Dunblane House is a large terraced house supporting up to four people with mental health difficulties. It is situated in a residential area of Blackpool close to local amenities. It is run as an ordinary domestic household. People live with the owners and share the communal facilities. Each person has their own bedroom. There is an outside area with seating at the rear of the property. At the front of the property there is parking for two vehicles.

At our last inspection we rated the service Good in all domains. At this inspection we found the evidence continued to support the rating of Good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The inspection visit took place on 05 June 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because the service was a small care home for younger adults who are often out during the day, we needed to be sure someone would be in.

At the time of our inspection visit four people lived at Dunblane House.

There was 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.

We spoke with people who told us they felt safe, comfortable and well supported by staff and observed interactions between staff and people. These were positive friendly and supportive.

Procedures were in place to minimise the risk of unsafe care or abuse and staff understood their responsibilities to report unsafe care or abusive practices. They had received training on safeguarding vulnerable people and knew how to do this.

Medicines were managed safely. People received their medicines when needed and appropriate records had been completed.

Care plans were focused on each person’s individual needs and preferences. Staff involved people and if appropriate, their relatives and records were informative about the care people received. Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had the skills, knowledge and experience required to support people. There were sufficient staffing levels in place to provide the support people required and staff responded promptly when people needed assistance.

We saw people had access to healthcare professionals. People’s healthcare needs were met promptly. Staff provided care in a way that respected peoples’ dignity, privacy and independence. People told us staff cared for them in the way they wanted.

We looked around the home. The building was a large family home the registered provider and registered manager shared with the people they supported. We found it had been maintained, was clean and hygienic and a safe place for people to live.

The design of the building and facilities provided were appropriate for the care and support provided. We found equipment had been serviced and maintained as required. There were safe infection control procedures and practices and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of infection.

People told us they liked the meals and were involved in shopping for and preparation of food. Staff encouraged people to have sufficient healthy and nutritious food and drink.

People had been supported to have maximum choice and control of their lives and staff supported them in the least r

This was an announced inspection visit carried out on 19 January 2016. The reason the inspection visit was announced was to ensure people were available on the day of our visit. Therefore we gave the service 24 hours’ notice.

Dunblane House is a large terraced house registered for four people with mental health problems. It is situated in a residential area of Blackpool. It is run as an ordinary domestic household. People live with the owners and share the communal facilities. The ground floor consists of a lounge and dining/kitchen area and one bedroom. There are four bedrooms, two have en-suite facilities. There are sufficient toilet and bathroom facilities available. There is a small garden area with seating at the rear of the property. At the front of the property there is parking for two vehicles. The house is close to all local amenities. At the time of the inspection three people lived at the home.

There was 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.

At the last inspection in April 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Systems were in place to protect people from abuse and unsafe care. The three people told us they felt safe and were happy at Dunblane House. One person said, “Oh yes I have been here for years we are all a family. I feel safe with people around me.”

We looked at the care records for two people. There was information in place about support needs for each person and how these were being met.

We found the three persons who lived at the home had their healthcare needs met. For example they told us they had access to their doctors and dentists when they required treatment.

We found medication procedures in place at the home were safe. The three people had locked facilities and managed their own medication with supervision from the owners and staff. All had been trained to administer medication.

People who lived at the home were responsible for their food choices with help from the staff and owners. One person who lived at the home said, “We do choose the meals but change when we want to they don’t mind.” People helped themselves to drinks and snacks throughout the day.

The registered provider understood the requirements of the Mental Capacity Act 2005 MCA and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

People had freedom of movement around the building. They were involved in decision making about their personal care needs and the running of the home. We saw no restrictions on people’s liberty during our visit.

People were encouraged to follow their ambitions and individual interests within the community. They included voluntary work and attending education facilities.

People who lived at the home were encouraged and supported to maintain relationships with their friends and family members.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular auditing of the service and meetings with the people who lived at the home formally and informally.

The inspection was led by one inspector. Information we gathered during the inspection helped answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Dunblane House is the home of the registered provider and registered manager. They live as a family with up to four people with mental health problems. There were three service users living at Dunblane House when we inspected. They had lived together at Dunblane House for many years.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. They told us they were receiving safe and appropriate care which was meeting their needs. They said the staff were good and kind.

