This unannounced inspection took place on 2 February 2017.

The Farmhouse provides care, accommodation and support with personal care for seven people with a learning disability.

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 and associated Regulations about how the service is run.

At the last inspection in August 2014, we found one breach of regulations. The registered provider had not notified us of incidents or allegations of abuse. At this inspection we found that action had been taken and we had received the necessary notifications of incidents at the service.

Systems were in place to minimise risk and to ensure that people were supported as safely as possible. Staff were aware of their responsibilities to ensure people were safe and what to do if they had any concerns. They were confident that the registered manager would address any concerns.

People were protected by the provider’s recruitment process which ensured that staff were suitable to work with people who need support.

People were encouraged to make choices and to have as much control as possible over what they did. Systems were in place to ensure that their human rights were protected.

People had complex needs and their care was planned in partnership with their relatives. Relative felt any issues or concerns they raised would be dealt with by the registered manager. Their views were sought and valued.

The staff team worked closely with other professionals to ensure people were supported to receive the healthcare they needed. People received their prescribed medicines safely.

Staff received the support and training they needed to give them the necessary skills and knowledge to meet people’s assessed needs, preferences and choices and to provide an effective and responsive service. Staffing levels were sufficient to meet people’s assessed needs.

People received a personalised service and were supported to be as independent as possible and to have an active social life.

People were treated with respect and their privacy and dignity was maintained. They were supported by a consistent staff team who knew them well.

People’s cultural and religious needs were respected and celebrated and their nutritional needs were met

The registered manager and the provider monitored the quality of service provided to ensure that people received a safe and effective service that met their needs.

Staff and relatives felt that the service had improved under the leadership of the registered manager.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

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 and has the legal responsibility for meeting the requirements of the law; as does the provider.

At the last inspection in September 2013 the service was found to be meeting the regulations we looked at. Lilliputs Farmhouse provides accommodation and support for up to seven adults with learning disabilities. There were seven people living at the service when we visited. This was an unannounced inspection.

Staff understood the needs of the people with a learning disability and we saw that care was provided with kindness and compassion. People and their relatives told us they were happy with their care. Staff were appropriately trained and skilled to provide care in a safe environment. They all received an induction before they started work at the service and understood their roles and responsibilities. The staff also completed relevant training to ensure care provided to people with a learning disability was safe and effective to meet their needs.

Staff supervision and appraisals of all staff were up to date. All staff felt supported by their line manager and said they received guidance as and when required, to meet the needs of people.

We saw there were procedures and risk assessments in place that reduced the risk of harm and abuse to people and kept them safe. Staff understood how to safeguard people they supported. Managers and staff received training on safeguarding adults, the Deprivation of Liberty Safeguards and the Mental Capacity Act 2005.

We saw examples of care where people and their relatives felt included and consulted. People and their relatives were involved in the planning of their care and people using the service were treated with dignity, privacy and respect.

People had access to external healthcare professional’s support when required. The provider had effective systems to regularly assess and monitor the quality of service people received. Relatives of people who used the service praised the manager and staff. Staff spoke positively about the culture of the service and told us it was well-managed and well led.

We found one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of this report.

People’s care, health and welfare needs were being met. Relatives told us that they were happy with the quality of care provided. One relative told us “it’s really fantastic. He is safe and well cared for.” Another said “I am really pleased with everything. They encourage ‘X’ to be as independent as possible with a high level of supervision.”

We saw that people were supported to have a nutritious diet that met their needs and preferences. There were systems in place to ensure that they received their prescribed medication appropriately. We found that staff received the training and support that they needed to carry out their duties and support people who used the service. One member of staff said “I have had lots of training and definitely get the right training and support.” A relative told us “the manager is training staff and making them more confident.”

People had confidence that if they were not happy about anything the manager would address this. One relative said “I am absolutely happy to raise anything. He does something about it and reports back to you.” Another said “when I have raised things with the manager he has dealt with them straightaway.” People were protected from the risks of unsafe or inappropriate care because accurate and appropriate records were maintained.

During the inspection we observed how staff interacted with the people who use the service but due to the communication needs of the people we were unable to gain any feedback from them about the service. We observed that staff were calm and patient in their interactions with people who use the service.

The relatives we spoke to made positive comments about the service and said that it was a "lovely environment". People also told us that they felt they were kept informed and involved with the service and that their relative was "happy and settled".

You can see our judgements on the front page of this report.

During the course of our inspection we met and spent time with all of the people who use the service. Due to the degree of their learning disability and communication problems they were only able to give us very limited feedback about the service. We saw that staff were calm and patient and interacted well with people. We also noted that people seemed happy and relaxed in the company of the staff and that staff treated them with respect.

We spoke with the relatives of two people who use the service. Both said that they felt their relatives were happy at Lilliputs Farmhouse. One relative said, “My son appears to be happy and content at Lilliputs Farmhouse. He comes home every weekend and always seems fine when we pick him up and happy to go back." Another said, "It’s a great service. We have lots of contact with our daughter and she comes home regularly. She is very much at home there and is very busy. She has a well rounded active life."

We also spoke with four members of staff. They all felt that people received a good service. Staff said: “People are supported as individuals and encouraged to do things for themselves.” “Staff work hard to make them as independent as possible. Most people make things for themselves for example, their drinks and snacks with staff support.” “Staff and service users are valued. We try to protect people's dignity and we offer them choice.” “We have been trained to cope with challenging behaviour. You need to speak to them quietly, politely and calmly. We work hard to manage their different behaviours.” “Each person has different safety issues so we watch them closely.” Staff also told us that people went out a lot and did a lot of activities.