We inspected this service on 23 March 2017 and was an unannounced inspection. At our last inspection on 29 February 2016, we rated the service as requires improvement as we identified concerns with how staff had been recruited and the number of staff on duty; how people were supported to remain safe and well and how their human rights were protected. The quality assurance systems had not been effective and had not identified these concerns. On this inspection we found improvements had been made.

The service was registered to provide support for up to 14 people who may have a learning disability or mental health condition. There were 12 people living in the home at the time of our inspection.

The service had a registered manager. 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.

Quality assurance monitoring systems were carried out; improvements were needed to identify how the environment could be enhanced and any stock of medicines were recorded. Other audits identified whether care records were reviewed and how the service was managed to help identify where improvements could be made.

People were protected from harm as staff had a good understanding of what constituted abuse and knew what actions to take to keep people safe. There were processes to minimise risks to people’s safety. These included procedures to manage identified risks with people’s care, for checking staff were suitable to work with people who used the service.

People were able to participate in activities that interested them and be independent. Care records were personalised and contained relevant information for staff to help them provide the care people required. Information about making a complaint was available for people and they knew how to complain if they needed to.

Staff had the skills, knowledge and experience to work with people. Staff respected people’s decisions and gained people’s consent before they provided any care. Where any restrictions were identified, applications had been made to ensure this was lawful.

People felt staff and registered manager were caring and treated them with respect and dignity. Staff understood the importance of treating people with kindness and compassion. They also provided good humour and enjoyed spending time with people.

People were provided with a choice of what to eat and drink. Where changes in people’s health were identified, they were referred to healthcare professionals to support people’s wellbeing.

This inspection took place on 29 February 2016 and was unannounced.

Flora Lodge provides care and accommodation for up to 14 people. The service specialises in supporting younger adults and older people with mental health needs, learning disabilities, and autistic spectrum disorders. The premises are situated in a residential area close to the centre of Leicester.

The service had a registered manager. This 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 using the service told us liked living at the Flora Lodge. The service had a friendly and relaxed atmosphere and people appeared content. They got on well with the staff who were kind and caring.

Although there were sufficient numbers of staff on duty to meet people’s needs during the day, this was not the case at night. We told the provider to take action to address this which they did as a matter of priority.

Records showed that not all of the staff had been safely recruited. This was because the provider had failed to carry out the necessary pre-employment checks or appropriate risk assessments to determine their suitability to work with the people using the service.

Staff protected people from risk while at the same time supporting and respecting their freedom. However records showed staff did not always have the information they needed to keep people safe. In addition, unsuitable storage facilities and poor record keeping meant that people were not protected from the risk of the unsafe management of medicines.

People told us they felt safe living at Flora Lodge and would tell staff if anything was wrong. Staff knew how to protect people from abuse. However the provider’s safeguarding policy and complaints procedure were both out of date and contained misleading information.

Staff had some understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards but did not have the information they needed ensure people’s human rights were being protected.

All the staff we met were enthusiastic about their roles and doing their best to understand of the needs of the people they supported. However not all had been trained in the areas considered essential for people working with those with mental health needs and learning disabilities.

People told us they liked the food provided and had plenty of choice. Staff knew people’s likes and dislikes and tried to encourage people to eat healthily. Improvements were needed to the way people’s dietary needs were assessed and planned for.

Most of the staff had worked at the service for several years which had enabled them to build up close therapeutic relationship with the people using the service. We saw that people interacted well with staff and had no hesitation in approaching them if they needed assistance. Staff were knowledgeable about people’s ongoing healthcare needs and supported them to access healthcare services.

Staff treated people with dignity and respected their privacy. They routinely involved people in making decisions about their. However there was no evidence that people using the service were formally involved in their own care planning. In addition, some daily records included observations that were written in a disrespectful way.

People told us the care and support provided was responsive and helped them to cope with their mental health needs and other issues. Staff encouraged people to develop the skills they needed to live more independent lives. People told us they had improved while using the service and become more independent.

Although the staff on duty were aware of people’s needs the knowledge they had was not always reflected in people’s care records. In addition care records were not personalised and contained