The home had policies and procedures in relation to the Mental Capacity Act. People who lived at Dunblane House when we inspected, had the capacity to make decisions about their lives, given appropriate information. Staff were aware of the need to seek assistance if an individual’s capacity changed. Staff were aware of Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people would be safeguarded as required.

The service was safe, clean and hygienic. Service contracts were in place. Maintenance records we looked at showed that regular safety checks were carried out. Any repairs were completed quickly and safely. These measures ensured the home was maintained so people were safe. Systems were in place to make sure managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

People’s health and care needs were assessed and reviewed with them, and they were involved in developing their plans of care. This included the way each person's care was provided, their daily routines, health needs and their hopes and aspirations. We saw that care plans were up to date and reflected people’s current individual, dietary, cultural and religious needs.

People confirmed and records showed that they were able to see people in private and that friends and relatives could visit whenever they wished. People’s needs were taken into account with the layout of the home enabling people to move around freely and safely.

Is the service caring?

People were supported by kind, attentive and informed staff. We saw that staff showed patience and gave encouragement and guidance when supporting people. Good care practices were observed. People told us that they were happy at Dunblane House and they liked living there.

Care plans were person centred had been maintained, recording the care and support people were receiving. People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

We found a range of meaningful work, educational, social and leisure activities were organised to encourage skills and enjoyment. People said they enjoyed these, particularly the regular visits to the owner’s caravan in Wales. We observed people getting ready to participate in these and they were enthusiastic about them. Relatives said how much they benefitted their family members. One relative said, “There is always so much going on. Staff also make sure that they support our son so he is always involved in all our family occasions and celebrations.”

People knew how to make a complaint if they were unhappy. They said they had no complaints but indicated that if they had they would be dealt with quickly. We discussed how minor niggles were dealt with quickly and to the satisfaction of people who lived at Dunblane House. There was a complaints procedure and any complaints would be dealt with in a timely manner and action taken as necessary.

Is the service well-led?

The service had a quality assurance system in place and planned to further develop this. Records showed that any identified problems were addressed promptly. Staff reflected on whether any incidents could have been managed more effectively or if lessons could be learnt. As a result of these measures the quality of the service was continuously improving

Staff had a good understanding of their roles and responsibilities and of the ethos of the home. As a small staff team of four, staff worked closely together and with service users. As well as regular informal chats meetings were held regularly so everyone could discuss support needs and any changes in care or routines. Staff also received regular supervision to assist with their development. This helped to ensure that people received a good quality service at all times.

The provider had made efforts to ensure the systems relating to the storage and adminstration of medication were safe. The records were found to be accurate, and the appropriate storage systems were in place.

We undertook this visit in order to follow up on the non-compliance issues we found at the inspection in August 2013. The systems relating to the way people's needs were assessed and planned for were now found to be satisfactory. Improvements to the systems operated by the service regarding how staff regularly assess and monitor the quality of the services provided, or identify, assess and manage potential risks were found to have been improved. Staff employment records were found to be up to date. Improvements to the way medication was stored within the home had improved, however, the process of secondary dispensing or "potting up" needed to be discontinued as agreed by the Registered Manager.

Staff were found to be involved in helping people make choices and decisions about their daily life, and some work had been undertaken to consult people about their future, where they would like to live and how they would like to spend their time. The systems reating to the way people's needs were assessed and planned for were found to be unsatisfactory. Improvements to the systems operated by the service regarding how staff regularly assess and monitor the quality of the services provided, or identify, assess and manage potential risks were found to be unsatisfactory and required improvement.

The people living at this home had been supported by the provider for a number of years. They told us they could express their views and were involved in decision making about their care. They said they were treated with dignity and respect and encouraged to maintain their independence. They told us they were happy living in the home and they felt safe and comfortable. They told us they were involved in decision making about their care and their views were always respected. They said routines were flexible and they could get up and go to bed when they wished. They said they enjoyed their meals and they could pursue activities individually and as a family group.

"This is a lovely place to live. Good home cooked meals with plenty of variety and choice. We all get on very well".

"They are very kind people. They look after us so well".

"Fully involved in decision making about my care and the running of the home. I am encouraged to maintain my independence which I like".

"I couldn't wish for a better place to live. I am happy with everything".