We inspected Higher Keason Care Home on 6 July 2016. This was an announced inspection. We told the provider three days before our inspection visit that we would be coming. This was because we wanted to make sure people would be at home to speak with us.

Higher Keason provides care and accommodation for up to three people. At the time of our inspection visit, the service provided support to two older people who had a learning disability. Higher Keason Care Home had recently changed its legal entity from that of a partnership to a sole provider. This was the first inspection under the sole provider registration

There was a registered person at the service who manages the service and was responsible for the day to day running of the service. 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. We have referred to Linda Olver as the registered person throughout this report.

The registered person worked and managed the service on a day to day basis. There were no permanent additional staff members. However, on occasions when the registered person was away from the service, there were systems in place for family members to support people. They had the necessary skills, experience and competence to support people. They also had the necessary safety checks in place to work in the service.

The Medicines Administration Records (MAR), showed that medicines had been administered as per the dispensing instructions. However there were no tallies of all medicines kept at the service. This meant that the registered provider could not account for all medicines in the home. We have made a recommendation about the recording of medicine stock.

People were happy and relaxed on the day of the inspection. People moved around the premises as they wished, interacting with the registered person freely. The two people at the service have lived there for many years and so the registered person knew the people they supported extremely well and spoke of them with affection. People told us they were settled and this was “our home” and “I don’t want to be anywhere else, I am settled here.” They felt they were part of the registered person’s family and joined in their family celebrations together.

People told us they felt safe living at Higher Keason. People told us, “I like living here. I’ve lived here for 16 years and I am always looked after very well,” and “If I had any worries I would talk to (registered person’s name) or to staff at the day centre.” Arrangements were in place to protect people from abuse and unsafe care.

The service was meeting the requirements of the Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards.

People had a choice of meals, snacks and drinks, which they told us they enjoyed. There was flexibility in what people were offered to eat. People told us that if they did not like the main meal an alternative would be provided. People prepared their own drinks and breakfast. The registered person prepared lunch and evening meals.

People told us they were involved in their care planning and reviews. People had individual care plans, detailing the support they needed and how they wanted this to be provided. People had seen their care plan and had signed it to show they were in agreement with how their support would be provided.

Care records were detailed and contained specific information to guide staff who were supporting people. Life history profiles about each person were developed in a format which was more meaningful for people. This included use of written and pictorial information. This meant the registered person was able to use them as communication tools.

Risk assessments were in place for day to day events and peoples life choices. For example going out into the community and for developing life skills such as preparing drinks. These were all included in people’s ca