Stoke House is a residential care home that provides care for up to 10 people who live with learning disabilities and mental health. Accommodation is on two floors. There are three communal areas and a garden people can use. At the time of our inspection 10 people were using the service.

At our last inspection in January 2015 the service was rated ‘Good’. At this inspection we found that the service remained ‘Good’ for being safe, effective, caring responsive and well-led.

People continued to receive safe care. Suitable staff were recruited and there were enough suitably skilled and experience staff to provide care and support to people to meet their needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision and training that they required to work effectively in their roles. The training and support staff received focused on the needs of the people using the service. People were supported to maintain good health and nutrition.

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 supported this practice.

People had positive relationships with the staff who were providing their care and staff treated people with respect, kindness and dignity.

People had plans of care that were focused on them as individuals. This allowed staff to provide consistent support in line with people’s personal preferences. People and their relatives were able to raise a concern if they had one. The provider had effective procedures to manage any complaints that they may receive.

The service had clear aims and objectives which were to support people to achieve and experience things that were important to them. People and staff told us that they felt confident that they could approach the registered manager and that they would listen.

There were quality assurance systems in place to monitor and review the quality of the service that was provided. The registered manager was supported by highly qualified staff at the provider’s head office.

Further information is detailed in the findings below.

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well lead?

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

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff demonstrated an understanding of the support required to enable people to make choices about their daily lives and their care. People received an assessment of their needs to identify any areas of risk in delivering their care. Staff reviewed people’s risk assessments to ensure any changes to people’s health and well-being were identified promptly. The provider completed a range of monthly safety checks to ensure fire detection equipment and systems had been regularly tested and maintained.

However, we saw that there were a number of repairs needed at the home. This included a broken window and broken items of furniture which were stored in the garden area and presented a risk to people who used the service. This meant there was a breach of the Health and Social Care Act regulations. A compliance action has been set and the provider must tell us how they plan to improve.

Is the service effective?

People’s health and care needs were assessed with them, and they and their family members were involved in writing their plans of care. People told us that they were happy with the level of care provided and liked living at Stoke House. We observed that people attended a range of activities and they told us they liked going out into the community. People also told us that they undertook daily tasks such as cleaning their bedrooms and participated in making the evening meal. We saw that a detailed programme of social and daily living activities were available to meet people’s needs.

Is the service caring?

People were supported by kind and attentive staff. People told us that they were happy living at Stoke House. One person said “The staff here are kind”. Another person said “The staff are all nice and they care about me”. We observed that staff supported people in a caring and respectful way and people enjoyed being with the staff working at the home.

Is the service responsive?

Staff had responded appropriately to a range of medical needs and we saw that medical professionals such as the G.P, psychiatrist and dentist were regularly involved in people’s care. People also told us that the food was good at Stoke House. One person said “We have plenty of food and I like the chips”. We observed staff prepare a home cooked meal which looked nutritious and appetising and people told us staff supported them to have a healthy diet.

We also observed people were excited about attending an evening disco. Some people told us the staff supported them to attend social activities of their choice which included going to local football matches.

Is the service well-led?

The service had a quality assurance system and included gaining regular feedback about the quality of service from people who used the service. We saw that the service worked well with other agencies to make sure people received their care in a joined up way.

Staff told us that the standard of care at the home had improved since the registered manager had joined the service. One member of staff told us that the registered manager was, “Nice and professional and does what needs to be done”. People also told us that they liked the registered manager. One person said “They are very kind and they listen to me”.

The service had clearly defined “aims and objectives” in place and included making sure people were respected, involved in their care planning, had a comfortable environment to live in, and were supported by a committed and well trained team of staff.

At the time of inspection there was one vacancy, with seven males and four females in residence. Some people were unable to express themselves verbally because their condition had impaired their ability to communicate in this way. We used a number of different methods to help us understand the experiences of people using the service. We looked at people's care records and observed how people interacted with staff on duty. We heard staff talk with people and their tone of voice was friendly, they explained what they were doing and they were able to manage a range of complex behaviours. Staff were patient, kind, and they were knowledgeable about the needs and behaviours of the people they supported. People who were able to speak with us confirmed they liked living at 'Stoke House'.

People we spoke with liked the staff. One person described the staff as “nice”. Everyone we were able to speak with confirmed they were happy at Stoke House and received the support they needed.

This unannounced inspection took place on 13 and 22 January 2015.

Stoke House provides accommodation for people requiring personal care. The service can accommodate up to 12 people. At the time of our inspection there were 8 people using the service. Stoke House provides care for people with learning disabilities and with behaviours that challenge the service.

There was a registered manager in post at the time of the inspection. 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.

At the last inspection on the 1 July 2014, we asked the provider to make improvements to the safety and suitability of the premises, and this has been completed.

There were enough staff to support people at all times of the day and night time.

People’s medicines were managed in a safe way.

People received an assessment of any risks relating to their care. Identified risks were managed by the staff to provide safer care.

People were safeguarded from the risk of abuse. There were clear lines of reporting safeguarding concerns to appropriate agencies and staff were knowledgeable about safeguarding adults.

People received a choice of foods and drinks that met their dietary requirements.

The registered manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). There were procedures in place to assess people’s ability to make decisions about their care. Staff understood how to make best interest decisions when people were unable to make decisions about their care.

People received support to maintain their health and wellbeing and people’s care was regularly reviewed to ensure it was effective.

People’s privacy and dignity was respected. Staff supported people to make decisions and choices about their care.

People were supported to undertake a range of social activities and pastimes.

People’s and relatives complaints were dealt with appropriately.

People were asked for their feedback about the service and improvements were made.

The provider had a system of quality assurance in place and this identified any shortfalls in providing a good service.