Harewood House is a residential care home providing personal care for up to seven people with learning disabilities and complex needs. Nursing care is not provided at the home. This is provided by the community nursing service. At the time of our inspection there were six people living in Harewood House but two had gone away on holiday.

At the last inspection in May 2016 the service was rated Good overall and Requires Improvement in the Well-Led key question. At this inspection we found the evidence continued to support the rating of good in Safe, Effective, Caring and Responsive. We found Well-Led had improved to a Good rating. The inspection is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

People who lived in Harewood House were provided with high quality care and support which met their individual needs and was person centred. Comments from people who lived in the home included; “I’m really happy here” and “I love it.”

Harewood House was family owned and run. Some people had lived in the home for over 18 years. Others had lived in a previous home owned by the provider before moving to Harewood House and had therefore known them for over 24 years. People commented on the family feeling of the home and they referred to the provider as their ‘aunty’.

People spoke highly of the staff who worked at the home and told us they had been involved in their recruitment. Recruitment procedures were in place to help ensure only people of good character were employed by the home. Staff underwent Disclosure and Barring Service (police record) checks before they started work. Staffing numbers at the home were sufficient to meet people’s needs. Staff had the competencies and information they required in order to meet people’s needs. Staff received sufficient training as well as regular supervision and appraisal. Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put this into practice.

Staff treated people with respect and kindness. There was a warm and pleasant atmosphere at the home where people and staff shared jokes and laughter. Staff knew people and their preferences well. People were supported to have enough to eat and drink in ways that met their needs and preferences. Meal times were social events and people spoke highly of the food at the home.

People who lived in Harewood House had a variety of needs with some being very independent and others requiring a lot of support. People were protected from risks relating to their health, mobility, medicines, nutrition and potential abuse. Staff had assessed individual risks to people and taken action to seek guidance and minimise identified risks. Staff knew how to recognise potential signs of abuse and how to raise concerns.

Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risks of reoccurrences. Staff supported people to take their medicines safely and staffs knowledge relating to the administration of medicines was regularly checked.

People, relatives, staff and healthcare professionals were asked for their feedback and suggestions in order to improve the service. There were systems in place to assess, monitor and improve the quality and safety of the care and support being delivered.

Further information is in the detailed findings below.

The inspection was unannounced and took place on 30 March 2016. At our last inspection in March 2014 no concerns were identified.

Harewood House is a residential home providing accommodation for up to seven adults with learning disabilities or autistic spectrum disorder. At the time of our inspection there were six people living at the home.

The home 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.

People felt safe living at the home. Staff demonstrated they knew how to keep people safe from harm or abuse and knew how to report any concerns. Risks to people were identified and were managed in a way that supported people to remain independent. People received their medicines on time and as prescribed. Medicines were stored safely and securely.

People were supported by sufficient numbers of staff to meet people’s individual needs. The provider ensured staff recruited to posts were trained to meet the care needs of people living at the home.

People were supported to access healthcare professionals when required to ensure their health needs were met.

Staff gained people’s consent before carrying out care and support and the provider had taken appropriate action to ensure people’s rights were protected. People enjoyed the food and had choices regarding their meals.

Staff were kind and caring. Staff understood people’s choices and preferences and respected their dignity when providing care.

People had access to a wide range of different leisure activities and were supported to maintain relationships that were important to them.

People knew how to make a complaint and felt their concerns would be listened to. Relatives told us they felt comfortable raising any concern or complaint with the registered manager or staff members.

There were new audit systems in place to monitor the care people received this included gathering feedback from people and relatives. However we found information was not used to identify issues or trends that would improve the quality of care people received.

We spoke with two people who live in the home, they told us how happy they were to live at the home, how they were supported to live independent lives and how they considered the other people living in the home to be part of their families. One person told us how they could do what they liked and how much fun they have, going on to talk about their job in a local centre and the activities they have planned for the rest of the year such as trips out for a meal and a holiday.

People we spoke with told us what they would do if they had any worries, saying “the manager is always here and always listens to us”.

Staff said how they enjoy their work and found it fulfilling, they said there were training opportunities and the home manager was supportive.

Both the people we spoke with and the staff said that they are involved in decisions about the home and discussed how everyone sat round the kitchen table chatting about the home and any issues that may occur. There was also documented evidence of home meetings and actions that had been taken following those meetings.

We spoke with four people who lived at Harewoood House who told us that that they were very happy living at the home. People told us that they were involved in making decisions about their daily care and they told us that they attended review meetings about their long term care needs. One person told us that "I can decide what I do during the day, today I am going to the cafe where I will be working".

People told us that "we like the staff because they look after us very well". We asked people about their care plan and they told us that they knew what was in the plan and that they attended review meetings with the manager, their family and social worker.

People told us that "we feel very safe living here". They told us that "if ever we have a concern we can go straight to the manager and she will listen to us".

We saw a training matrix that confirmed that staff had received a range of learning and development opportunities which promoted their professional development.

People told us that the manager listened to their views when making decisions about the running of the home. We saw that there were systems for ensuring that Harewood House delivered care and support that was safe for people living there.

Harewood House can accommodate people with mild to moderate learning disabilities.

People who spoke with us were able to discuss their life at the home and what they enjoyed about living there. Everyone has individual accommodation contracts that they have signed, and people confirmed to us that the contracts were discussed with them and they understood the ‘do's and don'ts’ about living at Harewood House.

People said that they appreciate having their own rooms, and being able to choose how they are decorated and what things they can have in them. People told us that they could do what they liked and that they made decisions about what they did. One person said that they enjoyed being able to meet up with their friends. Another person told us they like to watch the “soaps” on television.

People who use the service told us that they felt safe at the home and that staff,” are very kind”.

People told us that the food was “excellent” and that there was plenty to eat at times that suited them. There was assistance for them to maintain their personal hygiene if required and their privacy and dignity was respected. People told us that their rooms were warm and comfortable.

Overall people had positive comments to make about the home and we found that all the essential standards were met.