Neat Marsh House provides care and accommodation for up to four people who have a learning disability and/or autism. Accommodation is in small individual flats within a house that is situated in a rural area on the outskirts of Hull.

We last inspected the service in May 2015 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

There were safeguarding procedures in place. Staff were clear about what action they should take if abuse was suspected. The local authority safeguarding team informed us that there were no on-going safeguarding matters at this service.

The premises were clean. Checks and tests had been carried out to ensure that the premises were safe. Medicines were managed safely.

Recruitment checks were carried out to ensure that staff were suitable to work with vulnerable people. People at the service received one to one care during the day with reduced staffing at night. Records confirmed that training was available to ensure staff were suitably skilled. Staff were supported though a supervision system.

People's nutritional needs were met and they were supported to access healthcare services when required.

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.

We observed many positive interactions between staff and people who lived at the service. Staff promoted people's privacy and dignity. There were systems in place to ensure people and their relatives were involved in their care and support.

Care plans detailed the individual care and support to be provided for people. People had access to a wide range of activities each day if they chose to take part.

There was a complaints procedure in place. No complaints had been received since our last inspection.

There was a quality assurance system in place which monitored the service and identified where improvements were necessary. Staff were very positive about working for the registered provider and the registered manager. They said they enjoyed working at the service. We observed that they applied this positivity in their roles when supporting people.

Neat Marsh House is a residential care service registered to provide 24 hour accommodation and support for up to four people who may have a learning disability / Autism. At the time of our inspection three people were permanently living at the service. The service is located in the rural community of Preston, Hull. The service is within walking distance of local shops and amenities. The service comprises of four individual self-contained flats within a large property. Each of the flats accommodates one person and has its own fully equipped kitchen, bedroom, lounge and bathroom.

The service also has a communal lounge, utility / laundry area, kitchen, bathroom and staff office. The service offers outdoor space to the front and rear of the property.

The inspection was unannounced and took place on 14 May 2015. During the inspection we spoke with one person living at the service, two relatives, two care staff and the registered manager. 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.

The last inspection took place on 12 November 2013. At that inspection we found the provider was compliant with all the standards we assessed.

We found the service to be safe in its delivery of care. Staff were recruited safely and appropriate checks were completed prior to them working with vulnerable people. Staff had good knowledge and an understanding of the needs of the people who used the service and there were adequate numbers of staff to meet people’s needs.

Staff received regular supervision which enabled them to discuss any matters relating to practice or their personal development. There was a full training programme in place which ensured staff had the knowledge and skills required to carry out their role effectively.

We observed that staff spoke in a positive way to people and treated them with respect. Interactions between staff and the people who used the service were good and there were positive relationships between them. The people who used the service participated in a range of activities and days out. Relatives of those who used the service were positive about staffing levels and told us “The place is perfect.”

The registered manager and the staff team followed the principles of the Mental Capacity Act 2005 and we saw that applications, where required, had been submitted in respect of people being deprived of their liberty.

The inside living environment was well maintained and suitably decorated to reflect individual’s likes and personal preferences. There were, however, some issues with the perimeter fencing around the rear of the service. The registered manager was aware of this issue and assured us that action was being taken to get this replaced.

People who used the service had clear, personalised care plans in place and individual’s choices and preferences were clearly documented. Personalised communication plans, health plans and risk assessments were all in place within peoples care records.

Family and friends were welcome to visit the service at any time and people living at the service were encouraged to participate in activities and daily living tasks as much as possible. Relatives told us they the service “Was a little gem” and worked “Brilliantly” at supporting people.

One person who lived in the home told us they were happy living there and with the support they received. They said they received the right support and felt that staff listened to them. They did not wish to change anything about the home.

Information was available regarding people’s communication methods so that staff were aware when people consented.

Care planning and individual program plans (IPP) were in place to assess and describe the support which people required and to help in the meeting of people’s needs.

Systems were in place to support people with the meeting of their nutritional needs which included involving people with this as far as possible.

Quality assurance systems were in place to check the health and safety of the home regularly and maintenance work was undertaken to help ensure peoples safety. People who lived in the home were consulted about the support provided.

Some people who lived in the home had complex needs and we were unable to verbally communicate with them about their views and experiences.

We spoke with one person who lived in the home. They told us that they liked living in the home and that the staff were nice. They told us that they made choices each day and instructed the staff on these. We observed that they had a good rapport with staff members, who were knowledgeable on the needs of each person.