This inspection was carried out on the 18 January 2017 and was unannounced.

Roberta House is registered to provide accommodation and personal care for up to 16 people. Most people were living with Korsakov’s syndrome and had a history of alcohol dependence. Korsakov’s syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1). The outcome is that people have short-term loss and have difficulty acquiring new information or learning new skills. People required support with processing and retaining information. The service supported them to be as independent as possible.

The service is situated close to another care home service run by the same provider and shares staff and management with the other service.

The service had a registered manager in post. A registered manager is a person who is 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.

The management team had identified that some necessary training had not taken place and regular one to one meetings when staff could reflect on their practice were overdue. Sometimes, in extreme circumstances, when people exhibited behaviours that could be challenging the staff were directed to physically intervene but they had not received the training to do this safely. There was a plan in place to rectify this, but it had not yet been completed; so this was an area for improvement.

Regular health and safety checks were undertaken to ensure the environment was safe and equipment worked as required. The gas certificate for the service was out of date. The registered manager immediately booked someone to come and check it was safe. Regular fire drills were completed.

People were actively involved in writing their support plans and risk assessments. They identified goals to work towards and these were consistently met. An in-house cognitive behavioural therapist worked with people to help them understand their condition and how it impacted on their lives. Cognitive behavioural therapy is a talking therapy that can help you manage your problems by changing the way you think and behave.

People took part in a variety of activities inside and outside of the service. Some people organised their own activities, and arranged themed nights based on their individual choices and interests. Complaints were investigated and responded to promptly.

Staff knew how to recognise and respond to protect people from abuse. The registered manager was aware of their responsibilities regarding safeguarding and staff were confident the registered manager would act if any concerns were reported to them.

There was enough staff to keep people safe. Staff were checked before they started working with people to ensure they were of good character and had the necessary skills and experience to support people effectively.

People were supported to make decisions about their lives and gave consent when able. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLS applications had been made to the relevant local authority, in line with guidance.

People were supported to eat and drink a range of healthy and nutritious food. Food was prepared at the provider’s other service and was served warm. Food appeared home cooked and appetising.

Risks relating to people’s health, mobility and behaviours had been assessed and minimised where possible. People received their medicines when they needed them. Staff had sought advice and guidance from a variety of heal