Maeres House is a purpose-built building that provides accommodation for up to 8 people with an acquired brain injury including those that have complex physical disabilities. At the time of our inspection there were five people living at the service.

The inspection took place on 6 December 2017 and was unannounced. The previous inspection took place on 14 August 2015 and the service was rated overall good.

The service remained rated as good.

There continued to be sufficient staff to meet the needs of the people supported. Safe recruitment procedures were in place and staff had the required skills and knowledge to support people with their individual needs.

Staff demonstrated a good understanding of safeguarding and had all received training. They were clear about the procedures they would follow to raise any concerns they had.

Staff at completed all mandatory training for their role and regular training refreshers took place. Staff had all completed acquired brain injury training.

People’s needs were assessed prior to using the service and were fully included in the development of the care plans and risk assessments. People were included in the review process which took place regularly.

People’s dietary needs were assessed and fully met. People’s health needs were supported and fully recorded.

Medicine management systems in place were robust and undertaken by trained staff who had their competency assessed. This ensured people received their medicines safely.

People participated in activities of their choice and these included social events and holidays.

The registered provider had documents available in accessible formats that included easy read and pictorial to meet the communication needs of individual people supported.

A complaints policy and procedure was readily available for people and their relatives. They told us they felt confident about raising a complaint and thought any concerns would be listened and responded to promptly.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we find. We saw that the registered provider had policies and guidance in place for staff in relation to the MCA. Staff demonstrated a basic understanding of this and had received training.

The management team had quality monitoring systems in place that were used for development and improvements. Audit systems were regularly undertaken as part of the organisations governance process.

We carried out an unannounced inspection of Maeres House on 14 August 2015.

The home was purpose built and provides support and accommodation for up to eight people with acquired brain injury, particularly those with complex physical disabilities. At the time of the inspection there were eight people living in the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Prior to our inspection we received feedback from the local authority quality monitoring team who had visited the home in June 2015. They did not raise any concerns about the care people were receiving. We also spoke to a GP who said they had no concerns and that staff contacted them appropriately and acted on their instructions.

The experiences of people who lived at the home were positive. People told us they felt safe living at the home, staff were helpful and the care they received was good. A relative told us they had no concerns about the way their family member was treated. They said their relative felt very comfortable in Maeres House and now regarded it as home.

People’s needs were assessed and care plans were developed to identify what care and support people required. People were supported to undertake their hobbies and interests. Daily programmes were geared around people’s special interests which had been discerned through assessment.

People were protected from abuse and felt safe at the home. Staff were knowledgeable about the risks of abuse and reporting procedures. We found there were sufficient staff available to meet people’s needs and that safe and effective recruitment practices were followed.

Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

Staff had good relationships with people who lived at the home and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

People’s health care needs were met and their medicines were administered appropriately. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs. People were appropriately supported and had sufficient food and drink to maintain a healthy diet.

Staff received suitable induction and training to meet the needs of people living at the home. Staff also received supervision. This meant people were being cared for by suitably qualified, supported and trained staff.

There were systems and processes in place to monitor the quality of the service. Audits were carried out and where shortfalls were identified the provider had used the information to improve the service. This demonstrated that it was a learning organisation.