We inspected this service on 16 July 2018.

HF Trust – Falstaff House 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 service is delivered from a large detached house in a residential area and provides accommodation and nursing care for up to eight people with a learning disability or autistic spectrum disorder. Six people lived at the home on the day of our inspection visit.

There was a registered manager in post at 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.

At the last inspection in March 2016 the service was rated as Good. At this inspection we found the quality of care had been maintained and people continued to receive a service that was safe, caring, effective and responsive to their needs. The rating remains 'Good'.

There were enough staff to keep people safe and provide effective care and support. Staff had time to spend with people and respond to their physical and emotional needs. Staff knew people well, and were aware of changes in people’s wellbeing which could indicate they were worried or concerned. Staff understood their responsibility to report any concerns to their managers so they could be investigated further.

People were cared for and supported by staff who had the skills and training to meet their needs. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Risks to people’s individual health and wellbeing were identified and care was planned to minimise the risks, while promoting people’s choice and independence.

People were supported to eat and drink enough to maintain a balanced diet that met their preferences and were referred to healthcare services when their health needs changed. The provider had systems to ensure information between healthcare professionals was shared effectively and people received their medicines as prescribed.

Many staff had worked at the home for several years, which had allowed people to build strong relationships with them. Staff treated people in a way that respected their privacy and promoted their individuality. People were supported to take part in social activities which were meaningful to them, in a group or on a one-to-one basis.

The provider and registered manager completed quality assurance checks to ensure the home was meeting required standards and people who used the service were well cared for. The checks had ensured the standards of care we found at our last inspection had been maintained.

We inspected Falstaff House on 3 March 2016. Our inspection visit was unannounced.

The service provides accommodation and personal care for up to eight people with learning disabilities or autistic spectrum disorder. There were seven people living there at the time of our visit.

A requirement of the service’s registration is that they have 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 and associated Regulations about how the service is run. There was a registered manager in post at the time of our inspection.

People received care from staff who knew how to keep them safe. Staff knew what they would do to protect a person from the risk of harm and how to respond to any concerns. There were sufficient numbers of staff available to meet people’s individual needs and keep them safe. Risks to people’s health and welfare were assessed and management plans provided staff with information to minimise those risks.

There was a programme of induction, training and management support so staff could deliver effective care. The provider encouraged staff to obtain further qualifications in health and social care.

People were encouraged and supported to eat healthy diets which met any medical healthcare needs. Staff worked with a variety of different healthcare professionals to ensure people’s health needs were met. Relatives were confident that staff provided care that was responsive to their family member’s changing needs.

The registered manager understood their responsibilities under the Mental Capacity Act (MCA) to ensure people were looked after in a way that did not inappropriately restrict their freedom. This included authorisation by the relevant authority for any restrictions to people's freedom that were deemed as necessary to keep them safe; known as Deprivation of Liberty Safeguards (DoLS).

People were supported by a consistent staff team who knew their abilities, support needs, habits, preferred routines and social preferences. People were relaxed with staff who took time to listen to them and understand their needs. Staff respected people’s privacy and dignity and treated them as individuals.

People were supported to take part in a variety of different activities and hobbies and maintain their interests.

The provider had systems in place to monitor the quality of care that people received. This included gathering feedback from people and relatives. Staff told us they felt supported by the registered manager who was approachable and open to suggestions about the service people received in their home.

On the day we visited HF Trust Falstaff House we spoke with the senior support worker and two support workers. The seven people who lived at the home had complex needs. This meant they were not able to tell us in detail about their experiences. Therefore we observed care practice and staff’s interaction with people when they delivered their care. We read the care records for two people who lived at the home.

We saw that people who lived in the home were relaxed. Staff demonstrated they understood people’s personal needs and the individual ways they communicated their needs.

During our visit we observed that the staff were polite and asked people’s permission before they helped them. We saw people having their lunch, where they were supported appropriately and enjoyed their meal.

On the day of our visit, people who lived at the home engaged in different activities throughout the day. Four people spent the day at the provider’s resource centre. Three people were supported by staff to go to the local bank. Two people were supported by staff on a trip to the cinema. We observed staff speaking with people about the trip to the cinema and saw that people were looking forward to the trip.

We spoke with staff and found that they felt supported by their manager and felt able to raise any issues.

We saw that the home was clean and well maintained.

The provider had a system for monitoring the quality of the service, which included regular audits.

We carried out this review to check on the care and welfare of people using this service. During our inspection we spoke with the manager, three support workers and one person using the service.

When we arrived at the home we saw that everyone was friendly and helpful towards each other. One person was supported by their support worker to speak with us. This person spoke positively about their life at Falstaff House. This person told us they had been able to make their own choices and had been supported to manage their own needs. We saw that people had a choice and their independence was encouraged as much as possible. We were told that people had jobs to do around the house such as helping to prepare meals, tidy their rooms and assist with the washing of their clothes.

We saw people's needs had been assessed, risks identified and personalised plans of care developed. There was evidence of support by healthcare professionals to ensure people's ongoing healthcare needs were met.

When we spoke with the staff at the home one person said ‘’Very good working here. Good team. Lovely residents and manager.’’ Staff told us they felt well supported and had received sufficient training to enable them to maintain their skills and care for the people using the service. Discussions with the manager and staff confirmed that there was sufficient staff available to accommodate people’s needs.