We inspected Crowlin House on 13 and 14 December 2016. The inspection was unannounced.

The service is registered to provide accommodation for up to 18 people whose main need is in relation to their mental health. On the day of the inspection the service was fully occupied. The service is situated in Calmore near Southampton, close to local amenities. There are good transport links to Southampton and the surrounding area. There are three separate two storey buildings, each building has a communal lounge, dining room and kitchen where people can prepare food. There are six bedrooms in each building. One of which had three ground floor bedrooms. There is also a self-contained flat which can be used as part of a person's care pathway to develop independent living skills.

The service had a registered manager in place. 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 told us they felt safe and staff were aware of the procedure to take if abuse was suspected.

People's needs had been identified and the risks associated with people's care and support had been assessed and managed. Where risks had been identified these had been minimised to better protect people's health and welfare.

There were enough staff deployed to meet the care and support needs of the people living in the service. The management team monitored staffing levels on a regular basis to ensure appropriate numbers of staff were deployed.

Medicines were stored, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records. Medicines records were regularly audited.

The registered manager understood their obligations under the Mental Capacity Act 2005. Staff had received training and were fully informed of any changes at team meetings to ensure they continued to provide care within the framework of the act.

People told us the staff were caring and knew them well as individuals. We observed people and staff interacting in a relaxed and friendly way.

People told us they were offered choice about what they wanted to eat, where they wanted to eat and at what time they wanted to eat.

People told us they had been involved in reviewing their risk assessments and support plans and described how staff encouraged them to build their independence.

People and their relatives thought that the service was well-led. They all spoke positively about the registered manager and the staff team.

There was a robust system of monitoring checks and audits to identify any improvements that needed to be made. The results of these audits were monitored by the management team, who acted on the results to improve the quality of the service and care.

Complaints policies and procedures were in place and were available to people and visitors. Relatives told us they were confident that they could raise concerns or complaints and that these would be dealt with appropriately,

During our inspection we spoke with the manager and three staff. We spoke with two of the 18 people living in the home. We spent time with people, chatted to them and observed the care and support they received. We saw that they looked happy and well cared for. We observed staff that staff interacted with them in a friendly, relaxed manner and also treated them with respect. People moved freely around the home and garden and staff were readily available to offer support if required.

We saw that care plans were clear and detailed and kept under regular review. There was some evidence to show that people’s capacity to consent to their care had been assessed. Suitable arrangements were in place to ensure decisions were made in people’s best interests if they were deemed not to have mental capacity to do so themselves.

We looked at the procedures for safeguarding people’s monies and saw that this was carried out safely to protect both the person and staff.

We looked at the procedures for storing and administering medicines and found them to be safe and suitable to the needs of the people living there.

There was a suitable recruitment procedure in place that protected people.

The manager named in this report no longer works at the service. The current manager has applied to be registered with the commission.

We carried out an inspection in October 2011 when we identified concerns with care planning, risk assessments, safeguarding of patients, medicine administration and staffing levels. We made compliance actions asking the provider to take action in order that we were reassured that people were in receipt of safe and adequate care.

Since our last visit, Crowlin House has completed the transition from being an inpatient service to a social care one where people access community services and GP’s.

We carried out an inspection on 10 May 2012 to review the progress the provider had made in taking action to be compliant in the areas where we had previously assessed them as non compliant.

People told us that they can do what they want to, “I call this home”. Another person said “I have my own bank account and card. I like helping out in the kitchen”.

At the visit we spoke with five staff. Staff told us about the care plans and records and how they support the independence of people who use the service and facilitate them accessing the community. We spoke with one new member of staff who told us about their induction and the training they had attended. Staff we spoke with were generally happy with the changes and the new working arrangements that had been put in place.

We inspected the service following concerns raised by a whistle blower. The concerns related to the recent changes in the provision and type of care provided to people who use the service. We spoke with three people who use the service and although they said there were some new staff that they were getting to know; for them things had not changed much.

The service is in transition from an inpatient NHS service to an adult social care service which will provide care and support on a long term basis for some people. For people who use the service this means that most of their care will be provided by carers rather than by registered nurses and medical staff. Their health care needs will be provided by a local GP.

Staff were concerned that it was unclear who was offering support. We were told that as of the 1 October 2011 the service was no longer an inpatient one, however there are still nursing staff working at Crowlin House as the transition is not complete. On the day of our inspection a meeting was held at the service between senior nursing staff and the new management on how to move forward.

We were told that an application had been sent, in September 2011, to the Care Quality Commission to vary the registration carried out at Crowlin House. We have clarified that the application was returned as it was incorrect. At this time Crowlin House remains registered as an NHS inpatient service.