This inspection took place on 25 July 2018. We gave the service short notice of our arrival to ensure someone would be available at the service to meet with us.

Flexible Support Options Limited (Brilan) known as Brilan is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides accommodation for up to four people with a learning, physical disability or mental health condition. On the day of our inspection there were three people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.' Registering the Right Support CQC policy.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager in place. A registered manager is a person who has registered with CQC to manage the service. Like 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 last inspected the service in February 2016 and rated the service as ‘Good’. At this inspection we found the service remained ‘Good’.

We found some recording issues in relation to the administration of medicines that had not been found on internal audits. This meant that the medicines audit process was not being completed robustly. People told us they received their medicines in a safe way and when they were due. We saw staff supporting people to take their medicines in a safe and caring way.

People told us they felt safe at Brilan. There were sufficient numbers of staff on duty to keep people safe. There was an effective recruitment and selection procedure in place and relevant vetting checks were carried out. Staff were suitably trained and received regular supervisions and appraisals.

Accidents and incidents were appropriately recorded and risk assessments were in place. Safeguarding procedures had been correctly followed and staff had been trained in safeguarding vulnerable adults.

Health and safety checks were carried out to ensure people were supported to live in a safe environment.

People were 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 supported with their dietary needs and care records contained evidence of visits to and from external healthcare specialists.

People told us they were assisted by kind and caring staff members. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care records showed that people’s needs were assessed before they started using the service and support plans were written in a person-centred way. Person-centred means ensuring the person is at the centre of any support plans and their individual wishes, needs and choices are taken into account.

People were protected from social isolation. People were supported to access activities on site and in the community.

The provider had an effective complaints procedure in place, and people told us they knew how to complain if they wished to.

People who used the service and staff were regularly consulted about the quality of the service via meetings and surveys.

We carried out an inspection of Brilan on 5 and 22 February 2016. The first day of the inspection was unannounced. We last inspected Brilan in September 2014. At that inspection we found the service was meeting the legal requirements in force at that time.

Brilan is a three bed care home that provides care and support to people with learning disabilities and mental health needs. Nursing care is not provided. At the time of the inspection there were two people accommodated there.

The service had 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.

The people living at Brilan appeared comfortable and relaxed. The person we were able to speak with told us they felt safe and were well cared for. Staff knew about safeguarding vulnerable adults and knew how to deal appropriately with accidents and incidents, which helped to keep people safe.

We observed staff provided care safely. At the time of our inspection, the levels of staff on duty were sufficient to ensure safe, responsive and effective care. New staff were subject to thorough recruitment checks.

Medicines were managed safely with records completed correctly.

As Brilan is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found appropriate policies and procedures were in place and the registered manager was familiar with the processes involved in the application for a DoLS. Staff obtained consent before providing care. Arrangements were in place to assess mental capacity and to identify if decisions needed to be taken on behalf of the person in their best interests.

Staff had completed safety and care-related training relevant for their role. They were well supported by the registered manager and a service manager.

Staff kept clear nutritional and weight records and helped support people’s health needs, working with external professionals where necessary. This ensured people’s medical needs were met promptly.

Activities were arranged in-house, and community based activities were also accessed. We observed staff interacting positively with the people living at Brilan. We saw staff were respectful and ensured privacy and dignity were maintained. Staff understood the needs of the individual and we saw care plans were person centred. Reasonable adjustments had been made to ensure staff had the necessary skills to communicate with people at the service.

People using the service appeared comfortable with, and staff spoke well of, the registered manager. The registered manager was supported by a service manager, responsible for the direct line management of staff at the home. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care and their relatives.

We considered our inspection findings to answer questions we always ask:

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found -

Is the service safe?

People living at the home were supported to maintain their personal safety. Potential risks to their welfare were assessed and managed to ensure care was delivered safely. This included making sure that people were kept safe during help with personal care and when they were taking part in activities outside of the home.

There were appropriate arrangements in place to prevent avoidable harm and abuse and to respond to any allegations of abuse.

New staff were properly checked and vetted to ensure their suitability to work with vulnerable adults.

Is the service effective?

People were provided with extensive care and support that promoted their well-being and met their needs.

A relative told us they were happy with the care and the person’s care manager said, “X’s lifestyle has definitely improved”.

Staff were supported in developing their skills and were given training that equipped them to meet the needs of the people they cared for.

Is the service caring?

We found that each person’s planned care was tailored to their individual needs and wishes. People were cared for by kind and attentive staff who gave their support in the ways they preferred. Staff interacted well with people and encouraged them to do things at their own pace.

Is the service responsive?

Care was provided according to each person’s preferences, interests and diverse needs. People were supported to access activities that were important to them and to be actively involved in the community.

When people’s needs changed, their care and care plans were adjusted to make sure their welfare and safety was protected.

Is the service well-led?

The manager and staff had good understanding of the ethos of the service and their roles and responsibilities. Quality assurance processes were followed to check on standards at the home and get people’s views about their service. We received positive feedback from people’s representatives and they told us they had no complaints about the service and the care provided.