Mountview is based in Stocksfield, Northumberland and provides accommodation and personal care and support for up to 10 people with learning disabilities. At the time of our inspection there were ten people in receipt of care living at the service. This inspection took place on 3 and 4 November and was unannounced.

Our last comprehensive inspection of this service was in August 2015 where one breach of Regulations under the Health and Social Care Act 2008 was identified, namely Regulation 12, Safe care and treatment. At this inspection we found improvements had been made and the provider was now meeting legal requirements.

A registered manager was in post who had been registered with the Commission since April 2016, in line with the requirements of the provider's registration. 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.

Each person that we spoke with told us, or indicated (where they were not able to communicate with us verbally), that they felt safe and comfortable in the presence of staff. Policies and procedures were in place to protect vulnerable adults from harm and abuse. Staff were trained in safeguarding and they were aware of their own personal responsibility to report matters of a safeguarding nature.

Risks that people were exposed to in their daily lives and their environments had been appropriately assessed and measures put in place to mitigate these risks. Positive risk taking was promoted throughout the service and risk assessments were appropriately drafted, reviewed and updated.

Health and safety checks and the servicing of equipment within the home was carried out regularly to support people to remain safe. Any accidents or incidents that occurred were investigated and measures put in place to prevent repeat events. Emergency planning had been considered and guidance was in place for staff to follow should a range of eventualities occur.

Staffing levels were appropriate at the time of our visit and ensured that people's needs were met. Recruitment procedures were robust and enabled the provider to recruit staff of the correct calibre and skill sets to support the people in receipt of care from the service. Vetting checks were carried out to ensure that staff were not barred from working with vulnerable people. Training, supervision and appraisal of staff was carried out regularly. Staff said they felt supported in their roles.

The management of medicines was safe and people received the right medicines they needed, at the right times.

People's care was person-centred and appropriate to their needs. Their general healthcare needs were met. Evidence was available to demonstrate that people were supported to access routine medical support, such as that from a dentist or optician, as well as more specialist support, such as that from a speech and language therapist should this be required.

Staff displayed an in-depth knowledge of people and their needs. They relayed information about people's needs and steps they took to support them, which tallied with our own observations and documented information held within people’s care records. People's nutritional needs were met and managed well. Where necessary, food and fluid charts were used to monitor that people ate and drank in sufficient amounts to remain healthy.

Staff and people enjoyed good relationships and staff treated people with dignity and respect. People were supported to live as independently as possible and social inclusion and community involvement was promoted.

CQC monitors the application of the Mental Capacity Act (2005) and deprivation of liberty safeguards. The Mental Capacity Act (MCA) was appropriately applied and applications to deprive p

We had asked the provider to send us a report by 17 October 2013, setting out the action they will take to meet the standards. The provider supplied an action plan to meet the standards. This inspection was to check to make sure that this action was taken.

The premises had been improved and provided a warm, comfortable, personalised and clean environment.

At the time of this visit there were enough qualified, skilled and experienced staff available to meet people's needs. Staff responded promptly to requests for assistance. Staff received adequate supervision or appraisal.

In this report the name of the registered manager does not appear who were in post and managing the regulatory activities at this location at the time of the inspection. Their name does not appear because they were still in the process of becoming the registered manager on our register.

We saw people were relaxed and there were good interactions between people who used the service and staff. We saw staff consulted people before they provided care and support.

We found people's needs were assessed and care was planned in line with their needs. One person told us, "I am happy here.” Care plans were regularly updated and contained clear information about individuals' care.

The premises were in need of improvement but did provide a warm, comfortable, personalised and clean environment.

At the time of this visit there were enough qualified, skilled and experienced staff available to meet people's needs. Staff responded promptly to requests for assistance. Staff did not receive adequate supervision or appraisal.

People were asked their views about the service provided and these were taken account of. The provider had systems in place to monitor care delivery and ensure the health, welfare and safety of people who used the service was maintained.

People were not able to communicate with us about the care they received, due to the complexity and nature of their condition. There were no relatives or advocates available for us to speak to during our inspection. Consequently we used observations to measure people's experiences when in receipt of care from this service.

During our inspection we spoke with three members of staff and looked at the care records for three people. We found that people were involved in decisions about their care whenever possible and their privacy and dignity was respected.

