This inspection took place on 13 and 14 July 2017 and was unannounced on the first day. At our last inspection in June 2015 we rated this service “good”. At this inspection we found the service remained “good.”

Miranda House provides an extra care service for up to 20 older people who live in self-contained flats over three floors within the building with a single secure entrance. Each flat contains a lounge, bedroom, kitchen and walk-in shower. There are also shared bathrooms on each floor, and the ground floor contains a staff office and a shared lounge with a kitchen. There is a small courtyard outside. At the time of our inspection there were 16 people living in the service and four flats were vacant.

The service had a 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.

At our previous inspection we made a recommendation about how the provider developed policies and procedures around mental capacity. At this inspection we found the provider had acted on our recommendation to improve policies and training relating to mental capacity, but had highlighted the need to provide better evidence that people had consented to their care and support when they were unable to write. We have made a recommendation about this. Staff continued to receive suitable training and supervision to carry out their roles.

The provider had measures in place to monitor people’s views of the service and had acted on these. For example implementing a more detailed programme of activities included a weekly Sunday roast. People spoke of being treated well by care workers and commented positively on the cleanliness of the building.

People’s care was planned and delivered in a way that met their needs, and people received additional support as required. We saw that people received support to maintain good health and people’s weights were monitored, with action taken to address weight loss. People’s plans contained extensive information about peoples’ life histories and preferences, and regular reviews and keyworking sessions were used to ensure that people’s needs were still met.

The provider had systems in place to address and manage risks to people, in areas such as mobility and social isolation. The building was kept secure, and staffing levels were suitable to meet people’s needs. People were able to call for assistance from staff who were available 24 hours a day.

People received support where required to receive their medicines safely, and the provider had systems in place to detect possible errors or issues with medicines. The provider had suitable safeguarding measures in place to protect people from abuse and to investigate where allegations had taken place.

Managers carried out checks to ensure that standards of care remained good, and were working with local organisations to improve the service people received.

We inspected this service on 3 June 2015, the visit was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in. The service was last inspected in August 2013 when it met all the regulations inspected.

Miranda House provides extra care housing for up to 20 people with a variety of care and support needs. Each person who uses the service is a tenant and has their own single self-contained flat comprising a bedroom, a shower room and a combined lounge/diner/kitchen area. The flats are located on all three floors of the building and all had tenants at the time of inspection. People are referred to the service by the local authority.

There is an ordinary bath on one floor and two assisted ‘walk in’ baths, for those who prefer not to use a shower. People also have access to small seating areas on each corridor, a communal lounge and kitchen and two outside courtyard areas with benches. There is a laundry room on the ground floor which is operated by staff.

A registered manager was in place. 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 registered manager for Miranda House also had the same role at another of the provider’s locations.

We found that Miranda House was a well-run service in which people were encouraged to be individuals with care plans adapted to make this possible. Staff were well-informed and proud of their teamwork. They understood that Miranda House was not a care home and people had tenants’ rights. There was good evidence of learning from experience, well supported by the provider. People who used the service spoke well of staff and staff members spoke fondly of the people they cared for.

People were supported with shopping, food preparation and at mealtimes, if they had an assessed need for this. Staff supported people to take the right medicines at the right dose and the right time if they needed help with this. There were good links with local healthcare services which ensured people’s healthcare needs were kept under review. People participated in activities of their choosing.

There was a complaints system in place, but people told us they had no cause to use it. Regular quality checks were carried out by the manager and her line manager.

The provider needed to develop their policies and procedures in relation to the Mental Capacity Act 2005 which they acknowledged. We have made a recommendation about this. Some information about fire and gas safety was not immediately accessible, because it was kept at the provider’s head office, but we were sent it shortly after the inspection.

We spent time talking with three people who were very satisfied with the quality of service. All were positive about the care and support provided by staff. Two of the three people were aware of their care plan and the information it contained about them. People said that staff came to visit and review their care and support regularly.

The environment was seen to be clean and tidy on the day of this inspection. All communal areas were bright, well furnished and comfortable. The staff complete regular health and safety checks including fire alarm checks. Records looked at confirmed this.

All recruitment and employment checks are completed on staff before they are employed to work at Miranda House.

The service had an effective quality assurance procedure in place that ensures they are continually working to improve services for the people living at Miranda house.

There was a complaints procedure that was displayed on all notice boards throughout the building. People spoken with told us they would talk to staff if they were not happy with anything.

We spent time talking with four people who were very satisfied with the quality of service. All were positive about the skills of the staff who visited them, describing the care as “very good”.

The people said they were treated respectfully and that care assistants understood their rights and the need to have their dignity and privacy maintained.

People were aware of their care plan and the information it contained about them. People said that senior care assistants and manager came to visit and review their care regularly.