines and how they demonstrated anxiety. Staff were very creative in thinking of ways of meeting people’s needs and felt empowered to share ideas and suggestions for the good of the people in the home.

People’s desire for more independence and their potential for more independent living was recognised and actively promoted which meant people’s lives had improved and their horizons expanded.

There were enough staff to meet the varying and complex needs of the people living in the home. Staff understood their responsibilities to protect people from the risk of abuse and the registered manager checked staff’s suitability for their role before they started working at the service.

Potential risks relating to each person’s care had been identified and plans had been developed to inform staff how to manage and reduce the risks. Staff had received training and support to meet the specific needs of people living in the home. They felt confident to support people at times of agitation or distress to keep the person and others safe.

The provider worked in partnership with other health and social care professionals to support people’s needs. Medicines were stored, administered and managed safely.

People had developed strong relationships with staff. Staff listened to people and responded in a kind and compassionate manner. Staff knew about the care people needed, gave them time to express their views and respected the decisions they made. People had opportunities to do things they liked and that interested them.

The registered manager had a good understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Where people’s care plans included restrictions on people’s right, choices or liberties, the registered manager had applied to the Supervisory Body for the authority to do this in people’s best interests.

The service had a clear management structure with effective systems and processes for overseeing all aspects of care. Staff were motivated and inspired by the management team to deliver a person centred service, displaying the value of putting people at the heart of what they did. The registered manager was enthusiastic to seek out best practice to drive improvement in the home.

When we visited we spoke with three people who lived at Sharmer Fields and three relatives to obtain their views about the home. Due to the complex needs of people who used the service, some were not able to verbally share their experiences.

We therefore observed staff interaction and talked with care staff about how they met the needs of people they supported.

Staff demonstrated a clear understanding of people's needs and engaged with people in a positive manner. People appeared relaxed and happy in the company of the staff and were not hesitant when they approached them.

We looked to see if consent to care had been obtained for people who lived at the service. We found there was a lack of signed documentation in place to confirm this.

People who lived at the home told us they were happy at Sharmer Fields.

We looked at the care planning documentation and we found that care plans were very detailed and demonstrated that staff treated each person as an individual based upon their needs.

We found systems were in place to safely manage people’s medication.

Staff told us about their induction program and we saw records which showed robust recruitment processes were in place.

We saw that systems were in place to monitor the quality of the service.

We saw family’s involvement within the care plans had not been signed and medication temperature checks were not always completed.

We carried out an inspection at Sharmer Fields (Burgess Care) on 13 July 2012. The visit was unannounced so that no one living or working in the home knew we were coming.

Sharmer Fields consists of four separate units plus a bungalow, each of which had a designated staff team. We spent time in two of these units and spoke with two people living at Sharmer Fields, two care staff and one visitor.

Due to the complex needs of the people using the service some were not able to verbally share their experiences of what it was like living at Sharmer Fields. We therefore spent time observing staff interaction and talking with staff about how they meet the needs of the people they support. Staff demonstrated a clear understanding of people's needs and engaged with people in a positive manner. People appeared relaxed and happy in the company of the staff and were not hesitant in approaching them.

We found that staff knew people as individuals and understood their personal needs and ways of communicating those needs. Staff treated people kindly and respectfully and included them in conversation, asking for their input.

People who lived at the home said “Really nice, I love it here“ and “Nice, pleasant here”.

We looked at the care planning documentation to see what guidance was given to staff, to ensure that people received their care as they required to meet their needs. We found that care plans were very detailed and demonstrated that staff understood each person as an individual.

Risk areas were identified in the care plans we looked at, with plans in place on how to minimise and manage these.

We received positive comments about the staff from the visitor on the day. We were told “staff were always good” and said the personal care was good for their relative who lived at the home.

Staff told us told that training opportunities were frequent and planned to ensure staff had sufficient knowledge to meet people’s needs. Staff felt supported and told us they meet regularly with their manager.

We saw that quality assurance systems were in place which measured people’s and relative’s satisfaction with the service provided in the home. Burgess Care had their own quality assurance audits which were completed on a monthly basis.

This inspection took place on 15 March and 18 March 2015 and was unannounced.

Burgess Care is a residential care service and provides accommodation, care and support for up to 20 adults who have a learning disability. People who use the service may also have behaviour that challenges, or autism spectrum conditions that require specialist care and support. At the time of our inspection there were 17 people living at the home. The home is in a rural setting and divided into four bungalows known as Treetops, Meadows, Acorns and Paddocks. These all care for people with differing needs.

A requirement of the service’s registration is that they have a registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of our inspection a registered manager was working at the home.

At our last full inspection in August 2013 the home was found to need improvement in the area of records. Some daily records had not been completed and we could not see that people or their representatives had been involved in care arrangements. This was reviewed in March 2014 and improvements had been made. The provider had involved people and relatives in planning care and records were kept up to date.

We visited the service over two days, as concerns had been raised about staffing levels at the weekend. The first visit was carried out on a Sunday and we found staffing levels were sufficient to meet people’s needs at this time.

People told us they felt well cared for and safe living at Burgess Care and staff knew how to keep people safe from the risk of abuse. Staff were confident in their knowledge and responsibilities in safeguarding people.

Staff received training in areas considered essential to meet people’s health and social care needs safely and consistently. Staff were encouraged to complete further training to develop their skills in working with people so they could do this effectively.

Care plans and risk assessments contained relevant information for staff to help them provide the personalised care and treatment people required. These were updated regularly and people and their relatives had been involved in reviews.

People told us staff were respectful and kind towards them and we saw staff were caring to people during our visit. Staff protected people’s privacy and dignity when they provided care and asked people for their consent before care was given. We saw one example where privacy and dignity could be improved.

Staff understood they needed to respect people’s choices and decisions. Assessments had been made and reviewed to determine people’s capacity to make specific decisions. Where people did not have capacity, decisions were taken in ‘their best interests’ and these were recorded.

The provider was meeting the requirements set out in the Deprivation of Liberty Safeguards (DoLS). At the time of the inspection 17 applications, for everyone at the service, had been made under DoLS for people’s freedoms and liberties to be restricted.

People were given options about how they wanted to spend their day and were able to retain some independence in their lives. Family and friends were able to visit when they wished and staff encouraged them to maintain a role in providing care to their family members. People often stayed with relatives at weekends.

People told us they were supported to be involved in pursing their own hobbies and interests. Activities were available for people living at the home and staff made use of mini buses to take people on trips regularly. Keyworkers were responsible for providing activities for people and they knew people well.

Everyone we spoke with was positive about the manager and the running of the home. There were good systems to monitor and improve the quality of service people received. People knew how to complain if they wished to and information was available in an accessible format for people that lived there. Complaints were documented and actioned quickly and effectively.