Our inspection was unannounced and took place on 18 April 2017 and was unannounced.

At our last inspection in November 2015 the service was rated overall as good but required improvement in one of the questions we ask, Is the service safe? This was because although overall medicines were managed adequately some additional safeguards were needed to enhance safety and ensure people’s health and wellbeing. Staffing levels also required a review to ensure that people would be supported appropriately and safely. During this, our most recent inspection, we found that these areas had been improved upon.

The provider is registered to accommodate and deliver personal care to eight people. Eight people lived at the home at the time of our inspection. People lived with a profound hearing impairment and/or had other needs. These included needs relating to old age, poor mobility, dementia and mental health conditions.

The manager was registered with us as is required by law. 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 were available to keep people safe, to allow care and support to be provided flexibly and to meet all people’s needs. Medicine systems demonstrated safety and confirmed that people had been given their medicines as they had been prescribed. Staff knew the procedures they should follow to ensure the risk of harm and/or abuse was reduced. Recruitment processes ensured that unsuitable staff were not employed.

Staff had received the training they required to give them the knowledge they needed to support people safely. Staff knew that people must receive care in line with their best interests and not be unlawfully restricted. People were encouraged to make decisions about their care. The staff supported people appropriately with their nutritional needs. Meal options were offered to ensure that people’s food and drink preferences were catered for. Input from external healthcare professionals was secured to meet people’s healthcare needs.

The provider ensured a homely friendly atmosphere within the service. People were supported by staff who were kind and caring. People were treated with dignity and respect. People were encouraged to make decisions about their care and support and their independence was promoted. People could receive their visitors at any time.

Systems were in place for people and their relatives to raise their concerns or complaints if they had a need to. People could attend religious services of their choice if they wished to. People accessed a range of leisure activities on a regular basis.

People, relatives and staff felt that the quality of service was good. The registered manager had been in post for 15 years and that promoted consistency of management. The registered manager and provider undertook regular audits to determine shortfalls or to see if changes or improvements were needed.

Our inspection was unannounced and took place on 23 November 2015.

At our last inspection in January 2014 the provider was meeting all of the regulations that we assessed.

The provider is registered to accommodate and deliver personal care to eight people. Seven people lived at the home at the time of our inspection. All people lived with a profound hearing impairment and also had a varied range of other needs. These included needs relating to old age, poor mobility, dementia and mental health conditions.

The manager was registered with us as is required by law. 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 were available to keep people safe but there was not always enough staff to allow care and support to be provided flexibly, to consistently meet all people’s needs.

Medicine systems demonstrated safety and confirmed that people had been given their medicines as they had been prescribed. However, some changes and new safeguards were needed to enhance safety and ensure people’s health and wellbeing.

Staff had received the training they required to equip them with the skills they needed to communicate with, and support, the people in their care.

Staff received induction and the day to day support they needed equip them with the knowledge and direction to undertake their job roles.

Staff knew the procedures they should follow to ensure the risk of harm and/or abuse was reduced.

Recruitment processes mostly ensured that unsuitable staff were not employed.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This ensured that people received care in line with their best interests and would not be unlawfully restricted.

People were supported by staff who were kind and caring. People were encouraged to make decisions about their care and support.

Staff supported people with their nutrition and dietary needs to promote their good health.

All people received assessments and/or treatment when it was needed from a range of health care and social care professionals which helped to promote their health and well-being.

Systems were in place for people and their relatives to raise their concerns or complaints.

People, relatives and staff felt that the quality of service was good. The management of the service was stable. The registered manager and provider undertook regular audits to determine shortfalls or to see if changes or improvements were needed.

As part of our inspection we spoke with two people using the service, two relatives, two members of staff and the registered manager.

We saw that care plans were comprehensive. People’s needs had been individually assessed. One relative told us, “All X’s welfare, communication and social needs are taken care of”. Records showed care was planned in a way that ensured people’s safety and welfare. One person told us, “Staff look after me”.

People and relatives we spoke with said they felt able to tell staff if they were unhappy or worried. We found that people who used the service were protected from the risk of abuse.

We sampled four staff files and found that appropriate checks had been undertaken in regard to staff working in the service. The people and relatives we spoke with were very complimentary about the staff caring for them. One relative told us, “Staff are brilliant; I never have to worry as they care for X perfectly”.

We saw quality monitoring programmes in place, which included people giving feedback about their care, support and treatment. This provided a good overview of the quality of the service provided.

We looked at records and these were easily accessible, securely stored and fit for purpose.

We spoke with four people with the assistance of an expert in British Sign Language, two relatives and four members of staff.

People told us that they were happy and that the care that they received was very good. One said, “It’s good here, the staff are nice and really kind”.

We saw that staff treated people with respect and supported them in a friendly and engaging manner that put them at ease. One person said, “They ask me what I would like to do”.

People’s needs were assessed and care and support were planned and delivered in line with their individual care plan. We spoke with four members of staff who were aware of people’s specific needs. One relative said, “It’s the best care they have ever had”.

The building had a suitable design and layout for the people who used it. We saw that the home was clean, tidy and in a good state of repair and décor. Furnishings were comfortable and modern and suitable for the needs of people.

Staff were well supervised and had completed all mandatory training required as well as some more specialist courses which allowed them to care more effectively for people with specific needs.

Nobody we spoke with had any complaint to make, nor had they made one previously. All were more than complimentary about the service. They told us they knew how to make a complaint should the need arise. The people we spoke with told us that they felt confident to raise any complaint either directly with a staff member or with the manager.

We talked to six people who lived at 60 Olive Lane, and three staff, about the care and support that is given to people. We talked to the people who live there with the help of an independent expert in British Sign language (BSL). The BSL expert signed all our questions to people and translated people's signed response into English. Everyone we talked with said they were happy with the staff and that they were friends with most of the other people who lived there.

We saw that people moved freely between the communal areas and their own rooms. We saw that their own rooms were arranged with their personal possessions and photographs. One person enjoyed showing us the knitting they had done. We saw that a cat wandered into one person's room. This person told us they liked having the cat around because they used to have a cat at their own home.

We saw that most people had lunch together with staff and the registered manager in the dining room. People appeared to enjoy the social aspect of dining together. People cleared their own plates and put them in the dishwasher and helped themselves to ice cream afterwards. This meant that people were encouraged and supported to be independent.

The staff that we talked with were knowledgeable about people's needs and abilities. Staff described people's favourite activities and long term goals. All the staff told us they enjoyed working at 60 Olive Lane and we saw how they made life enjoyable for the people who lived there. One member of staff said, “I just think we are all very lucky to work here really”.

We found that the manager regularly looked at people's individual care plans to make sure that changes were identified and care plans updated. The manager regularly asked people, their families and other professionals what they thought about the service. The manager listened to their comments and made appropriate changes.