The inspection took place on the 26 March 2016 and was announced. We gave the provider 24 hours’ notice. This was due to only one person currently living at the service and we needed to be sure they were in. Rielly’s House provides care and accommodation for up to three people living with mental health issues.

The service had a registered manager in post. 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.

We were supported by the registered provider and registered manager during this inspection. They both lived on site, with their family, and with the one person currently living in the service.

We spoke and spend time with the person who lived at Rielly’s House. They were able to tell us about all aspects of their care and about the support they received. They told us they were happy with the service and how their needs were being met.

The service does not employ other staff to work at the service as this person lives as part of the registered providers and registered manager’s family. Policies and procedures were in place should the service employ staff when the number of people living in the service increases.

People were relaxed and observed to be happy with the registered manager, registered provider and their family. Care records were detailed and personalised to meet their needs. People were involved as much as possible with their care records to say how they liked to be supported. People were offered choice and their preferences were respected.

Care records contained information that described what personalised care and support people needed. Where appropriate health and social care professionals were involved in identifying people’s needs. People preferences, life histories, disabilities and abilities were taken into account, communicated and recorded.

People’s risks were managed well and monitored.

People were promoted to live full and active lives and were supported to go out and use local services and facilities. Activities were meaningful and reflected people’s interests and individual hobbies.

People were supported to maintain a healthy balanced diet. People enjoyed the meals offered and had access to snacks and drinks at any time. People were involved in planning menus, food shopping and preparing meals as much as possible. People were supported to say if meals were not to their liking.

People had their medicines managed safely and received their medicines as prescribed. People were supported to maintain good health through regular access to health and social care professionals, such as GPs and psychiatrists.

The service supported people to share their concerns and complaints. The registered manager confirmed that, whilst they had never received any form of complaint, if they did, they would investigate the matter thoroughly. The outcome would be used as an opportunity for learning to take place.

People were kept safe and protected from discrimination. The registered manager and registered provider had undertaken training on safeguarding adults from abuse and equality and diversity. They displayed good knowledge on how to report any concerns and described what action they would take to protect people from harm.

People had their needs met by the registered manager who was appropriately trained and had the correct skills to carry out their roles effectively. The registered manager followed safe infection control processes.

Due to people’s complex needs people were not able to comment on all aspects of their care and support. However we were able to meet them and observed staff as they provided support. We also spent time looking at records and speaking to the registered providers (one who is the registered manager and the other the deputy manager) of Rielly’s House.

We observing the registered manager and deputy talking with people and treating them respectfully and their choices promoted. The relationships we observed between the providers and people who lived in the home were positive and this helped to create a safe and homely environment for the people who used the service.

We looked at care files and found the care and support plans identified people’s needs. This may mean that staff had the information they needed and people’s care needs were met.

During our visit to the home we saw sufficient staff on duty to meet the needs of the people who lived in the home. We spoke with the providers who were working during our visit.

We saw that Rielly’s House held all records securely to protect people’s confidentiality.

During our visit we spoke with the two people who lived in the home. We spoke with one staff member and one of the owners.

We examined the care files belonging to the two people who lived in the home. We found that people had been involved in drawing these up. They were up to date with information about various aspects of people's needs and how people wanted those to be met by the staff team.

People told us that they were happy living in the home and had their own personal routines and activities. People were involved and supported to make decisions about their care and support needs and these were well met by the staff team. The people who talked to us about life in the home said "everything's OK", that it was "all right" living in the home, and the staff were "nice". People saw healthcare professionals on a regular basis or when they needed them.

Staff were friendly and respected people's rights to privacy, dignity, and independence. There were enough staff on duty to meet people's needs with additional staff available when required. Staff said they had received training to enable them to carry out their roles competently.

There were effective systems in place for monitoring the quality of care, safeguarding people from abuse, and administering medication. Legal safeguards, which protect people unable to make decisions about their own welfare, were understood by staff and used to protect people's rights.

We carried out a responsive inspection of Rielly's House due to concerns raised about the care of people who lived in the home. As part of this inspection we made unannounced visits to Rielly's House on 27 April and 23 May 2012. At the time of this inspection there were three women living in the care home and three care staff were employed who also carried out catering and domestic tasks. The owners, one of whom was the registered manager, worked as part of the care team.

During the course of our visit we talked with the three people who lived in the home. We spoke with two staff members and one of the owners. After our visits we spoke with a health care professional who visited the home on a regular basis.

We also looked at records relating to the care and support people received, staffing, and policies and procedures relating to the operation of the care home.

On our first visit to the home the people who lived in Rielly's House said they were satisfied with the care provided and had no complaints. Comments from people who lived in the care home included "it's a nice place", "they are very reassuring" and "the staff are my family". However, on our second visit to the home, one of the people who lived there made an allegation about one of the staff members and we made a safeguarding alert in relation to this. We found that, when we reported this allegation to the owner, he did not follow his own procedures in relation to the allegation.

During our visits we observed interactions between the staff and people who lived in the home and saw that staff were friendly, respectful, and attentive to the people they supported. People talked to us about their personal routines, the activities they enjoyed, and the meals provided in the home. People said there were enough staff on duty to meet their physical and health care needs supported by visiting healthcare professionals.

We found that people's rights to privacy, dignity and independence were not always respected. People were not consulted about the way the service was provided and delivered in relation to their care as they were not actively involved in the care planning process. Care plans were not comprehensive as they did not contain details of all the care and support needs that people had nor did they include their goals and aspirations for the future. Medication records were inaccurate and there were no guidelines in place about when, and under what circumstances, 'as required' medicines were to be given. Staff had not received appropriate training to enable them to properly support people with mental health needs.

We found that the registered provider has not kept us properly notified of significant events in the home that affected people's welfare, health and safety so that, where needed, action could be taken.

The provider had some elements of a quality monitoring system in place. However the issues we found during our visit identified that the system to assess and monitor the quality of service that people received was not effective.