We carried out an unannounced inspection on 15 and 16 December 2016. The inspection was completed on 4 January 2017 when we received information we had requested from the provider.

The service provides specialist support and treatment for up to six people living with eating disorders. Some of the people receive care and treatment within the frameworks of the Care Programme Approach (CPA) and Community Treatment Orders (CTO) of the Mental Health Act 2007. There were four people being supported by the service at the time of this inspection.

During our inspection of the service in September 2015, we found the provider did not always have safe recruitment processes in place and they did not have a system to enable them to continuously assess and monitor the quality of the service. Additionally, robust records had not always been kept in relation to staff supervision and training. We checked these areas during this inspection and we found they had made the required improvements.

There was a registered manager in post, who was also the provider of the service. 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 were safe because there were risk assessments in place that gave guidance to staff on how potential risks to people’s health and wellbeing could be minimised. There were systems in place to safeguard people and staff knew what to do if they suspected that a person was at risk of harm. The provider now had safe recruitment processes in place and there was sufficient staff to support people safely. People were supported to take their medicines safely.

There was now evidence that staff received regular supervision and they had been trained to meet people’s individual needs. Staff understood their roles and responsibilities to provide people’s care and treatment as set out by the Care Programme Approach (CPA) and Community Treatment Orders (CTO). Everyone supported by the service had mental capacity to make decisions about their care and treatment and therefore, the requirements of the Mental Capacity Act 2005 were not applicable.

People were supported by staff who were kind and caring, and their privacy and dignity was promoted. People were supported to meet their nutrition needs in a sensitive way and in accordance with their treatment plans. They had access to other healthcare services when required to maintain their health and wellbeing.

People had care and treatment plans that took account of their individual needs, preferences, and choices. They were fully involved in planning and reviewing their care, and were supported to manage their health conditions. People were supported to pursue their hobbies and interests, and were able to pursue a variety of activities outside of the home without staff supervision.

The provider had a system for handling complaints and concerns. They sought feedback from people and commissioners of the service in order to improve the quality of the service. The provider’s quality monitoring processes to enable them to assess and monitor the quality of the service had improved. However, they did not always keep robust records in relation to people’s medicines and staff recruitment processes.

We carried out an unannounced inspection on 28 September 2015.

The service provides specialist support and treatment for up to six people living with eating disorders. Some of the people receive care and treatment under the Care Programme Approach (CPA) and Community Treatment Orders (CTO), of the Mental Health Act 2007. There were five people being supported by the service at the time of this inspection and one person was in hospital.

There is a registered manager in post, who is also the provider of the service. 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 provider did not always have effective recruitment processes in place and this put people at risk of being supported by staff who might not be suitable.

People were safe and the provider had effective systems in place to safeguard them.

There were risk assessments in place that gave guidance to the staff on how risks to people could be minimised.

People were supported to manage their medicines safely.

There was enough skilled and experienced staff to support people safely.

The manager and the nurses understood their roles and responsibilities in relation to the care and treatment of people under the Care Programme Approach (CPA) and Community Treatment Orders (CTO).

Staff had received supervision and support that enabled them to support people appropriately, but this was not always clearly recorded.

People were supported to have nutritious food and drinks in order to maintain their health and wellbeing. They were also supported to access other health and social care services when required.

People were supported by staff who were compassionate and sensitive to their individual needs. Staff had received effective training so that they were able to understand people’s complex needs.

People’s needs had been assessed, and care plans took account of their individual needs, preferences, and choices. They were fully involved in planning their care and were supported to manage their health conditions.

People were supported to pursue their hobbies and interests, including acquiring qualifications.

The provider had a formal process for handling complaints and concerns. They encouraged feedback from people, their representatives, and health and social care professionals. They acted on the comments received to continuously improve the quality of the service.

The registered manager provided stable leadership, clinical expertise and managerial oversight. They encouraged staff to contribute to the development of the service.

The provider did not always evidence that they continually assessed the quality of the service provided. 

When we inspected Stockwood House on 17 September 2013 there were two people who currently used the service. We spoke with one person, and two members of staff. We found that people were treated with dignity and respect, and were encouraged to make choices about the care and support they received. One person said, “They are really quite good here, things are explained and I can give my opinion.”

The person we spoke with told us staff were kind, caring, and helpful and provided them with care that made them feel safe. Staff we spoke with were aware of the safeguarding policy and protocols they should follow.

We walked around the home to review the environment. We observed that all internal areas were clean, well decorated and in a good state of repair. We saw records of cleaning and maintenance tasks to be completed on each night shift, which were handed in at handover.

We looked at the recruitment records for four staff who worked at Stockwood House. We noted that personal files were well organised. They contained documentation which provided a clear audit trail which demonstrated that appropriate checks had been undertaken before staff commenced employment. People were made aware of the complaints system. Staff told us that they took all concerns seriously. The person we spoke with told us they knew how to raise a concern or complaint and said, “If I’m unhappy about anything I feel I would be listened to.”

We saw a robust system in place for ensuring that people in the service were actively involved in consenting to their care and support. A person living at the service said "They don't stop me doing the things I want. I come and go as I please. Its good like that." They also said "They fully involved me in everything and listen to my thoughts and feelings."

People living at the service told us that they were involved in their care planning and the way things happen in the home. They said "We have weekly meetings where we can raise things. They are quite proactive."

We found that there was a system in place to support people with managing their medication and all the people using the service were able to manage their medication independently.

The staff employed by the service told us they felt supported in their job role and were able to access training to keep their skills up to date. They had the opportunity to review their skills in one to one supervision sessions and took part in staff meetings.

We saw that the provider had a system in place to review the quality of the service provided and there was a policy for people to raise concerns and complaints. People living at the service knew how to complain and one person living there said "I sent a letter and they acknowledged it telling me how they would deal with it."