Jaden House offers transitional accommodation and personal care for up to five people living with a learning disability, autism or mental health needs. The aim is to develop people’s skills, confidence and self- esteem and support them to move on to supported living or other accommodation.

The inspection was unannounced and was carried out on 29 September 2017 by one inspector.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run. The registered manager was away on holiday at the time of the inspection, which was facilitated by the deputy manager.

Staff were extremely kind, compassionate and caring. They knew people and their family circumstances very well and provided sensitive support to help people at difficult times. Staff were very perceptive, understood people’s moods and body language and responded to this appropriately.

Staff were extremely skilled at creating a culture of support, dignity and respect within the home. This ethos was evident in how people felt about their home and their housemates. People spoke respectfully about one another and supported each other to go about their daily lives with the additional support of staff.

Staff were skilled in communicating with people in a way that met their needs. Information was presented around the home in a colourful and visual way which engaged and involved people who told us they felt valued, listened to and in control.

Staff understood the importance of empowering people to make choices and take control of their lives. There was an excellent focus on person centred support and staff were exceptionally committed and determined in finding ways to help people develop trust, confidence, and self-esteem and achieve excellent outcomes.

Individual and environmental risks relating to people’s health and welfare had been identified and assessed to reduce those risks. Regular safety checks were carried out on the environment and equipment to keep people safe. Plans were in place to manage emergencies and personal evacuation plans were in place for people.

People and staff told us they felt the home was safe. Staff had received safeguarding training and understood how to report abuse. People had been given information about what to do if they had any concerns and who they could speak to.

Effective systems were in place for the safe storage and administration of medicines. Safe procedures and risk assessments were in place for people who wanted to take their own medicines.

Safe recruitment procedures were in place and sufficient staff were deployed, including one to one and two to one staff support. People were supported by staff who had received appropriate induction, training and supervision and had the necessary qualifications, skills and knowledge to meet people’s individual, complex needs.

People were supported to maintain their health and well-being and received advice and treatment from health care professionals when required. People made choices about their own individual food and drink requirements and often cooked their own meals at the time when they wanted to eat.

People’s rights were protected because staff asked then for their consent. Staff understood the principles of the Mental Capacity Act 2005 and ensured decisions were made in their best interests. The registered manager understood the Deprivation of Liberty Safeguards and had submitted requests for authorisation when required. Other notifications were submitted to the commission when required.

People were encouraged to take part in a wide choice of activities and educational opportunities, both at home and in the community, which increased their skills and independence. Peop

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

The inspection was unannounced.

Jaden House is registered to provide care and support for up to five people with different health needs including a learning disability. There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Staff were suitably deployed to meet the needs of each person. Healthcare professionals and people told us they were satisfied with the number of staff working at each shift.

Staff understood the needs of people and care was provided with kindness and compassion. People, relatives and health and social care professionals told us they were happy with the care.

Staff were appropriately trained and skilled and provided care in a safe environment. They all received a thorough induction when they started work and fully understood their roles and responsibilities, as well as the values and philosophy of the home. They completed extensive training to ensure the care delivered to people was safe and effective.

The provider had employed skilled staff and took steps to make sure interventions applied were least restrictive and in line with best practice. Healthcare professionals told us they were kept informed when incidents or accidents had occurred.

The registered manager and senior staff assessed and monitored the quality of care consistently involving people, relatives and professionals. Each person told us they were asked for feedback and encouraged to voice their opinions about the quality of care provided.

There was a culture of respect, kindness and loyalty in the service. Interaction between staff and people was friendly and encouraging. People we spoke with consistently told us they had frequent opportunity to express their views with staff and management. Professionals consistently told us the leadership in the home was good and always displayed strong values when they visited people.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been authorised by the local authority as being required to protect the person from harm. We observed people’s freedoms were not unlawfully restricted and staff were knowledgeable about when a DoLS application should be made.

Records showed referrals to health care professionals were made quickly when people became unwell. Each health care professional told us the staff were responsive to people’s changing health needs.

Care plans were reviewed regularly and people’s support was personalised and tailored to their individual needs.

The provider had effective systems in place to support people with their medicines safely. Records showed medicines that were no longer needed were disposed of correctly.

