The inspection took place on 8 November 2016, and the visit was unannounced.

50 Stoneygate Road provides accommodation and personal care for 19 people who have specific mental health needs. The accommodation comprises of 19 single en-suite rooms. There were 18 people living in the service at the time of our inspection.

50 Stoneygate Road had a registered manager in post. 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.

Staff felt there were enough staff to keep people safe and ensure, as far as possible, people could go out when they wanted to. Staff worked as a team to ensure people received the appropriate level of support to keep them and others safe. Staff developed some people’s life skills to enable a transition back into live independently in the community. The provider had recruitment procedures that ensured staff were of a suitable character to work with people at the home. Most staff had received training in the areas the provider considered essential for meeting the needs of people in a care environment safely and effectively. Planned training was in place for the remainder of the staff to ensure all staffs’ knowledge was up to date.

Tests to ensure that the environment was safe were undertaken regularly, and there was a business continuity plan to ensure the effective running of the service in an emergency.

New staff received an induction which included working alongside more experienced staff. This helped them get to know people’s needs and establish a relationship with them before support them on a one to one basis. Staff had been provided with safeguarding training and the registered manager understood their responsibilities to manage any safeguarding concerns raised by staff.

Risk assessments and management plans covered all aspects of people’s needs and included safety when outside the home, travel, finances, health and daily routines. There were appropriate arrangements for the recording and checking of medicines to ensure people’s health and welfare was protected against the risks associated with the handling of medicines.

Staff worked within the principles of the Mental Capacity Act 2005 and had a good understanding of their responsibilities in making sure people were supported in accordance with their preferences and wishes. Staff knew people's individual communication skills and abilities and showed concern for people's wellbeing in a caring and meaningful way. They were observant of people and responded to their needs quickly.

Care plans and support records were personalised and each file contained information about the person's likes, dislikes, preferences and the people who were important to them. Care plans also included information that enabled the staff to monitor the well-being of people. There were systems in place for staff to share information through detailed daily records for each person.

Audits and checks of the service were carried out by the management team and the provider. These checks ensured the service had continuously improved. The provider ensured all notifications required by law had been sent to us in accordance with the legislation.

We did not speak to people using the service on this visit.

We found there was a clear and up to date recruitment procedure in place that was followed by the service. This meant that people were cared for, or supported by, suitably qualified, skilled and experienced staff.

We spoke with seven people using the service and one visiting healthcare professional. We also spoke to five staff members.

We found people were able to make informed decisions about their care and support. One person told us “there is a mutual respect between staff and clients: it is a two-way process.”

We found people experienced care and support that met their needs and protected their rights. One person told us “this is the best place I have ever been to.” We found people’s care needs had been assessed. Care and support was delivered in a way that met people’s needs and ensured their safety and welfare.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We found the provider had robust systems in place relating to the management of medicines.

Although there was a recruitment and selection process in place, we found that gaps in a person’s employment history were not fully explained. People using the service were potentially put at risk by absence of a satisfactory written explanation of any gaps in employment histories.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained. We found the provider had clear and effective systems in place relating to record keeping.

On the day of our visit, eight of the 19 people using the service were away on holiday. This meant we were not able to talk with several people using the service. We spoke with two people and observed staff supporting four other people.

One person told us she was very satisfied with the support she received. She said: “If you have good foundations, like I have here now, you can spread your wings and grow.” Both people we spoke with said they did a lot outside the service. They told us that they could do the activities they wanted independently. Care workers we spoke with agreed that most people could do the activities they wanted without support.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We saw that care workers knew the needs and preferences of different people. They supported each person differently dependent on their needs. Both people we spoke with said they felt they were treated with dignity and respect by care workers at the service. We saw that care workers spoke with people respectfully.

Both people we spoke with told us they felt safe using the service. People who use the service were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements. One person laughed when we asked about restraint, because she thought it was so unlikely. This shows that she was confident restraint would not be used at the service. She told us she had been restrained when using other services but it would never happen at this service. We saw that the provider had a policy of no restraint. The registered manager and the three care workers we spoke with confirmed that no type of restraint would be used.

The two people we spoke with were generally satisfied with the way staff provided support. We saw that staff supported each other when they were providing care. We saw that care workers approached senior staff and the registered manager when they had queries or needed support or advice. This showed that support was available to staff when they needed it.

One of the people we spoke with told us that the registered manager arranged meetings for people using the service to meet together and make suggestions about the running of the service. They gave us examples of suggestions they had made and how these had been taken into account. For example, people had suggested growing vegetables, so care workers had supported them to plant a vegetable patch.