49 Bonham Road provides accommodation and treatment to up to four people with personality disorders who are progressing towards independent living. People live in a block of individual self-contained flats and the landlord was a housing association.

At the last inspection of December 2015, the service was rated ‘Good’. We carried out this unannounced inspection of the service on 3 February 2017. At this inspection, we found that the service had maintained its 'Good' rating.

People are supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were safe using the service. Staff knew how to keep people safe from the risk of abuse. Risks to people were identified and managed well. There were sufficient numbers of staff deployed to keep people safe and meet their needs. Appropriate recruitment procedures were used to ensure that staff employed at the service were suitable to support people safely.

Staff worked effectively with people and knew their needs, likes and preferences. People were supported by staff who had the relevant skills and knowledge to meet their needs.

People were encouraged to eat healthy foods and supported to develop their skills for independent living. Staff supported people to access healthcare services they needed to maintain good health.

People’s care was provided with kindness and compassion. Staff respected people’s dignity and privacy. People were encouraged and supported to pursue their interests and hobbies.

People received individualised care, which enabled them to move on from the service to independent living in the community. They knew how to raise a concern and how to make a complaint about their care when needed.

People were involved in how the service was run and their views were considered. People, healthcare professionals and staff were happy about how the service was managed. The registered manager was approachable and available to talk to people. Quality audits were carried out and findings were used to ensure to improve the care provided to people.

Further information is in the detailed findings below.

The two men living in the two self-contained flats at 49 Bonham Road were not at home during the day of our inspection and the building is not staffed in the evening. We therefore spoke with one of the men living at the service on the telephone, and spoke with the staff and manager and looked at records at Akerman Road (the Focus project). The team support the men across the two services and operates in partnership with a team at the NHS mental health trust. The men living at Bonham Road previously lived at Akerman Road.

The residents had a degree of autonomy in the way they spent their time. They had regular meetings with their key worker to discuss their support plans and the steps they needed to take to move onto independent living. The men also attended joint meetings with their key worker and members of the team from the NHS mental health trust, at which risks were assessed and progress with support plans discussed.

There were effective recruitment processes in place. New staff were supported to gain appropriate knowledge and skills.

There were monitoring systems in place to maintain the quality of the service. Members of staff were allocated to an area of responsibility, such as liaison with the mental health team health or health and safety.

There were two men living in the two self contained flats at 49 Bonham Road on the day of our visit. The team who work with the men also work with the people living at the Focus project, 29 Ackerman Road. The team operates in partnership with a team at the mental health trust with responsibility for for providing rehabilitation and therapeutic treatment for men with personality disorders.

We did not speak to either of the men during our inspection, but staff described how people were involved in decisions about their care and treatment.

People using the service met their key worker regularly to discuss the plans in place for them. Staff spent time supporting them to develop their skills and promote their independence.

There were appropriate arrangements in place for checking the safety and suitability of the premises. The building had recently had work done, including the installation of new boilers and heaters.

Staff were supported by an extensive training programme, regular meetings with line managers and group support sessions.

The records kept by the service were accurate and fit for purpose.

"This was my first real home, it has been a lifesaver, lots of the stress factors affecting me were reduced since I began using the service", were the remarks from a person that has moved successfully to this more independent style of living. He finds that the support is available when he needs it, but that generally he is more prepared to lead a busy life in pursuing his educational interests.

We heard from professionals within the mental health services that this low level support home was part of the Focus Project. We heard from them that staff in the service worked together with the colleagues from the FIPTS Community Team to successfully integrate people back into the community.

A professional from the mental health team said that people living at the unit were enabled to lead active lives with the options of work placement and educational opportunities. They had low levels of support but knew that staff were available on call if they required support.

The project at Bonham Road provides accommodation and treatment to up to four men across two flats with personality disorders who are progressing towards independent living. At the time of our inspection three men were using the service.

Our inspection was unannounced. At our previous inspection on 23 October 2013 the service was meeting the regulations inspected.

The service had a registered manager as required by their registration. 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.

The service worked closely with the community mental health team and the probation service to provide a joined up service to meet people’s needs. Assessments were undertaken to identify any risks to the person or to others, and to identify the support people required. People were consulted and involved in the assessment and care planning process. Plans were in place stating how people were to be supported to manage the risks they presented. Support plans were in place in relation to their personality disorder, mental health, physical health, financial and employment needs.

People were allocated a key worker who they met with regularly to discuss the plans in place for them whilst they were at the service and to review the progress they were making. People were supported to plan and prepare for a move to independent living and staff helped them to identify suitable accommodation. Support was provided by staff focussing on supporting the person to manage their own risks, and to identify when they required additional help with their mental health. People had access to staff at the service during the day and from a sister service out of hours to ensure they always had staff available to speak with when they required some advice or someone to talk to.

Staff received the training required to ensure they had the skills and knowledge to meet people’s needs, and to help keep people safe. Staff supported people to practice the techniques learnt during therapy sessions with the community mental health team to help them self-manage their behaviour.

Staff received support from their manager and from their peers. Individual supervision and group reflective practice was undertaken to provide staff with the opportunity to discuss how they supported people and to identify any learning to improve the support provided.

Regular monitoring was undertaken to ensure the quality of the service provided. Reports were made to all agencies involved in people’s care and to provide professionals with an update on any changes to people’s needs. Reports were made to the provider about the performance of the service to ensure people received the support they required and to identify any service level learning to improve the quality of service delivery.