This inspection took place on 14 June 2017 and was unannounced.

Chesapeake House is registered to provide accommodation and personal care for up to 11 adults with learning disabilities, who live at Chesapeake House. Personal care is also provided for up to four people who are supported to live more independently in individual flats, which are located on the same site. At the time of our inspection, 10 people were living at Chesapeake House and three people were living in the flats located on the same site.

A registered manager was in post and was available throughout the inspection. 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.

Staff understood how to keep people safe and were aware of their duty to protect people from the risk of abuse. Risks were managed so that people were protected from avoidable harm and not unnecessarily restricted.

Sufficient staff were on duty to meet people’s needs and staff were recruited through safe recruitment practices. Safe medicines management practices were followed by staff.

Staff felt supported and received induction, training, supervision and appraisal. People’s rights were protected under the Mental Capacity Act 2005.

People had sufficient to eat and drink and nutritional risks were monitored by staff. External professionals were involved in people’s care as appropriate.

Staff were kind and knew people well. People and their relatives were involved in decisions about their care. However, advocacy information was not easily available to people. People received care that respected their privacy and dignity and encouraged their independence.

People received personalised care that was responsive to their needs. Care records contained sufficient information to support staff to meet people’s individual needs. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising concerns with the management team and that appropriate action would be taken.

The provider was meeting their regulatory responsibilities. There were effective systems in place to monitor and improve the quality of the service provided. However, these systems could be more clearly documented and more structured audit tools could be used to ensure that all areas of the service were being fully monitored.

This inspection took place on 29 October 2015 and was unannounced.

We last inspected this service in July 2014 and found some breaches of legal requirements. These were in respect of consent to care and treatment and also assessing and monitoring the quality of service providers; associated with unsafe premises. During this inspection we found that some improvements had been made to meet these requirements. This included improvements in obtaining people’s consent to care and treatment, and also the suitability and safety of the premises.

Chesapeake House is registered to provide accommodation and personal care for up to 14 adults with physical and/or learning disabilities.

There is 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 saw that people living at the service felt safe. The registered manager and staff had a good awareness of abuse and had received appropriate training in order to provide care and support in a safe manner.

There were sufficient staff to meet the people’s individual needs, however people’s safety was not always maintained during the night as they were no regular checks and people had limited means to get the attention of the member of staff who was supporting them.

People living at the service were happy and well cared for. The service had an atmosphere that was warm, friendly, inclusive and supportive. We saw staff positively engaging with people living at the service.

There were daily outings and activities for people living at the service.

We saw that medication was administered in a safe and timely manner by staff who were trained to administer medication. Some of the people living at the service were able to self medicate and appropriate risk assessments were in place. However there was no evidence of any medication audits. There were no protocols or risk assessments in place for homely remedies, (non-prescription drugs that are available over the counter in community pharmacies). Since the inspection the provider has informed us that these risk assessments are now in place.

We saw risk assessments were completed and people’s plans of care showed the measures to minimise risk and promote people’s safety.

We saw that consent was obtained and documented in people’s plans of care, however we saw that the Mental Capacity Act 2005 (MCA) had not always been followed to ensure that people’s consent was obtained when staff considered that a restriction to a person’s freedom may be needed to keep them safe. The MCA is a law providing a system of assessment and decision making to protect people who do not have capacity to give consent themselves.

Plans of care were individualised and included information about people’s life histories, as well as their care and support needs, interests, and likes and dislikes.

This provided staff with sufficient information to enable them to provide care effectively.

People took part in a wide range of activities which they were able to choose themselves, of which some were in the local community.

People were referred to relevant health professionals in a timely manner to meet their health needs.

The building was well maintained and checks of the building were up to date to ensure people’s safety.

There was no evidence that the registered manager or provider undertook regular checks of the quality and safety of people’s care as there were no audit systems in place for these checks.

Staff were happy and felt well supported. They understood their roles and responsibilities and the service aims and values for people’s care and rights.

The registered manager encouraged an open, inclusive and empowering culture for the people living at the service.

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 the Care Quality Commission, which looks at the overall quality of the service.

Accommodation and personal care is provided at Chesapeake House for up to 11 adults with physical and/or learning disabilities. Personal care is also provided for up to four people who lived in their own flats that are located in the grounds of the main home.

There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law; as does the provider.

This inspection was unannounced on 22 July 2014. There were nine people living in the home with learning disabilities who received personal care. There were four people with learning disabilities who received personal care in their own flats that were all located in the same grounds. Two of the people living in flats were away on holiday and another person was also out doing voluntary work.

People felt safe and were protected from avoidable harm or abuse and their rights were mostly promoted and upheld. However, although staff, were aware of the Mental Capacity Act 2005 [MCA]; they did not always understand or follow this to ensure that peoples consent was obtained to their care; and to demonstrate that appropriate action was taken, when staff considered that a restriction to a person’s freedom may be needed to keep them safe. The MCA is a law providing a system of assessment and decision making to protect people who do not have capacity to give consent themselves.

