The inspection took place on 3 and 10 January 2018 and was announced on both days. We gave the provider 48 hours’ notice because the service supports a small number of people and we needed to ensure people and staff were available to carry out the inspection.

Henshaws Society for Blind People – 8 Spring Mount Harrogate is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Up to six people can be accommodated at the service. Six people lived there when we inspected. All of the people who lived in the service had a sensory impairment and/ or a learning disability and/or autism spectrum disorder.

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 a learning disability and/or autism using the service can live as ordinary life as any citizen.

At the last inspection, the service was rated Good. At this inspection, we found the service remained Good. However we saw improvements had been made and the service was now outstanding in the responsive are.

There was a manager in post who had registered with CQC.

Systems in place minimised the risk of harm to people. These included effective risk assessment of people’s needs, management of medicines, safe recruitment and effective management of accidents and incidents. The environment was well maintained and the provider had ensured all appropriate safety checks had been made.

We made a recommendation that the provider use the theory of Positive Behavioural Support (PBS) to design a care plan format which will provide staff with the information they need to intervene proactively where people need support. PBS is a method of learning about a person and why they may become anxious or distressed. Once staff understand why, they can work to remove triggers and/or support people better to prevent anxiety.

There were enough staff on duty to meet people’s needs. Staff received appropriate levels of training and support to enable them to carry out their role to a high standard. People benefited from staff having exceptional skills around understanding each person’s needs and aspirations. This included an excellent understanding of sensory impairment and how to use assistive technology to support people to be as independent as possible in all areas of their life, particularly through positive communication. Information was available in each person’s preferred format including policies and procedures such as complaints.

This meant people had feelings of wellbeing and a sense of being valued and included. People were supported to design their own care and make their own choices. They were treated with dignity and respect at all times.

The staff team were supported by an experienced registered manager who worked alongside the team and people who lived at the service, to ensure people received a quality and safe service. Quality assurance systems were effective.

The person centred care people received meant they were supported to achieve their chosen goals, maintain good health and improve their skills. Staff went the extra mile so people were able to live as full a life as possible.

Further information is in the detailed findings below.

This inspection took place on 27 November 2015 and was unannounced. When we last inspected the service on 25 April 2014 we found there were no breaches of regulations.

8 Spring Mount is owned and managed by Henshaws Society for Blind People. The service is registered to provide accommodation and personal care for up to six people who have a learning disability and an additional sensory impairment. The house is well situated within half a mile of Harrogate town centre and there are local amenities nearby. The house is a large three storey terraced house. There is a small garden to the front of the property and a patio at the rear.

There was a registered manager employed by this 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 who used the service told us they felt safe with the staff and the care and support they were provided with. People also demonstrated how safe they felt through their verbal and non-verbal communication and their reactions to staff. Accidents and incidents had been recorded.

Each person had a detailed care and support plan which explained how staff could best support them. There were associated risk assessments completed. Where people required support taking their medicines staff had been trained and were competent to do so.

Staff had been recruited safely and there were sufficient staff to meet peoples assessed needs. Existing staff covered for unexpected absences or other events. Staff were supported through regular supervision. We found people were cared for, or supported by, appropriately trained staff. Staff received support to help them understand how to deliver appropriate care. People told us they got the support they needed with meals and healthcare.

We found there were systems in place to protect people from risk of harm. There were policies and procedures in place in relation to the Mental Capacity Act 2005. The care plans contained a record of decisions people were able to make and the ones they needed support with.

People were supported to engage in activities which were meaningful to them and encouraged them to be part of the local community. People’s views about the service were sought and acted upon.

The service had good management and leadership. Systems were in place to monitor the quality and safety of service provision and we found there were appropriate systems in place for the management of complaints.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

We observed people being treated with dignity and respect during our visit. People told us they knew who to speak to if they had any worries or concerns.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. Systems included people living in the service as far as practicable. This reduced the risks to people and helped the service to continually improve.

The service had policies and procedures in relation to Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. We found relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people were safeguarded as required.

We found that staff had involved other health and social care professionals to make sure people received the right care. This had included following multi-agency procedures about safeguarding concerns. However, we have asked the provider to note that CQC also need advising of certain events affecting people’s welfare.

People were supported to increase their choices and independence, and develop their independent living skills. Greater emphasis needed to be given to record keeping to ensure that monetary expenditure can be reconciled and verified properly.

Systems were in place to make sure that the service was well maintained and equipment was serviced regularly.

Is the service effective?

People’s health care needs were assessed with them, and they were involved in developing their support plans. People told us they were included in any decisions about how their care and support was provided. For example, people were involved in planning what food was provided.

Staff had received training to meet the needs of people they supported. This helped ensure a staff team with the right skills, knowledge and experience to meet people’s care needs.

Is the service caring?

There was a relaxed and friendly atmosphere in the home throughout our visit. People were positive about the care they received. Comments included “Staff help me,” and “They (the staff) are good to us.”

Is the service responsive?

People received specialist support from the organisation’s vision support team to assist with their sensory and mobility needs. Suitable aids and equipment were provided to promote and maintain people’s skills and independence.

Records confirmed people’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

People had access to activities that were important to them and were supported to maintain significant relationships.

Is the service well-led?

Effective management systems were in place to promote and people's safety and welfare.

Staff were clear about their roles and responsibilities. The service had a quality assurance system. This helped to ensure people received a good quality service.

During our inspection we looked at how people were respected and involved in the care and support they received. We found that people had been involved in deciding how they wanted to be supported to live their lives. People we spoke with told us they felt respected and listened to. We spoke with three people who were in at the time when we visited the home. People told us they were happy living at the home. They said they were treated well by the care staff. One person said “It is good living here” another said “We all enjoy living here.”

We saw from people's care plans that people were supported to live as independently as possible. Care plans were personal and included essential risk assessments, which had been kept under review, to enable appropriate care and support to be given.

People who lived at the home were protected from risks of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The staff we spoke with had received training in safeguarding adults.

Records we looked at confirmed that there was sufficient staff to meet people’s needs. People we spoke with confirmed that they were supported to attend various activities. One person said “There always enough staff.”

We saw that the provider had put systems in place to make sure people were safely cared for. This included policies and procedures, induction training for staff and quality monitoring systems.

We talked with three people who were in at the time when we visited the home. People we spoke with told us about the care they received and what it was like living at the home. People told us that they were well looked after and that they were happy with the care they received. Comments made to us during this review included, “Overall I am quite happy with everything." One person said "Yes, it is quite good living here."

We spoke with people about meals at the home. They told us that the food was good as everyone living at 8 Spring Mount continue to cook their own meals with support from staff. People we spoke with told us that they receive the necessary support from staff when they need it.

Everyone we spoke with told us that if they were upset or had a complaint they would either speak to a member of staff or the manager of the home. One person said “I would speak to either my key worker or the manager. If I was not happy I would go higher up and speak with the Community Services Manager or the Director of Care.”

We spoke with the Local Authority Contracts Officer who informed us that they did not have any concerns about this service.

We talked with three people who were in at the time when we visited the home. They told us about the care they received and what it was like living at the home. People told us that they were well looked after and that they were happy with the care they received. One person commented "It is really good here I talk to staff a lot. Staff here are really nice and helpful" another person told us "It is good living at 8 Spring Mount. The staff are all very nice, they support me and they respect my privacy" and someone else said "It is lovely living here"

We spoke with people about meals at the home. One person said "I do my own cooking trying new recipes" whilst another person said "The food here is brilliant"

We spoke with the Local Authority Contracts Officer who informed us that they did not have any concerns about this service.