This inspection took place on 4 December 2018. This was the first inspection of Next Steps Mental Health Levensulme (known as Next Steps) since first registering with the Care Quality Commission (CQC) in December 2017.

Next Steps is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Next Steps is registered for up to five people with mental health needs. The house has a shared lounge, dining room, bathroom and kitchen. Each person has their own bedroom. There were five people living at the home at the time of our inspection, with one person being short term whilst a more independent supported living home was identified.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People living at Next Steps can live as ordinary a life as any citizen.

The service had two managers registered with the CQC. One registered manager was one of the directors who had set up the home and one had been registered since to manage the home on a day to day basis. 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.

Clear, person centred care plans and risk assessments were in place to identify people’s needs and provide guidance for staff in how to support people to meet these needs. Care plans gave details about people’s mental health needs and provided strategies and distraction techniques for each person. People were supported to take positive risks where appropriate and to increase their independence. Care plans and risk assessments were regularly reviewed to ensure they were current.

People were involved in agreeing their care and support. They met with their key worker each month to discuss their support and what they were happy or unhappy with. Goals were agreed and reviewed.

The service was working within the principles of the Mental Capacity Act (2005). Capacity assessments and best interest decision meetings were seen in people’s care files.

Staff were knowledgeable about people’s needs and how to support them to minimise their anxiety levels. Staff told us they enjoyed working at the service and felt well supported by the registered manager, nurses and directors. Regular supervisions and team meetings were held.

Staff received the training they needed to fulfil their role. Training courses were used alongside micro-teach sessions within supervisions and team days to discuss the support strategies being used.

There were sufficient staff on duty to meet people’s assessed needs. A recruitment system was in place to ensure staff were suitable for working with vulnerable people.

People were supported to access their local community and to maintain their independence where possible. They were encouraged to complete any tasks they could do for themselves.

People’s health, nutritional and dietary needs were being met by the service. Other professionals, for example psychiatry services, were involved in supporting people and the service where needed.

A quality assurance system was in place at the service. The registered manager and directors completed checks for medicines, finances, care plans, the environment and health and safety.

All incidents were reviewed by the manager to identify any patterns in the incidents. Where applicable following serious incidents de-brief meetings were held with the staff involved to review the incident and to review how people were supported to try to reduce the risk of further incidents occu