The manager undertook regular checks of the quality and safety of people’s care. However, these did not always protect people who used the service and others against the risks of unsafe care. This was because risks associated with unsafe or unsuitable premises were not always checked or properly managed in people’s best interests.

Where we have identified breaches of the legal requirements and regulations associated with the Health and Social Care Act 2008, relating to people’s rights and the quality and safety of people’s care, you can see what action we told the provider to take at the back of the full version of the report.

People were generally happy with and positive about their care, the management of the home and the way staff treated them. Staff, were recruited through robust procedures and were sufficient to meet people’s needs. Staff, were caring and spent time with people and respected their rights to dignity, privacy and independence and to be involved in decision and make choices about their care. People’s views about their care and their relatives views, were often sought. Complaints and concerns were monitored and taken seriously and people knew who to speak with if they were unhappy or wanted to raise any concerns about their care.

People received care from skilled staff who, understood and acted to ensure their personal, safety, health and communication needs and their care and daily living preferences; as well as their wishes and hopes for the future. People’s needs, preferences and instructions and advice from relevant health and social care professionals, were included in their written care plans, which staff followed. People’s care plans were kept under review. They were revised with people and their representatives when required.

People enjoyed most of their meals and were supported to maintain any special dietary needs when needed. People were actively involved in and agreed food menu planning, shopping and healthy eating menus.

People were supported to participate in a wide range of interests and hobbies of their choice and to access the local and wider community for their social, leisure and educational interests. They were supported to maintain their contacts with families and friends and to establish and maintain new friendships and personal relationships.

Staff, were happy, supported and motivated in their jobs. Staff understood their roles and responsibilities and the service aims and values for people’s care and rights. They were confident to report any concerns they may have about people’s care or safety and knew how to do this in people’s best interests. Management strategies meant that ways to improve people’s care were being sought. Improvements being made included, supporting people who chose, to regain access to advocacy services and to access and use computers in the home.

People we spoke with confirmed that their care and support was discussed with them and they were helped to make decisions. One person told us “They explain everything”. One person said “I like it here” and they confirmed they liked the staff and that they received the right support.

Relatives also told us that they were satisfied with the service provided. One said "They look after people very well".

We saw that people were undertaking a range of activities during the period of our visit such as pursuing their own hobbies and accessing local community facilities.

We found the provider had made some improvements to the service following our last inspection visit in November 2012. Medication procedures had improved, water temperatures in one area were being monitored and safeguarding information had improved. Although the provider had purchased new policies some of the information in them remained out date. There had been no improvement in monitoring the quality of the service as there was no evidence that feedback was obtained from either service users or staff.

We spoke with six people using this service and one visitor. We also spoke to two staff members.

We found that people were involved in discussions about their needs and care. One person said that “I like it here. I like the food and staff look after me well.” Another person told us that “staff help me to be independent. I can go to bed when I want and get up when I want.”

A visitor said that Chesapeake House is a “wonderful place, with a friendly and family environment.” They told us that the staff “really do care about residents by thinking about their individual needs and giving them choices.” They felt that their friend was always respected and treated well by staff.

We found that there were enough appropriately trained, skilled and experienced staff to meet people’s needs. We saw that staff had received relevant training for their job.

We found that the provider did not have up to date safeguarding policies and procedures in place to identify the possibility of abuse and prevent abuse from happening to people who use the service.

We found that the provider did not have appropriate arrangements in place to manage medicines which meant that people may not be protected against the risks associated with medicines.

We found that the provider did not have formal systems in place to monitor the quality of the care and service that people receive, and to identify and manage risks to the health, safety and welfare of people using the service and others.

We observed staff treating people respectfully and people appeared to be comfortable in their surroundings.

We spoke to four people using the service about their experience of living at the service and how they were cared for. We were told “I am very happy here. There are plenty of things to do and the staff are nice to me” , “Staff are kind and help me when I want them to” and “I like my room and I go out a lot with family. The staff help me with my medication.”

The people we spoke with told us they liked the staff at the home and were happy with the care and support they received.

People we spoke with told us they enjoyed using the service and said staff were supportive. One person said “Staff help me”.

Staff also told us they had the opportunity to undertaken qualification courses and said they were satisfied with the training they received.

We found that staff training had improved since our previous visit in April 2013 and training in essential health and safety areas was up to date. Staff had the opportunity for supervision on a group basis.

We saw that quality assurance processes had improved and the service had gathered feedback from staff and service users and their families via meetings and surveys. Feedback was all positive and praised the service and staff. One comment said “An extremely well run establishment”.

However, the service was not recording any checks of care records or medication records, which meant it was unclear if policies and procedures and good practice were being followed.

Water temperatures were being monitored on a monthly basis to ensure they were safe and the provider had purchased new policies that were up to date.