This inspection took place on 17 and 19 October 2016 and the inspection was unannounced, which meant the registered provider did not know we would be visiting the service.

Mary & Joseph House provides high quality accommodation and personal care to adult males with enduring mental health needs. Mary and Joseph House is part of the Joseph Cox Charity founded in 1963, and has been in its present purpose built house since 1993.

At the time of our inspection there were 41 people living at the home. The home specialises in the care of people living with Korsakoff syndrome. Korsakoff syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1). Korsakoff syndrome is most commonly caused by alcohol misuse, but certain other conditions also can cause the syndrome.

The property provides 11 self-contained flats and 30 single bedrooms. The home has been built to an exceptionally good modern standard, specifically adapted for people living with dementia. The home provides accommodation over two floors arranged in five suites. There is a lift, a games room, dining room, chapel, art studio, project room and two lounges on the ground floor. There was a sensory garden for people and their relatives to enjoy that stimulated the senses of smell and hearing.

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.

There was a truly open atmosphere on entering the premises. People could access the internet if they wanted to and could use a tablet computer provided by the service if they wished to send emails or skype family. All areas within the home had been designed for the needs of the people. There was plenty of communal space, lounges, and dining areas were available to people, as were quiet areas where people could sit in peace. We observed that this was a very safe home with a well-designed system enabling staff and visitors to move freely within the home. A relative said, “I know my dad is extremely safe at Mary & Joseph House, the environment doesn’t restrict his movement.”

The registered manager was inspiring and dedicated to providing care which met the highest of standards. They strived for excellence through consultation, they were passionate and dedicated to providing an outstanding service to people. They led with a dynamic approach and continually reflected on how to improve the service further. They demonstrated a strong and supportive leadership style, seeking feedback in order to further improve what was offered. The provider's vision and values were understood and shared across the staff team, and they were fully supportive of development plans.

People's care plans were tailored for them as individuals with the involvement of their families at all stages. People were cared for by staff that knew them really well and understood how to support them to maximise their potential and attain their goals. People's progress was monitored and celebrated. Staff were constantly looking for opportunities to offer to people that would help them grow, gain confidence and live a fulfilled life. People were supported and encouraged with their goals of moving back into the community. People were able to participate in the quality assurance processes of their home and could undertake a variety of different training offered by the provider.

The culture of the service was open, transparent and progressive. All the staff were committed to continuous improvement of the service, individual care and looking at the provider as a whole.

People using the service, their representatives and the staff felt valued and important representatives of the organisation. The staff felt ownership of and

Peoples' diversity, values and human rights were respected and people were treated as

individuals. Staff told us they understood peoples' care and mental health needs. People

using the service had their needs, physical health, mental health and social support needs

assessed and monitored through the care planning processes and regular one to one

sessions.

The service worked in partnership with other providers to ensure people's health, safety and welfare needs were met. Information about people who used the service was obtained and shared appropriately.

People were supported in premises that were suitably designed and adequately maintained to meet their rehabilitation needs.

There were effective recruitment and selection processes in place and people were supported by suitably qualified, skilled and experienced staff.

People's records, staff records and other records relevant to the management of the services were up to date, accurate and fit for purpose.

We talked with six people who used the service, three people who worked in the home including the assistant manager in-charge at the time of the inspection. Prior to the inspection visit we also talked with a member of Manchester city council commissioning team. There were no concerns raised about the services provided at the home.

People who used the service told us they liked living at the home because they were treated with respect and because their needs were met. People’s comments included:

“It’s the longest place I’ve ever stayed.”

“I make a choice in all things.”

“I’ve got no problems at the moment and I’m very happy here.”

And

“The spirit of the place is excellent, all the staff are willing to give their attention to you when you need it.”

Staff said they liked working in the home. The Manchester city council officer said there were no concerns about the service provided at Mary and Joseph House.

We found that people gave informed consent to their care and treatment; were protected from harm and abuse and there were sufficient staff on duty with the skills to meet people’s needs.

We found that Mary and Joseph met the individual needs of people and promoted their physical, emotional, and social wellbeing and development.

We saw that people using the service were supported to act as independently as possible to achieve a positive lifestyle and so their sense of self worth and personal value was promoted.

We spoke with many of the people in the home in a group. This was at a community meeting which occurred during our visit. We also spoke to several people individually. People told us that they felt well cared for and stated that they were treated with dignity and respect. All the men we spoke to were very complementary about the support that they had received by the service in their recovery against alcohol addiction. One person commented that they [staff] have been 'absolutely marvellous. The way they look after you is incredible. I can't say enough for the place. I don't know where I'd be now if I hadn't come here'. Several men commented on the good rapport between paid staff and people who use the service. This was summed up by one person who said of staff: " They're all understanding. It's like a family."

Mary and Joseph House is a residential service providing care and support to adult men with enduring mental health needs and alcohol dependency. The property comprises of 11 self-contained flats and 30 single bedrooms. The home was fully occupied on the day of our inspection. People living at Mary & Joseph House have access to a wide range of facilities including; a games room, small lounge areas, an art therapy room, a workshop, a chapel and well maintained gardens. There is parking available for visitors. There is good access to all parts of the property.

The manager had worked at the service for 10 years and was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards. While no applications have been submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and in how to submit one. People’s human rights were therefore properly recognised, respected and promoted.

People were involved and consulted with about their needs and wishes. Care records provided good information to direct staff in the safe delivery of people’s care and support. Records were kept under review so information reflected the current and changing needs of people. Information was stored securely ensuring confidentiality was maintained.

People were offered a wide range of activities both in and away from the home. These ranged from social and leisure activities to housekeeping and laundry. This offered people some structure to their day and helped those people intending to move to more independent living so they had the skills to manage.

Staff worked closely with healthcare agencies so that people received the care and treatment they needed. Information was shared with other services so that people continued to receive safe and effective care.

Records showed people who had applied to work at the service had been robustly recruited so only those applicants suitable for employment were offered work at the home.

Staff received on-going training and development in the areas of care and support people required. This helped to ensure staff had the knowledge and skills needed to meet the specific needs of people.

Sufficient numbers of staff were available to support people in meeting their emotional, social and physical needs so their health and well-being was maintained.

Systems to monitor and review the quality of service provided were in place to check that people received a quality service. People were offered a good standard of accommodation. Checks were made to the premises and servicing of equipment ensuring people were kept safe.