We carried out an unannounced comprehensive inspection of this service on 28 June 2017. At which a breach of legal requirements was found. This was because the assessment, auditing and reporting systems the provider had in place were not effective to ensure 'medicines as and when required' were audited and administered safely. It was also because essential documents were not sent to the local authority and the Care Quality Commission (CQC) as required by law.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on 10 August 2017 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Our House on our website at www.cqc.org.uk.

Our House provides accommodation and support with personal care for five people with a learning disability. At the time of the inspection there were five people using the service.

The service had a registered manager. 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.

At our focused inspection on 10 August 2017, we found that the provider had followed their plan which they had told us would be completed by 9 August 2017 and legal requirements had been met.

During this inspection we found the provider had made improvements. We found the registered manager liaised with the GP and had improved the management, administration and auditing of all medicines. The registered manager had also sent notifications and essential information to the local authorities and CQC as required. The registered manager, who was not present at the last inspection, was back at work and we noted that the service was well managed. The registered manager was supported by two senior care workers and an assistant director of operations, who regularly came to the service to undertake auditing of various aspects of the service.

This unannounced inspection took place on 28 June 2017. The service was last inspected on 30 September 2015 and met all regulations inspected.

Our House provides accommodation and support with personal care for five people with a learning disability. At the time of the inspection there were five people using the service.

The service had a registered manager. 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.

People lived in spacious, clean and tidy premises. Staff understood their responsibilities to identify and report incidence of abuse. There were enough staff available to provide care and support people needed. People were confident that staff reviewed and followed their risk assessments in order to manage potential risks to their health and safety.

Staff recruitment processes were robust to ensure that new staff had been properly checked to ensure they were fit to work with people who used the service. Staff also had opportunities to develop their skills through the support, supervision and training they received at the service.

People were encouraged and supported to make their own decisions about their food, care and activities. Staff had received training on Mental Capacity Act 2005 and Deprivation of Liberty Safeguards for them. We found that the management of ‘medicines when required’ were not always effective. We made a recommendation about this and asked the provider how they intended to make improvement.

The care provided at the service was good. Staff were friendly, kind and caring. All people at the service looked clean and happy. Records showed people had regular medical checks. They also had a variety of activities within the service and in the community.

Although there were good systems and practices such as surveys and meetings to obtain people, relatives and staff views about the quality of care provided at the service, the management was not always effective.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.

This unannounced inspection took place on 30 September 2015. The service was last inspected on 21 August 2013 and met all regulations inspected.

Our House provides accommodation and support with personal care for five people with a learning disabilities. At the time of the inspection there were five people using the service.

The service had a registered manager. 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.

Each person had a risk assessment which identified possible risks and how these could be managed. Staff were clear about the risks and guidance was in place to ensure that the risks to people's health and safety were managed. Records showed there was a recruitment process which ensured that staff employed at the home were vetted and only suitable people were employed. We noted that staff had training and the necessary skills to provide care that was appropriate to people's needs. People were provided with care and support that was personalised, met their needs, and was delivered in line with the principles of the Mental Capacity Act 2005.

People's health and social care needs had been assessed. Records showed that people regularly saw health professionals for medical check-ups and treatment. We noted that people were involved in developing the menus and were able to choose the meals and when to eat. There were a lot of stimulating activities for people to participate in.

Staff developed positive relationships with people. The home had a key worker system and staff regularly reviewed and monitored people's needs to check they were being met. People and their relatives told us that staff treated people with respect and dignity and ensured that people's choices and preferences were met.

The home was accessible, clean and tidy. The registered manager ensured that the facilities and equipment used at the home were regularly monitored and were safe to use. People were consulted about the quality of the service through face-to-face meetings and the registered manager was planning to develop a formal quality assurance system by introducing a survey questionnaire.

People’s care and welfare needs were being met. They and their relatives told us they were happy with the quality of care that they received. A person who used the service said “I like it here. It’s alright.” One relative told us “it’s absolutely marvellous. She could not be looked after any better.” Another said “I am very pleased with the way she is looked after, she is relaxed and happy there.”

We found that people were treated with respect and their health needs were met. A healthcare professional told us “the staff are excellent. They pick things up and contact the GP when needed. They don’t force anything on people but work in partnership with them.” A relative said “they are absolutely on the ball and are very quick at noticing if someone is not well.” There were systems in place to ensure that people received their prescribed medication safely and appropriately.

People were given meals that they liked and that met their nutritional and health needs. A relative told us “she enjoys her food and eats well. They are always asked what they want and their individual choices are catered for as far as possible." Another said “they make sure she gets the nourishment she needs.”

People were protected from the risks of unsafe or inappropriate care because accurate and appropriate records were maintained.

People living at Our House experience varying levels of difficulties expressing their views due to having learning disabilities or autism. We observed during our visit that people were treated with patience and respect. People who use the service were relaxed and felt comfortable to approach staff members in the home. A relative told us that the service at Our House was 'exemplary and the staff was the best the home had ever had'.

People who use the service and their relatives spoke very positively about the quality of care provided and about the staff team.

Relatives said:

“My son is very happy here. He is happy with the staff. The staff are patient and good and it is a lovely project. Relatives are always included and invited to various things. I sometimes go for breakfast. Staff have been very good in supporting people with their health needs and not giving up on them.”

“My son is well and is happy there. I am very happy with the service. He goes out a lot and has a good social life. You can always get in touch with them and they get in touch with you. I visit each week and have lunch. It's a nice place.”

“I am very pleased with the way things are going. My daughter is very happy there. They keep in contact with me and there are regular meetings to discuss things. They also have individual meetings so that you can discuss your relative. I am very satisfied and yes indeed she is safe there.”

“I am very pleased, it’s fantastic. Staff are so supportive and helpful. We visit at least once a week and just pop in if we are passing. We are always made to feel welcome. It’s like an extended family there.”