Sapphire House is a ‘care home’. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Sapphire House accommodates up to 5 people who have a learning disability, in one adapted building. At the time of our comprehensive announced inspection on 22 January 2019 there were 4 people living in the home.

There was 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.

This was the first comprehensive inspection of this service.

At this inspection we found the provider to be in breach of four of the regulations.

Risks around fire safety were not appropriately managed. One person did not have a personal emergency evacuation plan and fire drills were not carried out. This meant the provider was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

A further breach of the regulations was found, this was because there were gaps in staff training and staff did not attend training in infection control and food hygiene. Therefore, the provider was in breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

The provider was also in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014. This was because there was a lack of governance processes in place which monitored the quality of the service being delivered. Some checks were being carried out but these did not provide a thorough oversight of the service.

We found the provider was in breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. This was because safeguarding and other important events were not always reported appropriately. Whilst the local safeguarding team had been informed, we were not notified of some events.

Staff understood what constituted abuse and had attended training in safeguarding. Staff also attended courses relating to people’s individual care needs such as challenging behaviour and autism.

Individual risks to people’s health and wellbeing had been identified and appropriate plans were in place to minimise known risks.

There were consistently enough staff to support people safely and there were safe practices around the recruitment of staff.

New staff completed an induction and shadowed experienced members of staff. Staff were further supported in their role through regular supervisions.

Full assessments of people’s care needs took place before they started living in the home.

Mealtimes in the home were relaxed and flexible to suit people’s needs. People were able to choose their own food and were supported to maintain a healthy diet.

Staff worked alongside healthcare professionals to provide collaborative care to meet people’s needs. Prompt referrals were made to healthcare professionals where there were concerns about a person’s health or wellbeing.

The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that the service was working within the principles of the MCA. People were involved in day to day decisions about their care and treatment and staff knew the importance and guidance around making a decision in a person’s best interest. Where people were deprived of their liberty, records relating to this had been completed in line with the Mental Capacity Act 2005.

Staff treated people in a kind and caring way and knew people’s care needs well. Staff were responsive to people’s needs and effectively communicated with people. People were supported to mainta