We inspected Sheldon Ridge on the 27 June 2018. The inspection was unannounced. At our last inspection in December 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

Sheldon Ridge is located in the Bierley area of Bradford and provides nursing and accommodation to 12 people who have a learning disability and complex needs. Accommodation is split into two ground floor units each containing single occupancy bedrooms. Each unit has its own dining and lounge area. To the exterior of the building there is a communal garden.

Sheldon Ridge is a ‘care home.’ People in care homes receive accommodation and nursing or 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.

The service was working in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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.

People who used the service were unable to verbally communicate with us therefore we observed people’s gestures and body language to determine their level of engagement with staff. People appeared comfortable and relaxed in the company of staff and staff clearly understood people’s individual methods of communication.

Policies and procedures ensured people were protected from the risk of abuse and avoidable harm. Staff told us they had regular safeguarding training, and were confident they knew how to recognise and report potential abuse. Where concerns had been brought to the registered manager’s attention, they had worked in partnership with the relevant authorities to make sure issues were fully investigated and appropriate action taken to make sure people were protected.

The registered manager and staff were observed to have positive relationships with people living in the home. People were relaxed in the company of staff and there were no restrictions placed on visiting times for friends and relatives.

From our observations it was clear staff knew individual people well and were knowledgeable about their needs, preferences and personalities.

Appropriate Deprivation of Liberty Safeguard (DOLS) applications had been made to the local authority and people's mental capacity to make their own decisions had been assessed and recorded in line the requirements of the Mental Capacity Act 2005. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

Each person had a support plan that was person centred and sufficiently detailed to ensure they were at the centre of their care. People’s care and support was kept under review and, where appropriate, they were involved in decisions about their care. Risks to people’s health and safety had been identified, assessed and managed safely. Relevant health and social care professionals provided advice and support when people’s needs changed.

There were enough staff on duty to support people when they needed assistance. However, the deployment of staff and the skill mix on some shifts was not always appropriate to meet people's needs.

The registered manager followed a robust recruitment procedure to ensure new staff were suitable to care for vulnerable people and arrangements were i

Sheldon Ridge is located in Bierley, Bradford and provides nursing care and accommodation to 12 people who have a learning disability and complex needs. Accommodation is split into two ground floor units each containing six single occupancy bedrooms. Each unit has its own dining and living areas. To the exterior of the building is a communal garden.

The inspection was unannounced and took place on 14 and 15 December 2015.

A registered manager was in place. 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. The registered manager was responsible for the strategic oversight of the home, with a home manager in post, who was responsible for the day to day running of the home.

People who used the service were unable to verbally communicate with us, however we extensively observed care and support including people’s gestures and body language. We observed kind and caring interactions between staff and people who used the service. People appeared comfortable and relaxed in the company of staff and staff understood people’s individual methods of communication.

Relatives told us that people using the service were safe and did not raise any concerns with us.

Staff had a good understanding of how to identify and act on allegations of abuse and we saw examples where action had been taken following incidents to keep people safe.

Medicines were safely managed. People received their medicines as prescribed and at times that met their individual needs.

There were sufficient numbers of staff deploy to ensure safe care and support. Staff were safely recruited to help ensure they were of suitable character to work with vulnerable people.

The service adopted a personalised approach to risk management. Risks to each individual were thoroughly assessed by the service and a highly individualised plan of support put in place to help keep people safe.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act (MCA).

People were supported appropriately to eat and drink and maintain good nutrition. People’s weights were regularly monitored and health professional input sought where risks were identified.

Staff received a range of training which was kept up-to-date. Staff we spoke with demonstrated a good understanding of the people and topics we asked them about indicating this training had been effective.

Relatives we spoke with said staff were kind and caring and praised the high level of attention to detail and personalised support provided by the service. Relatives told us staff had gone the extra mile in ensuring individualised support and activities were provided to people. Staff displayed an excellent understanding of the people they were caring for and a motivation and passion to providing a caring service.

The service had put considerable time and resources into providing creative care solutions to identified problems such as privacy, dignity and distress. We saw these had been effective in improving people’s care and support outcomes.

People’s needs were fully assessed and a range of care plans put in place. Staff we spoke with were knowledgeable about people’s plans of care and we saw examples of these plans being followed.

A range of activities were provided to people which met their individual needs. We found documentation of the activities people had been involved in was not consistently in place, although plans were in place to address.

The service had not reported all statutory notifications to the Commission as it had not notified us of all safeguarding referrals made to the local authority.

A range of audits and checks

During our inspection we looked for the answers to five questions;

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, staff supporting them and from looking at records.

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff we spoke with understood how to safeguard the people they supported.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

People’s health and care needs were assessed with them, and they were involved in writing their plans of care.

People’s needs were taken into account with signage and the layout of the service enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People knew how to make a complaint if they were unhappy. People told us they had never needed to make a complaint but if they did they thought complaints would be investigated and action taken as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

Staff had attended several training courses which took into account the needs of the people who used the service. This ensured that people's needs were met.

Where people who used the service were unable to verbalise their needs, we saw advocates or members of their family, had been involved in making decisions about their care and treatment.

Some people who lived at Sheldon Ridge, due to their complex health needs, were unable to tell us their experiences. So we observed how staff talked with people and provided their care and support. We observed lunch time and saw staff were warm and accepting of people. They explained their actions to people and provided them with choices. Our observations demonstrated to us people who lived at Sheldon Ridge experienced care, treatment and support which met their needs.

We talked with a relative of a person who used the service, they told us they were satisfied with the care and treatment their relative had received. They told us staff were respectful and responded promptly when their relative needed help. The relative said "the staff were so lovely and really good".

We found safeguarding processes were in place and staff understood the different types of abuse and how to report any concerns.