The inspection took place on the 30 November and 6 December 2017 and was unannounced.

Stepping Stones Red Marley is a ‘care home’ with nursing. 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 care home accommodates 19 people in three ‘houses’ within one adapted building. At the time of our inspection visit there were 19 people using the service. People were supported with mental health conditions and learning disabilities with some having associated behaviour difficulties.

At the last comprehensive inspection on 21 and 25 August 2015, the service was rated Good. At this inspection we found the service remained Good overall.

We received positive comments from health and social care professionals about the home such as, “I have certainly never had any concerns and I must say I think they do an absolutely wonderful job” and “Good knowledge and understanding of individual residents and their needs.”

Staff and management understood how to protect people from harm and abuse. Risks to people's safety were identified, assessed and appropriate action was taken to keep people safe. People's medicines were safely managed. People were supported by sufficient numbers of staff who had been recruited using thorough checks.

People were supported by staff who had training and support to maintain their skills and knowledge to meet their needs. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People whose behaviour could put themselves and others at risk received support in accordance with current best practice. Staff received training to manage people’s behaviour with further training planned.

People were treated with dignity, respect and kindness and were involved in the planning and review of their care and support. People were supported to maintain and develop their independence.

People received individualised care which reflected their personal preferences, wishes and routines. There were arrangements to investigate and respond to complaints.

The registered manager was visible and accessible to people and staff. Quality checks were made with the aim of improving the service in response to people's needs.

Further information is in the detailed findings below.

The inspection took place on the 28 March 2017 and was unannounced. We previously inspected the service on 21 and 25 August 2015 where we found a breach of regulation 13 of the Health and

Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to a lack of applications for legal authorisation to deprive people of their liberty.

Stepping Stones Red Marley is a care home with nursing for 19 people with mental health conditions and learning disabilities.

People’s rights were now protected by the use of the Deprivation of Liberty Safeguards (DoLS). Applications had been made for three people for legal authorisation to deprive them of their liberty.

At the time of our inspection visit Stepping Stones Red Marley 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 spoke with two people who were using the service. They confirmed that they were involved in the way their house units were run, by being part of meetings and making suggestions for change, which were listened to and taken seriously. They described the personalised activities programmes, which they enjoyed and provided structure to their days.

The staff team was organised in a way to maximise people's individuality and independence. We saw the interaction between the staff and people living at the home to be friendly, supportive and geared to each person as an individual.

People's clinical needs, their mood and behaviour were under constant review by staff. We were told that this data was collated and reproduced in a detailed report by the assistant psychologist, which we saw on care files. This information was used to support people on a daily basis and at reviews, to assist in making decisions about people's care.

We spoke to two people who were using the service. They confirmed that meetings had been held to make decisions about activities. They also told us that staff respected their privacy. People told us about the health checks they received and commented that their individual rooms were "alright".

The inspection took place on the 21 and 25 August 2015 and was unannounced.

Stepping Stones Red Marley is a care home with nursing for 19 people with mental health conditions and learning disabilities.

Stepping Stones Red Marley had a registered manager. 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.

Although there was an understanding and correct use of the Mental Capacity Act 2005, the associated Deprivation of Liberty Safeguards (DoLS) had not been used correctly to uphold people’s rights.

People were protected from the risk of being cared for by unsuitable staff because robust recruitment practices were operated. Medicines were well managed. People were supported by sufficient numbers of staff who received appropriate training and had the right knowledge and skills to carry out their role. People were protected from the risk of abuse by staff who understood safeguarding procedures.

People were supported by staff with the knowledge and skills to carry out their roles. People were active in choosing menus and received support to eat a varied diet. They were supported to maintain their health through support in accessing healthcare.

People were treated with kindness, their privacy and dignity was respected and they were supported to develop their independence.

People received individualised care through regular review and consultation by staff. They were enabled to engage in a range of activities both in the care home and in the wider community. There were arrangements to respond to any concerns and complaints by people using the service.

The vision and values of the service were clearly communicated to staff. The registered manager maintained an accessible presence at Stepping Stones Red Marley. Quality assurance systems were in place to monitor the quality of care and safety of the home. As part of this, the views of people using the service were taken into account and responded to.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.