St Brannocks is a small residential care home for up to six people with a learning disability. The service supports people to access the community and to develop their independent living skills as much as possible. At the last inspection on 13 August 2014, the service was rated Good. At this inspection we found the service remained Good.

People were safe at the service. Staff knew about abuse and to report any concerns that they had. Risks to people were well-managed and staffing levels were sufficient to ensure people received the care they needed. People's medicines were administered by the service and there were systems in place to ensure that this was done safely.

Staff had the training and support they needed for their roles. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Nutritional needs were being met and people were supported to attend appointments with healthcare professionals.

There were positive relationships between people and members of staff. Staff adapted their communication and involved people and their families in decisions about their care. People's privacy and dignity was maintained by members of staff.

Care was person-centred. People had individual care plans in place which provided staff with information about specific goals, preferences, needs and abilities. Activities were provided in the service and local community and the feedback of people and their family members, including complaints, was welcomed.

There was a positive culture at the service and staff members were motivated by their roles. The registered manager had a visible presence and was known to people, relatives and staff. There were quality assurance processes in place to monitor and review the care being provided.

The leadership of the service had changed since the last inspection; we found that staff morale had improved and staff felt opportunities to express their views had improved. Staff told us they felt valued and listened to.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

We inspected St Brannocks on 13 August 2014. This was an unannounced inspection which meant the staff and the provider did not know we would be visiting. Our previous inspection was on 22 April 2013, and the home was meeting the regulations assessed.

This home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the home and has the legal responsibility for meeting the requirements of the law; as does the provider.

St Brannocks can provide care and support to seven people with learning disabilities. At the time of the inspection six people were living at the service. There was a low staff turnover and many staff had worked with the same people for a number of years. We saw that staff understood people’s needs, and care was provided with kindness and compassion. Staff actively supported people to make everyday decisions for themselves. Some people also undertook their own administration of medicines and there were appropriate arrangements in place for the safe management of medicines. People were enabled to lead a busy lifestyle doing the things that they wanted to do.

Although systems were in place to provide staff with opportunities to express their views through staff meetings and one to one supervisions, staff said they did not particularly value these. This was due to past experiences when they did not feel they had been listened to, and for them many issues remained unresolved. As a result staff morale was low, but we found staff demonstrated a commitment towards the people they supported to provide a good level of support that was unaffected by how they were feeling. We found that whilst the provider had made progress in providing appropriate training to staff, further team and skill building was needed.

Thorough recruitment practices were in place to ensure that appropriate checks of new staff were undertaken. New staff received an induction when they started work at the home. Interviews with staff and records viewed showed that they were appropriately trained and skilled to provide care in a safe environment. Staff understood their roles and responsibilities but some felt that sometimes other staff could be inconsistent in the messages they gave to people and that the overall flow of communication in the home could be improved.

Discussions with staff and our observations showed us that there were enough staff to support people. Throughout our inspection we saw that staff treated people with kindness, patience and respect, and that staff consulted with them about all aspects of their support. We saw that the home was mindful of the need for some people to have space away from others and had re-arranged furniture in shared areas to help this.

An in-depth quality assurance process was in place that involved ongoing monitoring by the registered and area managers, with further monitoring undertaken by an internal compliance team. We saw that where issues were highlighted, action plans were drawn up and timescales for improvement set.

People living at the service told us they liked living there, the staff were nice and they felt safe. An existing staff member had taken on the role of activity coordinator and we saw that people participated in activities they enjoyed. One person told us the service was “fantastic”. A relative told us “The service is so much better now. [Their relative] is much happier and goes out more often”.

People were supported to consent to their care and treatment. There was written guidance available to staff around the Mental Capacity Act 2005 and staff had undertaken training in the subject. Staff were able to demonstrate their knowledge related to safeguarding and the procedure to follow.

People received care that met their needs and promoted their rights. People’s care was reviewed regularly and service delivery was amended accordingly. Advice and guidance was sought from health and social care professionals to be able to meet people’s needs effectively and promote their welfare and safety.

There were enough staff on duty to be able to meet people’s needs effectively. Staffing levels were adjusted to reflect people’s needs. One person had one to one support to assist in reducing behaviour that could be described as challenging.

Information about how to make a complaint was available to people in an accessible format. Complaints were investigated and action was taken to address the issues identified.

As part of the inspection we visited the service and saw it was part way through an extensive refurbishment project of the entire premises. The manager had been in post three weeks.

During the inspection we spoke with people using the service and they told us they liked living there. People told us they felt safe and supported by the staff. A person told us the staff “make sure I am alright,” adding “they give me support to write letters, help cook dinners and take me out to the cinema. They take good care of me”.

A relative told us that their relative “seems to like it there”. Another relative told us the manager was a “breath of fresh air” and that their relative always looked forward to returning to the service after visiting family. During the inspection we observed positive interactions between people and staff and saw they were able to meet the needs of the people at the service.

However, we spoke with staff who told us they did not always feel supported in their role; they did not always receive supervision frequently. Staff were not always able to share information about practice and service delivery because team meetings were not always held frequently.

We looked at records and saw that care plans did not always contain up to date risk assessments to reflect the current needs of people who lived at the service. Complaints were not always logged to enable them to be responded to and inform service delivery.