This was Caraston Hall’s first inspection since registering with the Care Quality Commission. We carried out this unannounced inspection on the 06 October 2018.

The service specialises in care for people who have severe and enduring mental health needs. On the day we visited five people lived in the service.

Not everyone using Caraston Hall receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Caraston Hall is a ‘care home’. 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. 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 met and spoke with people living in the service during our visit. However, some people were not able to fully verbalise their views, so staff used other methods of communication, for example a translator tool if English was not people’s first language.

People were safe at Caraston Hall. Staff had completed safeguarding training and updates were provided. Staff had a good knowledge of what constituted abuse and how to report any concerns. Staff understood what action they would take to protect people against harm and were confident any incidents or allegations would be fully investigated. Staff confirmed they’d have no hesitation reporting any issues to the registered manager or provider.

People were protected by safe recruitment procedures. This helped to ensure staff employed were suitable to work with vulnerable people. Staff confirmed there were sufficient staff to meet people’s needs. Staff had completed appropriate training and had the right skills and knowledge to meet people’s needs. New staff completed an induction programme when they started work and staff competency was assessed. Staff also completed training appropriate to the people they cared for, for example mental health awareness training. Staff also completed formal care qualifications which included equality and diversity training.

People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. Risk assessments were completed to enable people to retain as much independence as possible.

All significant events and incidences were document and analysed. Evaluation of incidents was used to help make improvements and keep people safe. Improvements helped to ensure positive progress was made in the delivery of care and support provided by the staff. Feedback to assess and improve the ongoing quality of the service provided was sought from people living in the home, professionals and staff.

People’s medicines were managed safely. Medicines were stored, given to people as prescribed and disposed of safely. Staff received appropriate training and understood the importance of safe administration and management of medicines. People were supported to maintain good health through regular access to health and social care professionals.

People lived full and active lives and were supported to access local areas and activities. Activities reflected people’s interests and individual hobbies. People were engaged in different activities during our visit including some people going out independently while others enjoyed the company of the staff.

People had free access to the kitchen and where given the choice of meals, snacks and drinks they enjoyed, while trying to maintain a healthy diet. People had input as much as they were