We conducted an inspection of Ringstead House on 27 November 2017. We previously inspected the service on 29 September 2015 and found the service was in breach of the regulation relating to safe staffing levels. The service was rated good overall. Following the last inspection, we asked the provider to complete an action plan to show what they would do to improve staffing levels. At this inspection we found appropriate actions had been taken to provide safe staffing levels and meet all the fundamental standards

Ringstead House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The service provides care for up to four people and there were four people using the service when we visited.

The service had a registered manager, which 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.

Risk assessments and care plans contained a good level of information for care staff about known risks and guidance for how they were expected to mitigate these.

Staff followed safe practices for administering, storing and recording medicines given to people.

Staff demonstrated an understanding of people’s life histories and current circumstances and supported people to meet their individual needs. People were supported to access activities they enjoyed. Care records included information about activities people attended and how staff could support them to do so.

The service ensured people's privacy and dignity was respected and promoted.

People were supported with their nutritional needs. Care records contained information about people’s dietary needs. Care was delivered in line with relevant legislation and standards.

Safeguarding adults from abuse procedures were in place and care workers understood how to safeguard people they supported. Care workers had received safeguarding adults training and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.

Staff demonstrated knowledge of their responsibilities under the Mental Capacity Act 2005 (MCA). Care records contained details of people’s capacity and were signed by people using the service or those lawfully acting on their behalf.

People told us they were involved in decisions about their care and how their needs were met.

Recruitment procedures ensured that only staff who were suitable worked within the service. The service also ensured there were sufficient numbers of suitable staff to support people.

Complaints were investigated and responded to in a timely manner.

Staff had the skills, knowledge and experience to deliver effective care and support, and received support for their roles. There was an induction programme for new staff which prepared them for their role.

Quality assurance processes were thorough. Senior management completed a variety of audits and ensured learning was undertaken from these.

The provider had a vision to deliver high-quality care and support. Staff demonstrated that they were clear about the values of the organisation and how these supported their work.

We conducted an inspection of Ringstead House on 27 November 2017. We previously inspected the service on 29 September 2015 and found the service was in breach of the regulation relating to safe staffing levels. The service was rated good overall. Following the last inspection, we asked the provider to complete an action plan to show what they would do to improve staffing levels. At this inspection we found appropriate actions had been taken to provide safe staffing levels and meet all the fundamental standards

Ringstead House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The service provides care for up to four people and there were four people using the service when we visited.

The service had a registered manager, which 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.

Risk assessments and care plans contained a good level of information for care staff about known risks and guidance for how they were expected to mitigate these.

Staff followed safe practices for administering, storing and recording medicines given to people.

Staff demonstrated an understanding of people’s life histories and current circumstances and supported people to meet their individual needs. People were supported to access activities they enjoyed. Care records included information about activities people attended and how staff could support them to do so.

The service ensured people's privacy and dignity was respected and promoted.

People were supported with their nutritional needs. Care records contained information about people’s dietary needs. Care was delivered in line with relevant legislation and standards.

Safeguarding adults from abuse procedures were in place and care workers understood how to safeguard people they supported. Care workers had received safeguarding adults training and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.

Staff demonstrated knowledge of their responsibilities under the Mental Capacity Act 2005 (MCA). Care records contained details of people’s capacity and were signed by people using the service or those lawfully acting on their behalf.

People told us they were involved in decisions about their care and how their needs were met.

Recruitment procedures ensured that only staff who were suitable worked within the service. The service also ensured there were sufficient numbers of suitable staff to support people.

Complaints were investigated and responded to in a timely manner.

Staff had the skills, knowledge and experience to deliver effective care and support, and received support for their roles. There was an induction programme for new staff which prepared them for their role.

Quality assurance processes were thorough. Senior management completed a variety of audits and ensured learning was undertaken from these.

The provider had a vision to deliver high-quality care and support. Staff demonstrated that they were clear about the values of the organisation and how these supported their work.

This inspection was carried out by an inspector who gathered evidence to answer our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Safeguarding and restraint procedures were in place and staff were trained and understood how to safeguard the people they supported. Risks were assessed for people and actions were taken to address any risk promptly.

Deprivation of liberty safeguards (DoLS) were obtained before people were restricted in anyway in accordance with the Mental Capacity Act 2005. Best interest assessment was carried out to ensure it was done for the best interest of the person.

Is the service effective?

People were involved in their care, support and treatment. The provider cooperated with other health professionals in the planning and coordination of their care and treatment. People were supported to access services as required. People’s support plans were tailored to reflect their individual needs and the outcomes they wanted to achieve.

Is the service caring?

Staff understood the needs of people they supported. They treated people with dignity and respect. Staff showed understanding of the needs of people they supported and their different circumstances. Interactions between people and staff were positive and open.

Is the service responsive?

People were supported to participate in activities within and outside the home. There was effective joint working between the home and other professionals to ensure the service responded to people’s needs. Support plans and risk assessments were reviewed monthly and reflected the changing needs of people.

Is the service well-led?

There was a range of quality assurance systems in place. External auditors visited annually to assess the quality of service. Monthly review meetings, daily handover meetings, meetings for people using the service and staff meetings took place where the quality of service was discussed. Staff and people using the service told us their views were listened to and feedback was used to improve the service.

There were two people using services at Ringstead House when we inspected. We spoke with both residents and they did not raise any concerns about living at Ringstead House.

We observed staff interactions with the residents and found them supportive and respectful.

People were supported to maintain their independence, get involved in various community based activities and attend college courses of their choice.

Ringstead House was clean, well maintained and free from unpleasant odours.

There were sufficient members of staff on duty at Ringstead House, and they had suitable training and experience in caring for people with mental health conditions.

As this was an unannounced night visit, there was no opportunity to speak to people using the service.

Two people using the service spoke with us about their care and support experiences in the home. One person told us, “My key worker is someone that supports me and gives me the help I need.” Another person told us, “I’ve been going to college, studying Maths, English and Music. They [the staff in the service] have been helping me with using the internet. I enjoy it.”

Throughout our inspection, we observed staff interactions with people using the service. We found that staff were friendly, approachable and supportive, yet professional in their interactions with people using the service.

People were protected from unsafe or unsuitable equipment because the provider followed appropriate guidelines that ensured people had access to safe equipment. All electrical equipment was Portable Appliance Testing (PAT) tested, fire safety equipment was in place and suitable furnishings were in place.

There were effective recruitment and selection processes in place, and appropriate checks were undertaken before staff began work.

Arrangements were in place to monitor the quality of the service, which included residents’ meetings, key work sessions, and regular health and safety monitoring checks.