We previously inspected Jaden House on 7 October 2013 and found the provider did not have suitable systems in place to effectively monitor and assess the quality of the service. We also found the provider did not seek the views of people that used the service, relatives or care workers. We judged the provider was non-compliant and told the service to send us an action plan outlining the steps they were going to take to meet the compliance action.

At this inspection we found the provider implemented monitoring systems and achieved compliance with this essential standard. During the inspection we spoke with the registered manager, a senior support worker and a care worker. We also spoke with two people that used the service. We looked at three people's care records and observed the interaction between staff and people that used the service.

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

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

Is the service safe?

Care plans and risk assessments provided detailed strategies in order to support people who may exhibit challenging behaviours. The provider conducted regular audits to ensure people and relatives had the opportunity to express any concerns about their safety in the home or in the community.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. The manager understood when an application should be made and how to submit one and was aware of recent changes to the legislation.

Is the service effective?

Care workers we spoke with had a good understanding of people's needs and told us they felt the care plans and risk assessments in place were effective. We found the provider had an effective system in place to check and reassess the suitability of care workers to work with vulnerable people.

Each person that used the service had a personal emergency evacuation plan in place (PEEP). These plans detailed instructions for care workers and people to follow should a fire take place in the home. We spoke with one person who was able to describe the content of their individual PEEP. This demonstrated the provider had effective emergency fire procedures in place.

Is the service caring?

People's life style choices, preferences, interests, and different needs had been written in their plans and care and support had been provided to make sure these were upheld. Each person we spoke with told us they felt the care workers cared for them properly. One person said: "The staff are really good here, I have never had any problems I needed to complain about. They really care about us and they want us to do well in life".

Is the service responsive?

People's needs had been assessed before they received care.This included involving them in regular care reviews and keeping them or their relatives informed of changes, if appropriate. We saw that people's health needs were monitored and if necessary the support of health care professionals was obtained. This helped to ensure that the delivery of care was responsive to people's needs and based on up to date information and guidance. The records showed that any concerns were followed up and relevant action was taken.

Is the service well led?

There were clear lines of accountability within the service. We saw evidence that regular audits of the quality and safety of the service were carried out. For example, there were audits of the care plans and care workers training records.

We spoke with three people who used the service. We spoke with two members of staff and the registered manager

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We looked at two care plans. We saw they followed a consistent format and contained an assessment of people's needs, the desired outcome and what support was required from staff to achieve such.

People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People we spoke with told us they felt safe. One said, "If I had any problems I'd go to my keyworker or the manager".

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were enough skilled and experienced staff to meet people's needs. People we spoke to about staff said "staff are very helpful". Another said "staff are really encouraging, they want me to succeed as much as I do".

The registered person did not regularly assess and monitor the quality of the services provided. They also did not seek the views of service users or persons acting on their behalf to enable the registered person to come to an informed view in relation to the standard of care and treatment provided to service users.

During the visit we spoke to two people who used the service. People said that they were well treated by the staff and felt respected. They told us they were fully involved in the support and care they received and went to meetings where their care was discussed. They said they felt safe and independent. One person told us: “I get on really well with the staff; they listen to me and speak to me as an adult”

A relative we spoke with said the service was “brilliant” and there had been full consultation in regard to care and support.

Throughout our visit we observed people were being treated with dignity and spoken to in a respectful way. People were being enabled to do what they wanted for themselves.

We saw that people's privacy and independence were respected, people experienced safe and effective care based on detailed care plans and risk assessments that met individual needs and promoted independence.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding adults. We saw policies on whistle blowing and safeguarding. People’s rights were respected.

We saw evidence that staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of the people they were supporting.

The Provider had effective systems in place to monitor quality assurance and compliance.

During the visit we spoke with four people who use the service. People said they felt they were well treated by staff. We were told that staff were respectful of them and listened to their requests. One person told us that she had been supported to try out different work experience before finding a job that she enjoyed.

People said they received the care and support that they needed, in the way that they wanted it to be provided. One person said she was involved in the writing and reviewing of her support plan and staff always consulted her about what information went in the plans.

People we spoke with said they felt safe in the home and said they were confident that staff would respond appropriately to any concerns they raised.

People told us there were enough staff available to provide the support they needed.