Seventrees is a care home. People in care homes receive accommodation and their care as a 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. Seventrees provides care for up to eight adults living with a range of learning difficulties and mental health needs. At the time of our inspection there were eight people living at the home some of whom also lived with physical disabilities. The service is located in a residential area and has an accessible garden and parking. For some people, the service was their long term home. Others were being supported to achieve independent living skills enabling them to move on to supported living settings.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

At our last inspection we rated the service good. At this inspection we have rated the service as requires improvement as we found concerns in some of the areas we inspected. For example, the recruitment practices and checks were not always sufficiently robust.

Overall, the design and layout of the premises met people’s needs, but some of the décor in the communal areas was tired and worn and could be more homely and reflective of people’s interests and individuality.

Whilst staff felt well supported, they had not always been receiving regular supervision and none of the staff who had worked at the service for more than a year had had an appraisal

The leadership team understood the requirements of the Mental Capacity Act (MCA) 2005 although the documentation in place did not always support this. Action is being taken to address this.

Other areas remained good.

Staff understood how to recognise and respond to abuse and had a good understanding of risks to people’s health and wellbeing. Incidents and accidents affecting the safety of people were investigated to make sure that any causes were identified and action taken to minimise any risk of reoccurrence.

Medicines were managed safely.

There were sufficient numbers of experienced staff to meet people’s needs.

There was evidence that the care provided at Seventrees was being delivered in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. People were encouraged to live their life in the same way as any other citizen and their choices, independence and inclusion were encouraged.

People were supported to have enough to eat and drink and their dietary needs were met. Staff worked effectively with a range of other healthcare professionals to help ensure people’s health care needs were met.

People were supported by staff who were kind and caring. People were cared for with dignity and respect and staff were mindful of their need for privacy.

Staff understood the needs of the people they supported and this enabled them to care for them in a person centred manner that was responsive to their individual needs.

People were supported to take part in a range of leisure activities and follow their own interests.

The registered manager used complaints or concerns to understand how they could improve or where they were doing well.

Further work was planned to ensure that staff had information about people’s wishes and preferences for how and where their care should be provided at the end of their life.

Feedback about the registered manager was positive and people and staff felt the service was well led. There were systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving the best possible support.

During our inspection we spoke with two people who use the service, two members of staff, the registered manager and the service manager. We reviewed three support plans and three personnel records.

People who use the service told us that staff asked for their consent. One person said “They’re good like that.” Another confirmed that they often refused a shower and that staff respected their wishes and offered a shower at other times.

We observed interactions between staff and people during our visit and saw that staff communicated with people in a sensitive and caring way. People who use the service confirmed they were happy with the care and support they received describing it as ‘good.’ They told us that the staff were kind to them and listened to them.

Medicines were administered safely. We spoke to two members of staff who confirmed they had received medication administration training and that this was updated every two years.

Appropriate checks were undertaken before staff began work. We reviewed personnel records which showed that all three staff had undertaken a Criminal Records Bureau (CRB) check or a Disclosure and Barring (DBS) check before they started work.

People who use the service, their representatives and staff were asked for their views about their care and they were acted upon. A survey involving staff and people who use the service was carried out annually.

We looked at the care plans for all eight people and other documentation at the service. We observed people being supported by staff. We saw that people's privacy, dignity and independence was respected and that people's views and experiences were taken into account.

We were told by a family member that Seventrees was a "nice home" and two people told us they liked living at Seventrees. One person had moved into the home in March 2012. The individual needs of the person had been assessed and significant positive outcomes had been experienced by that person. People experienced care, treatment and support that met their needs and protected their rights.

Through looking at safeguarding referrals that had been made, reviewing arrangements for staff training, talking to staff and reviewing care plans. We found that people were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff rotas, staff training records and observing staff supporting people demonstrated that there were enough qualified, skilled and experienced staff to meet people's needs.

The provider had in place systems that sought people's views, took account of complaints and comments and learnt from investigations into accidents and incidents. This meant the provider had an effective system to assess and monitor the quality of service.

People we spoke with said they liked living at Seventrees and staff provided good support. One person said staff treated them very well and they didn’t want to move. People told us they liked the food and said there was a choice of meals available.

People felt they had everything they needed in the home and said that it was comfortable.

Seventrees is registered to provide accommodation for persons who require personal care for up to eight people with a learning disability or autistic spectrum disorder. This service does not provide nursing care.

The home has eight en-suite bedrooms, a lounge, dining room and a conservatory. Five of the bedrooms are situated on the ground floor and three bedrooms are situated on the first floor which are accessed stairs. The home is located in Fawley on the edge of the New Forest. Public transport and a range of shops are located within walking distance of the service. On the day of our inspection eight people were living at the home.

There was not 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 and associated Regulations about how the service is run. The manager had taken up their role in July 2015 and had submitted an application to become the registered manager at this location with the Care Quality Commission.

This inspection took place on 21 and 22 October 2015 and was unannounced.

The provider had systems in place to respond and manage safeguarding matters and make sure that safeguarding alerts were raised with other agencies.

People who were able to talk with us said that they felt safe in the home and if they had any concerns they were confident these would be quickly addressed by the staff or manager

There were sufficient numbers of qualified, skilled and experienced staff to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly. The provider operated safe and effective recruitment procedures.

Medicines were stored and administered safely. Clear and accurate medicines records were maintained. Training records showed that staff had completed training in a range of areas that reflected their job role.

Staff received supervision and appraisals which were on-going, providing them with appropriate support to carry out their roles.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager understood when an application should be made and how to submit one. They were aware of a recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.

People were involved in their care planning. Staff supported people with health care appointments and visits from health care professionals. Care plans were amended to show any changes and care plans were routinely reviewed to check they were up to date.

People were treated with kindness. Staff encouraged people to make their own choices and promoted their independence.

People were encouraged to take part in activities and leisure pursuits of their choice and to go out into the community as they wished.

People spoke positively about the way the home was run. The manager and staff understood their respective roles and responsibilities. The manager was approachable and understanding to both the people in the home and staff who supported them.

There were effective systems in place to monitor and improve the quality of the service provided. We saw that various audits had been undertaken.