Iris Hayter House is a residential home registered for up to 13 people with a diagnosis of mental health problems. The service provides care and accommodation and has strong links with community mental health teams. On the day of our inspection 13 people were living at the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated good:

People remained safe living in the home. There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking which enable people to live their lives as they chose. People received their medicines safely.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's G.P's to ensure their health and well-being was monitored.

The service continued to provide support in a caring way. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity. People were involved in decisions about their care needs and the support they required to meet those needs.

The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People had access to a variety of activities that met their individual needs.

The service was led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people, relatives and staff and promoted a caring ethos.

This inspection took place on 31 March 2015. It was an unannounced inspection. The service had met all of the outcomes we inspected against at our last inspection on 26 September 2013.

Iris Hayter House is a residential home registered for up to 13 people with a diagnosis of mental health problems. The service provides care and accommodation and has strong links with community mental health teams. On the day of our inspection 12 people were living at the service.

There was 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 told us staff knew how to support them. Comments included; “The staff do everything well for me” and “They seem to know what they’re doing.” Staff told us and records confirmed they had the training and support to meet people’s needs and support them safely.

People told us they enjoyed living at the home. Comments included; “Excellent care, I’ve got no complaints.” People also told us they valued the support they received from staff. They told us staff spent time with them and they were “Understanding.”

Staff understood the needs of people and we saw that care was provided with kindness and compassion. People spoke positively about the home and the care they received. Staff took time to talk with people or provide activities such as and arts and crafts, games and religious services.

All staff spoke positively about the support they received from the registered manager. Staff told us the registered manager was approachable and there was a good level of communication within the home.

People told us they felt safe. Staff told us, and training records confirmed that staff received regular training to make sure they stayed up to date with recognising and reporting safety concerns. Records confirmed the service notified the appropriate authorities where concerns relating to abuse were identified.

Risks to people were managed and reviewed. Where risks to people had been identified risk assessments were in place and action had been taken to reduce the risks. Staff were aware of people’s needs and followed guidance to keep them safe.

The service ensured staff had the necessary skills to support people through, training, and regular supervision. Staff told us they understood their roles and responsibilities and received the support they needed.

People received their medicines as prescribed. Medicines were stored securely and accurate records maintained. Staffs received competency based training in administering medicines and were observed by the registered manager before being signed as competent.

People had enough to eat and drink. People told us that they enjoyed the meals provided. One person said “I really like the food, it’s good and hot.” We saw the staff were kind and provided the support people needed with eating and drinking.

The registered manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 (MCA) which governs decision-making on behalf of adults who may not be able to make particular decisions themselves. People’s capacity to make decisions was regularly assessed.

People told us they were confident they would be listened to and action would be taken. The service had systems to assess the quality of the service provided in the home. Learning was identified and action taken to make improvements. These systems ensured people were protected against the risks of unsafe or inappropriate care.

Senior managers regularly visited the home and staff told us they were approachable and supportive. One care worker told us they were “Absolutely wonderful.”

We visited Iris Hayter House in July 2013 and found concerns regarding assessing and measuring the quality of service provided. The service sent us an action plan about how they would address these concerns.

We revisited the service and looked at the care plans for people and saw that they had been reviewed and revised care plans had been implemented. For example, one person's bed had been fitted with rubber feet to reduce the risk of falls. Risk assessments had been reviewed and we saw detailed actions taken including referrals to specialists where appropriate.

Residential meetings had been re-organised and we saw that any issues raised were addressed. We also saw that attendance at the meetings had increased because of changes made to the timing of the meetings. This was at the request of people who used the service.

We looked at the audits for the service and saw that people's needs were responded to. For example, we noted that one audit identified three people had diabetes and the provider had organised training for care workers with Oxfordshire County Council to equip them to provide appropriate care.

At the time of our visit 11 people were living at the home. Not everyone was able to speak to us. We spoke with four people who used the service. They said they were happy to be at the home and that they felt well cared for. One person said "I get up when I want, go to bed when I want and I have my own room". Another said "it is nice, they take care of me". Everyone we spoke with understood the concept of being safe and when asked if they felt safe told us they did. One said "I know I am safe because they look after me".

We spoke with four members of care staff. They all said they liked working at the home. One said "I love my job, we are supported, there is lots of training and I learn all the time. It is so interesting and rewarding". Another said "I have been here years and I love this place".

We looked at care staff records and saw that staff were recruited and selected in line with the provider’s policy on recruitment and selection. We also looked at how the provider measured the quality of the service by looking at surveys, audits and records. These documents were completed but they were difficult for the manager to locate. The office where records were kept was cluttered and disorganised.

The provider did not always use information to learn from events and respond to peoples’ needs. We looked at care plans for people using the service and found them to be complete. However, it was difficult to find specific and important information relating to people’s care and welfare needs. Some risks were not always effectively managed.

Some people we spoke with would have preferred to be accommodated at home or with relatives. They did however tell us that they accepted that they had to be there and that it was an “ok “ place to live. People we spoke with told us that they were treated well and that most people had their own room. Two rooms were for shared occupancy and we spoke to one person who was sharing who told us that “he preferred company as he didn’t like being on his own“. The bedroom was separated into two sections allowing plenty of personal space.

We spent some time in the communal lounge. There was a relaxed atmosphere with people talking to each other and sharing what they had been doing that day. Some people had been out with staff and others had been to the day centre. Some people had chosen to remain in the home due to the weather. People told us that they were consulted about their care and had a say in what, where and how they wanted care to be provided. People had a choice about the food on a daily basis and also could eat away from the dining room and in their own room if they wished.