What life is like for people using this service:

• People enjoyed living at Chepstow House and were cared for by staff who were kind and recognised people’s areas of independence.

• Staff were respectful to the people they cared for and promoted people’s right to dignity and privacy.

• People's, their relatives' and other health and social care professional’s views were listened to when people’s needs were assessed and plans for their care were developed.

• People were supported to enjoy the best health outcomes possible, and staff were proactive in addressing people’s health and well-being needs. Staff advocated for people so they had access to the healthcare they wanted. There were effective ways of working with other health and social care professionals.

• Staff recognised when people’s needs changed and made adjustments, so people continued live at the place they wanted to and to maintain relationships with other people at Chepstow House and staff who were important to them.

• People were confident to make their own day to day decisions and choices; staff supported people to do this when they wanted assistance, by using people’s preferred ways of communicating.

•Staff understood people’s safety needs well and supported them so their individual risks were reduced.

• People were supported to have their medicines safely, by staff who were competent to do this. People’s medicines were regularly checked and reviewed.

•There were sufficient staff to care for people at the times people wanted assistance, and people were supported by staff who knew their preferences well.

•The environment at the home was regularly checked. The risk of infections and accidental harm was reduced, as staff used the knowledge and equipment provided to do this.

• Staff had received specialist training and developed the skills they needed to care for people. This helped staff to provide good care to people.

•Staff supported people to have the nutrition they needed, based on their preferences, so people remained well. Where people required specialist diets, or assistance or equipment when eating and drinking this was provided.

•People were supported to enjoy a range of activities which reflected their interests. This included support to enjoy spending time in the community, doing things they liked and to keep in touch with people who were important to them.

•Systems were in place to take any learning from complaints and to reflect on people’s needs and to further inmove people’s care.

•The registered manager sought suggestions for improving people’s care further. We found suggestions were listened to.

•The registered manager and staff reflected on the care provided, so improvements in people’s care would be driven through. The registered manger planned to continue to develop the facilities at the home and to further develop people’s access to information to enable people to continue to make informed choices about their care.

•We found the service met the characteristics of a “Good” rating in all areas; More information is available in the full report

Rating at last inspection: Good. The last report for Chepstow House was published on 4 August 2016.

About the service: Chepstow House is a is a residential care home, providing personal care and accommodation. There were 14 people living at the home at the time of our inspection. People living at Chepstow House live with dementia, learning disabilities or autistic spectrum disorders, mental health conditions, sensory impairments or physical disabilities. Care and accommodation is offered to older and younger people.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 7 July 2016 and was unannounced.

Chepstow House is registered to provide accommodation for personal care for a maximum of 14 people with learning disabilities or autistic spectrum disorder. There were 14 people living at the home on the day of our visit. At the time of our 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.

People were supported by care staff that reduced their risk of harm and from the risk of abuse. All care staff knew each person well which helped them to understand and reduce their risk of harm or abuse. Care staff were consistent in helping people with any anxiety or distress by providing reassurance and guidance. Care staff told us that helping people to live in a calm and relaxed environment reduced the risk of abuse to people living at the home. All care staff felt confident in recognising any potential signs of abuse and would report these through to senior staff or management at the home.

People said care staff were available and there were sufficient numbers of staff to provide care to all people living at the home. Where people had risks identified as part of their daily living, care staff provided support to reduce those risks. People had their medicines given to them when required and at the correct time.

People were cared for by care staff who told us their training reflected the needs of people who lived at the home. Where people had not been able to consent to certain aspects or decisions about their care, records of decisions had been completed.

People had access to snacks and meals throughout the day and night. Where people required support to prepare their meals care staff helped them. People had accessed other healthcare professionals to support them.

People told us they liked the care staff and had developed positive and respectful relationships and care staff were very kind and caring in their approach. People’s privacy and dignity were respected and they were supported and empowered to be independent in all aspects of their lives.

People were involved in the planning of their care and were regularly involved in updating their care plans. People’s care plans recorded their care needs in an individual way that reflected their preferences and life histories. People got to choose their hobbies, interests and the things they did whilst in their home or out and about.

People were happy to raise any concerns or worries directly with the care staff who were able to provide solutions or answers at that time. The registered manger was keen to answer people’s concerns.

People were involved in their home and knew the registered manager. People were seen to approach and make request through the day with all care staff, including the registered manager. The registered manager told us it was important that they were approachable and visible within the home which helped them monitor and maintain a home which people liked. The provider ensured regular checks were completed to monitor the quality of the care delivered. The management team had kept their knowledge current and they led by example.

People told us they liked living in the home and that the staff were kind and helpful. Some people were not able to give us their views because of their learning disability and communication difficulties.

People told us they liked the food and that they were given plenty of drinks. We found people's dietary preferences and special requirements were being met. Staff knew people and their preferences well and had time to support them during mealtimes.

People's medicines were being safely managed.

We found that there were enough staff to support people. The staff were suitably trained and felt supported. Additional staffing had been funded as two people’s needs had increased during 2013. The staff team was quiet stable and there were staff who had worked in the home for over ten years. This meant that they knew people very well which particularly helped those who had communication difficulties.

When we visited we met the majority of the people who lived there. We found that people had been supported to look their best and they were relaxed and comfortable. We spent time in one lounge with five people and observed how they spent the afternoon. The staff engaged pleasantly with people and were attentive to their needs.

People told us they liked the staff and they felt they treated them with respect and listened to their views. They felt safe in their home. One person’s relative told us they would be able to raise any concerns but had not needed to. They said, “there is a good variety of activities” and “the care is absolutely fabulous”. Staff told us they had time to spend with people and they were well supported and trained.

We carried out this review to check on the care and welfare of people who used this service. When we visited the home we met people who lived there, staff on duty and the registered manager.

Some of the people who lived at Chepstow House were not able to tell us much about their experience at the home due to their condition. We saw that staff interacted with people who used the service in a friendly, courteous and respectful manner. We saw that people were very relaxed and at ease with staff and within their home environment. The atmosphere was calm and the home was clean and tidy.

We pathway tracked the care for two people and looked at how their care was provided and managed. We saw that staff looked after people well and wrote down what care they needed. We talked with staff who demonstrated they were aware of people’s care and support needs. Staff said they were trained to help them understand how to meet people’s needs and give the support they needed. We found that people received effective and appropriate care, treatment and support to meet their personal needs.

Staff told us they worked well as a team and that they received support from the registered manager.

The provider regularly audited the service people received at Chepstow House. This included questionnaires sent annually to the people who used the service, other interested parties and professionals as part of their monitoring process and review of the service provided. We saw that other ways had been used to gain the views of people who lived at the home where questionnaires had not been appropriate.