The inspection took place on 9 November 2016 and was unannounced. Barclay House provides care and accommodation for up to nine people. The home specialises in meeting the needs of adults with a learning disability, mental health diagnosis, acquired brain injury and a visual impairment. The main house accommodates seven people and there are two separate flats on the site to accommodate two other people. On the day we visited nine people were living in the service.

The service had 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.

We met and spoke with eight people during our visit. People were not always able to fully verbalise their views and used other methods of communication, for example objects and assisted technology. We therefore spent some time observing people. One person said; “I feel safe with here.” One person said; “The best home I’ve stayed in. I’m happy living here.” A staff member said; “If I had a family member who needed care I would bring them here!”

People were engaged in different activities and enjoyed the company of the staff. There was a calm and relaxed atmosphere within the service. One person said; “I go out to a day centre some days.”

People who were able to said they were happy with the care the staff provided. People were encouraged and supported to make decisions and choices whenever possible in their day to day lives.

People had their privacy and dignity maintained. Staff were observed supporting people with patience and kindness.

People had visits from healthcare professionals. For example, GPs and occupational therapists, to ensure they received appropriate care and treatment to meet their healthcare needs. People received the care they needed to remain safe and well. For example, people had regular visits by community nurses and support to access specialist epilepsy nurses.

People’s medicines were managed safely. Medicines were stored, given to people as prescribed and disposed of safely. Staff received appropriate training and understood the importance of safe administration and management of medicines. People were supported to maintain good health through regular access to health and social care professionals, such as specialist epilepsy nurses.

People’s care records were detailed and personalised to meet people’s individual needs. Staff understood people’s needs and responded when needed. People were not all able to be fully involved with their support plans, therefore family members or advocates supported staff to complete and review the support plans. People’s preferences were sought and respected.

People’s risks were documented, monitored and managed well to ensure they remained safe. People lived full and active lives and were supported to access local areas and activities. Activities reflected people’s interests and individual hobbies. People were given the choice of meals, snacks and drinks they enjoyed whilst maintaining a healthy diet. People told us they enjoyed their meals and there was plenty of food available. We observed people, who required it, being supported at mealtimes. One person said; “The food is very good.”

Staff understood their role with regards to ensuring people’s human and legal rights were respected. For example, the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS) were used appropriately. People’s right to choose, safety and liberty were promoted.

Staff had completed safeguarding training and had a good knowledge of what constituted abuse and how to report any concerns. Staff described what action they would take to protect people against harm and were confident any incidents or alle

People's health and welfare needs had been assessed and monitored. Care plans were person centred and holistic. People who lived at the home told us they were very happy with the support they were provided. Records confirmed people’s health care needs had been monitored and referrals had been made to health care professionals when needed.

One person told us “Staff are kind to me”.

Another person told us “I can do pretty much what I want. I choose and the staff support me”.

The home worked in co-operation with others. We saw that each person’s care was reviewed annually and that relevant health care and social care professionals had been involved in this process. The home worked in accordance with the local protocol for the safeguarding of adults at risk.

The arrangements for the ordering, storage and administration of medicines were safe. People were supported to administer their own medicines when it had been assessed as safe to do so.

People were protected from unsafe or unsuitable equipment. Systems were in place to ensure that equipment was regularly well maintained, tested and serviced. Furniture and fittings were comfortable and met people's needs. People had access to specialist equipment that promoted their independence.

Recruitment practices were safe and staff with relevant skills and experience had been recruited. People who lived in the home participated in the interviewing of prospective staff.

Three people we spoke with and a relative of another person told us they were happy living in the home and felt that they felt safe. We noted that staff knew people well and had the skills they needed to effectively communicate with the people living there.

It was evident from the smiling, laughter and positive interactions we observed, that people were happy and relaxed with each other and with the staff team. We observed people moving freely throughout the home and grounds and were clearly comfortable with their surroundings.

We noted that people initiated their own activities and that staff supported them to do this. Staff showed patience, understanding and gave encouragement to people when supporting them. People were asked about their preferences in relation to food and drink and involved in discussions around planning activities and outings.