We found people's needs were assessed and care and treatment was planned and delivered in line with their individual care plans. One staff member said, "We tend to know who likes what so we can accommodate their needs but we always ask, we don't assume, we work on different ways of communicating."

We saw the building was well maintained and designed to be accessible to all people.

Appropriate checks were undertaken before staff began work.

The service had a complaints system in place and staff confirmed they were happy in dealing with any complaints. One staff member said, "I would do a number of things, I could write it down and pass it to the manager, refer them to the manager or if I thought I could rectify it then I would do my best to help them."

People told us they were happy with the care and attention they received at Stocksfield Square. They confirmed that they were given choices in life and staff supported them to take some risks and be independent.

Stocksfield Square provides accommodation and personal care and support for up to 10 people with learning disabilities. At the time of our inspection there were nine people living at the service.

This inspection took place on 10 and 11 August 2015 and was unannounced.

The last full inspection of this service was in July 2013. We found two breaches in relation to supporting workers and the safety and suitability of premises. In January 2014 we visited the service again to make sure the provider had met the requirements of the two regulations that had previously been breached, and we found that they had.

A registered manager is required under this service’s registration with the Care Quality Commission (CQC). At the time of our inspection the name of a registered manager appeared on our register and website, who had not been in post since May 2015. Their name appears because they had not formally cancelled their registration with the CQC after leaving the organisation. We are pursuing this matter separately with the provider. The deputy manager of this home was covering the registered manager’s post, whilst it remained vacant and recruitment was undertaken. A registered manager is a person who has registered with the 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.

Most people were unable to tell us what they thought about living at the home as they could not communicate verbally due to the nature of their condition. Those who could, told us they felt safe living at the home. There were systems in place to protect people from abuse and channels through which staff could raise concerns. Staff were aware of their responsibilities to protect people from abuse.

People’s needs and the risks they were exposed to when going about their daily lives had been appropriately assessed. Regular health and safety checks were carried out on the premises and on equipment used during care delivery. However, the provider had failed to identify concerns related to the premises and they had not ensured the premises were safe and secure. Not all environmental risks within the home had been assessed and not all areas of the home and equipment that people came into contact with were clean. This exposed people to the risk of catching an infection. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which is entitled ‘Safe care and treatment’. You can see the action we told the provider to take at the back of the full version of this report.

Medicines were managed and administered safely. Recruitment processes were thorough and included checks to ensure that staff employed were of good character, appropriately skilled and physically and mentally fit. Staffing levels were determined by people’s needs. Staff records showed they received regular training and that training was up to date. Supervisions for staff were conducted regularly and staff confirmed they could feedback their views during these meetings with the deputy manager.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. We found that applications had been made for DoLS for all of the people living at the home. In addition, people’s ability to make informed decisions had been assessed and the ‘best interest’ decision process had been followed and details of individual decisions documented within people’s care records.

Staff received appropriate training and supervision which was up to date. An appraisal system was in place and following the change in management, the deputy manager told us that appraisals were due to be carried out in the very near future.

Records confirmed that people’s general healthcare needs were met and care plans and risk assessments related to people’s care were regularly reviewed. People’s general practitioners were contacted where there were concerns about their welfare and other healthcare professionals were also involved in their care, such as occupational therapists. People’s nutritional needs were met and where necessary, their weight and food and fluid consumption was monitored to ensure that they remained healthy. Specialist nutritional advice and input to people’s care was sought and implemented where necessary.

Our observations confirmed people experienced care and treatment that protected and promoted their privacy and dignity. Staff displayed caring and compassionate attitudes towards people and people’s relatives spoke highly of the staff team. People had individualised care plans and risk assessments and staff were very aware of people’s individual needs. People enjoyed trips out into the community with the support of staff and several people attended day care centres on a weekly basis and participated in a range of activities.

We received positive feedback about the leadership and current management arrangements in the home, from people, their relatives and staff. A complaints policy and procedure was in place but there had not been any complaints made about the service in the last 12 months for us to review. The deputy manager told us that complaints about the service were rare.

Systems were in place to monitor the service provided and care delivered. However, not all issues were identified and addressed by the provider. For example, we identified risks associated with the premises and infection control which had not been identified and addressed by management via the audits and checks that were in place.

We recommend the provider revisits their quality assurance systems and processes to ensure that all issues are appropriately identified and addressed in a timely manner.