Maison Moti Care Home provides care and support to a maximum of 15 adults with mental health needs. At the time of our inspection, there were nine people using the service.

This inspection took place on 3 August 2017 and was unannounced.

At the last inspection on 5 May 2015 the service was rated ‘Good’.

At this inspection we found the service remained ‘Good’.

Statutory notifications to the Care Quality Commission (CQC) had not been made in respect of two incidents reported to the police.

People told us they felt safe at the service and staff demonstrated an understanding of types of abuse to look out for and how to raise safeguarding concerns.

Detailed current risk assessments were in place for people using the service. Risk assessments in place were reviewed and updated regularly. Staff were knowledgeable around the risks associated with people’s mental health conditions.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

There were systems in place to ensure medicines were handled and stored securely and administered to people safely and appropriately.

The home maintained sufficient staffing levels to support people in a responsive and person centred way.

We saw friendly, caring and supportive interactions between staff and people and staff knew the needs and preferences of the people using the service. Care plans were person centred.

We saw evidence of a comprehensive staff induction and on-going training programme. Staff had regular supervisions and annual appraisals. Staff were safely recruited with necessary pre-employment checks carried out.

People were supported to engage in regular activities and develop and maintain independence.

Quality assurance processes were in place to monitor the quality of care delivered.

Further information is in the detailed findings below.

This inspection took place on 5 May 2015 and was unannounced. The provider met all the standards we inspected against at our last inspection on 2 July 2014.

Maison Moti Care Home provides care and support to a maximum of 15 adults with mental health needs. At the time of our inspection, there were twelve people using the service.

There was a registered manager in post at the time of our inspection. 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 who used the service told us they felt safe in the home and around staff. There were systems and processes in place to help protect people from the risk of harm. These included thorough staff recruitment, staff training and systems for protecting people against risks of abuse.

There were enough suitably trained staff to meet people’s individual care needs. We saw staff spent time with people and provided assistance to people who needed it.

Medicines were managed and administered safely and staff received appropriate medicines administration training.

People received personalised care that was responsive to their needs. Care plans were person-centred, detailed and specific to each person and their needs. People were consulted and their care preferences were also reflected. People’s health and social care needs had been appropriately assessed. Identified risks associated with people’s care had been assessed and plans were in place to minimise the potential risks to people.

Staff had the knowledge and skills they needed to perform their roles. Staff spoke positively about their experiences working at the home.

The majority of staff had received training in the Mental Capacity Act 2005 and were able to demonstrate a good understanding of how to obtain consent from people. Staff understood they needed to respect people’s choice and decisions if they had the capacity to do so.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person’s best interests. No DoLS applications had been submitted as people were not restricted.

Positive caring relationships had developed between people who used the service and staff and people were treated with kindness and compassion. People were being treated with respect and dignity and staff provided prompt assistance but also encouraged people to build and retain their independent living skills.

The service had an open and transparent culture where people were encouraged to have their say and staff were supported to improve their practice. We found the home had a clear management structure in place with a team of care staff and the registered manager. There was a system in place to monitor and improve the quality of the service which included feedback from people who used the service, staff meetings and a programme of audits and checks.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. We spoke with five people who used the service and two family members. We spoke with the registered manager and two care workers. We also spoke to a care coordinator from the local Clinical Commissioning Group and one social worker. We looked at five care records and four staff records.

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

Is the service safe?

People had been cared for in an environment that was safe, clean and hygienic. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies. A person who used the service told us that “I feel safe here. There are staff on duty 24 hours a day; there are locks on the doors and alarms around the building.” One care worker told us that “safeguarding is a constant consideration of my job.” We saw evidence that all staff had received safeguarding training and those with whom we spoke demonstrated a good understanding of the signs of abuse and were familiar with the safeguarding policy of the home.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People we spoke with told us that they were happy with the care they received and felt their needs were being met. It was clear from what we saw and from speaking with staff that they understood people’s care and support needs and had a good relationship with them. One person who used the service told us, “this is the first time in years that I can say I am mentally well, and it is all to do with living here.” Another told us how the support they received had “stabilised” them. We saw that staff had received training to meet the needs of the people living at the home.

Is the service caring?

