We inspected the service on 7 February 2017. It was unannounced.

Forge House is a privately owned care home. The service provides personal care, accommodation and support for up to six adults. People had a variety of complex needs including mental and physical health needs and behaviours that may challenge. There were six people living at the service at the time of the inspection.

At the last Care Quality Commission (CQC) inspection on 17 February 2015, the service was rated Good in all domains and overall.

At this inspection we found the service remained Good.

Due to people’s varied needs, some of the people living in the service had a limited ability to verbally communicate with us or engage directly in the inspection process. People demonstrated that they were happy in their home by showing warmth to the deputy manager and staff who were supporting them. Staff were attentive and interacted with people that used the service in a warm and friendly manner. Staff were available throughout the day, and responded quickly to people’s requests for help.

The provider was also the registered manager of the service. 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 continued to be safe at Forge House. People were protected against the risk of abuse. We observed that people felt safe in the home. Staff recognised the signs of abuse or neglect and what to look out for. Staff knew how to protect people from the risk of abuse or harm. They followed appropriate guidance to minimise identified risks to people's health, safety and welfare. Medicines were managed safely and people received them as prescribed.

There were enough staff to keep people safe. The provider had appropriate arrangements in place to check the suitability and fitness of new staff. Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.

Each person had an up to date, personalised support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly. Staff received regular support to help them to meet people's needs effectively.

People were supported to eat and drink enough to meet their needs. They also received the support they needed to stay healthy and to access healthcare services.

Staff encouraged people to actively participate in activities, pursue their interests and to maintain relationships with people that mattered to them.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The provider and staff understood their responsibilities under the Mental Capacity Act 2005.

Staff were caring and treated people with dignity and respect and ensured people's privacy was maintained, particularly when being supported with their personal care needs. 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.

The deputy manager was in day to day control of the service. They ensured the complaints procedure was made available in an accessible format if people wished to make a complaint. Regular checks and reviews of the service continued to be made to ensure people experienced good quality safe care and support.

There were systems in place to review accidents and incidents and make any relevant improvements as a result.

The deputy manager provided good leadership. They checked staff were focussed on people experiencing good quality care and support. People and staff were encouraged to provide feedback about how the servic

We carried out this inspection on the 17 February 2015 and it was unannounced.

Forge House is a privately owned care home. The service provided personal care, accommodation and support for up to six adults. People had a variety of complex needs including mental and physical health needs and behaviours that may challenge.

Due to people’s varied needs, some of the people living in the service had a limited ability to verbally communicate with us or engage directly in the inspection process. People demonstrated that they were happy in their home by showing warmth to the deputy manager and staff who were supporting them. Staff were attentive and interacted with people that used the service in a warm and friendly manner. Staff were available throughout the day, and responded quickly to people’s requests for help.

The service had a registered manager, who was also the nominated individual for the company. 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.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Staff had been trained in how to protect people from abuse, and discussions with them confirmed that they knew the action to take in the event of any suspicion of abuse. Staff understood the whistle blowing policy and how to use it. They were confident they could raise any concerns with the registered manager or outside agencies if this was needed.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act (MCA) 2005 to ensure any decisions were made in the person’s best interests. Staff were trained in the Mental Capacity Act 2005 (MCA) and showed they understood and promoted people’s rights through asking for people’s consent before they carried out care tasks.

Staff were knowledgeable about the needs and requirements of people using the service. Staff involved people in planning their own care in formats that they were able to understand, for example pictorial formats. Staff supported them in making arrangements to meet their health needs.

Medicines were managed, stored, disposed of and administered safely. People received their medicines when they needed them and as prescribed.

People were provided with food and fluids that met their needs and preferences. Menus offered variety and choice.

There were risk assessments in place for the environment, and for each individual person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. People were involved in making decisions about their care and treatment.

There were systems in place to review accidents and incidents and make any relevant improvements as a result.

The registered manager investigated and responded to people’s complaints and people said they felt able to raise any concerns with staff.

Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or the lunch was served and at other times during the day.

People were given individual support to take part in their preferred hobbies and interests.

Staff were recruited using procedures designed to protect people from the employment of unsuitable staff.

Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.

There were systems in place to obtain people’s views about the quality of the service and the care they received. People were listened to and their views were taken into account in the way the service was run.

The inspection included a visit to the premises where six people who used the service lived; and a visit to one of the two houses where people received supported living.

We had limited conversations with people who used the service as not everyone was able to tell us about their experiences. It was noted that people interacted well with staff they were familiar with, and observations showed that people appeared happy and contented.

The staff supporting the people that used the service knew what support they needed and we saw that the support being given to people matched what their care plan said they needed.

Medications were handled appropriately and people that used the service had their medicines given to them in a safe way.

We found that there was a robust recruitment process in place that helped to make sure that only people who were deemed as suitable were employed to care for people that used the service.

We saw that there were monitoring processes in place that ensured that people were protected against the risks of inappropriate or unsafe care and treatment as the service regularly assessed and monitored the quality of the service provided.

We had limited conversation with people who used the service and not everyone was able to tell us about their experiences. It was noted that people interacted with staff who they were familiar with and observations showed that people appeared happy and contented.

The staff supporting the people that used the service knew what support they needed and we saw that the support being given to people matched what their care plan said they needed.

We had limited conversation with people who used the service as they seemed reluctant to meaningfully engage with a stranger. It was noted that people interacted with staff who they were familiar with and observations showed that people appeared happy and contented.