People were supported by responsive and attentive staff. We saw that care workers gave encouragement when supporting people and spoke to them in a respectful manner. A family member told us that they could visit the service at any time and that staff made them feel welcomed. This family member told us that the home had “removed all the worry I had about my relative.” A person who used the service told us that, “staff are thoughtful and polite, they look after you.”

Is the service responsive?

People’s needs had been assessed before they moved into the home. People told us they met with their key workers once a month to discuss what was important to them. Records confirmed that people’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives if they wished. We saw that care plans were amended in line with the persons changing needs, in consultation with the care coordinator. A person who used the service told us that when he needed support to attend medical appointments, “I ask for help to go there and I always get it.” The registered manager told us, “it is important that we are all working towards the same goal of recovery.”

Is the service well-led?

Staff had a good understanding of the ethos of the home and they told us they were clear about their roles and responsibilities. Quality assurance processes were in place and people were encouraged to complete a service user survey. Family members told us they were frequently asked for their views on the quality of the service provided. A care worker told us how their work was closely supervised and said, “the manager is very knowledgeable and approachable.” The registered manager told us, “we are all fully committed to getting it right.” We spoke with a care coordinator from the local Clinical Commissioning Group. They said, “it is clear from the style of management that staff feel valued and want to do their best.

During this inspection we met and spoke with most of the people using the service. People we spoke with confirmed that staff communicated well with them and asked for their permission before any care or support took place. They told us that staff respected their wishes and preferences.

We observed a calm and relaxed atmosphere throughout the inspection and staff did not appear to be rushed and were able to spend time with people they were supporting. Both staff and people using the service that we spoke with said there were enough staff on duty to meet people’s needs.

People were positive about the care and treatment they received at the home. They confirmed that staff assisted them when they needed support and that staff were very helpful and knew their needs. One person commented that the staff, “know me well.”

People using the service told us that they were satisfied with the food provided by the home and that they had enough to eat and drink. People described the food as "good” and “OK.” One person commented “they give you nice food.”

People told us they had no complaints about the service but knew how to make a complaint if they needed to. We saw that people who use the service were encouraged to express their views and raise any concerns during monthly one to one meetings with their key worker.

People who use the service told us that staff were kind and respected their privacy. They confirmed that staff treated them with respect and dignity. One person commented, “the staff are great, they are engaging and attentive.”

They told us that they had meetings to talk about their care and could comment on how the service was run as well as make suggestions for improvements. One person commented, “the key worker sessions are good. It gives me the time to reflect on things.”

People were positive about the care and treatment they received from staff at the home. They confirmed that staff assisted them when they needed support and staff were very helpful. They told us they had good access to health care professionals such as doctors, district nurses, dentists and chiropodists and were happy with the way the service managed their medication.

People told us that they felt safe with the staff who supported them. They said they had no concerns or complaints about their care but would speak with their relatives, the manager or their key worker if they needed to.

We saw evidence that recruitment procedures for staff were being appropriately followed so that people who use the service were protected from unsuitable staff being employed at the home.

We saw that the manager carried out regular checks at the home including health and safety audits to make sure people were being supported in a safe environment.

People using the service who told us that staff were kind and respected their privacy.

We observed staff treating people with respect and kindness.

Staff were able to describe how they met the cultural and spiritual needs of the people they support.

People who use the service said they enjoyed going out of the home and told us about recent trips to the shops, restaurants and family visits. People also confirmed that they help out around the home with domestic tasks such as cooking and cleaning.

We asked people who use the service what they thought about the care and treatment they received at the service. They responded positively and said they felt supported by the staff team and that they were included in decisions about their care as far as possible.

The newly introduced computer care planning format was not user friendly and could be difficult for people who use the service to access.

We observed that the way staff were supporting people in the home had a positive effect on their well being. Staff we interviewed had a good understanding of the needs of the people they supported.

People who use the service indicated to us that they felt safe with the staff at the home. They told us they had no concerns about the home but felt able to talk to the manager or other staff if they needed to.

We observed staff being appropriately supported by the manager so that they could provide for the care needs of the people who use the service.

People who use the service confirmed that the staff ask them how things are going and if they are happy with the care provided at Maison Moti Care Home