Tarrant House provides accommodation and personal care for up to seven people who have a learning disability, physical disability and health care needs. There were seven people living at the service. The service was as domesticated as possible. People had their own spacious rooms and the use of a comfortable communal area. Most people took their meals together in the dining room. There was a private rear garden which was not overlooked, with a patio area accessible for people with mobility needs.

The service is situated close to Perranporth on the north coast of Cornwall. People living at Tarrant House had access to all areas of the service. There were a range of suitable adaptations and mobility aids specifically designed to support people, both in the service and community.

We carried out a comprehensive inspection of Tarrant House on 2 October 2017. This was an announced inspection. We told the provider two days before our inspection visit that we would be coming. This was because we wanted to make sure the registered manager was there, as well as staff and people to speak with and access to records. At the last inspection the service was rated good. At this inspection the rating remained good.

People told us they felt safe living at Tarrant House. People's safety and well-being had been assessed by the registered and deputy managers. Risk assessments were in place to minimise any hazards and keep people safe. Where a loose blind cord was seen as a potential risk, immediate action was taken by the registered manager and staff were reminded of the need to be vigilant in their observations in the environment.

Most people had lived at Tarrant House for some time and staff were very familiar with their individual needs. Relatives told us, “It is no doubt due to the friendly ‘family’ atmosphere that the staff have created and maintained” and “Doesn’t feel like a home [residential].” There were clear lines of responsibility in place. The registered manager was supported by an assistant manager and senior support workers as well as a core staff team who had worked at the service for some time. The registered manager took an active role in the running of the service.

Four of the seven people were at the service on the day of the inspection. The atmosphere at Tarrant House was calm and friendly. Interactions between staff and people were kind and supportive. Staff described how they worked to support people to make day to day choices and enable people to lead a quality of life within the constraints of individual disabilities. They said, “We are here to make a difference in people’s lives” and “I get such a good feeling that I have made a difference to somebodies life after every shift. It’s a good place to work.”

There were sufficient staff to keep people safe. There were safe recruitment systems in place to ensure that staff were safe to work with people.

Staff told us they loved their jobs and felt they had all the support they needed to carry out their role. They told us, “We get a lot of support and always encouraged to share information or ask if we are not sure about anything” and “My induction and training really helped me to get into the role. It was a team effort.”

People were protected from avoidable harm. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns.

People's medicines were administered, stored and disposed of safely. Staff were trained in the safe administration of medicines and kept relevant and accurate records.

People's human rights were protected as the registered manager ensured that the requirements of the Mental Capacity Act 2005 were followed. Where people were assessed to lack capacity to make some decisions, mental capacity assessment and best interest meetings had been undertaken. Staff were heard to ask peoples consent before they provided support.

Where people's liberty may be restricted to ke

We carried out a comprehensive inspection of Tarrant House on 2 November 2015. This was an announced inspection. We told the provider two days before our inspection visit that we would be coming. This was because we wanted to make sure people would be at the service to speak with us. The service was last inspected in January 2014. The service was meeting regulations at that time.

Tarrant House provides care and accommodation for up to seven people who have learning disabilities and autistic spectrum disorders. At the time of the inspection seven people were living at the service.

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 at Tarrant House were supported to lead fulfilling lives which reflected their individual preferences and interests. There were enough staff available to make sure everyone was supported according to their own needs. On the day of the inspection visit two people were attending separate college placements, one person was visiting family. Four people remained at the service. The four people in the house were engaged in their individual routines and activities and one of them went out for part of the day with staff to shop for groceries. Relatives told us they believed their family members had choice and control in their lives and were supported safely and with respect. Comments included, “The staff at Tarrant are very supportive and [persons name] is happy” and “I cannot speak highly enough of the manager or indeed of their staff”.

Staff were well trained in a range of subjects which were relevant to the needs of the people they supported. New employees undertook a structured induction programme which prepared them well for their role. The staff team were well supported by the registered manager through daily communication. However formal supervision sessions were not occurring on a consistent basis to support staff personally in their learning and personal development.

There were sufficient numbers of suitably qualified staff on duty to support peoples’ needs and engage in activities. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

Where people did not have the capacity to make certain decisions, the service acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff had a good understanding of the principles of the legislation and training was updated regularly. A staff member told us, “Its important people can do the things they want to do, but it’s also important they are kept safe. I know that means we have to put things in place for their own best interest”.

Staff demonstrated they had an excellent knowledge of the people they supported and were able to appropriately support people and promote their independence. Staff consistently spent time speaking with the people they were supporting. We saw many positive interactions and people enjoyed talking to and interacting with staff. Staff told us, “It’s a great place to work, very fulfilling” and “We [staff] really know everybody living here and we have the resources to give them [people living at the service] a good quality of life”.

Care plans were informative and contained clear guidance for staff. They included information about people’s routines, personal histories, preferences and any situations which might cause anxiety or stress. They clearly described how staff could support people in these circumstances. In addition records included assessments and support plans from other health professionals. These were in easy read versions to aid communication.

Accidents and incidents were appropriately recorded and analysed to identify any trends. Quality assurance systems were in place, gaining people’s views about the service they or their relative received. Regular audits were carried out to help ensure the service was running effectively and safely.

There were clear lines of accountability and responsibility at Tarrant House. There were plenty of opportunities for people, relatives and staff to voice how they felt about the service and any concerns they had. Annual surveys were circulated to all stakeholders any visitors were asked for their feedback. Comments included, “The home is open to new ideas and ways of working differently” and “A home from home in choice and ethos”.

We met with six people who lived at Tarrant House. We observed how staff interacted with people who lived at Tarrant House. People's verbal and non- verbal communication, expressed satisfaction with the care and support they received. One person told us they were, “very happy” to live at Tarrant House.

We found there were suitable arrangements in place for obtaining, and acting in accordance with, the consent of people who were supported by the agency in relation to the care and treatment provided for them.

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We saw there was a choice of suitable and nutritious food and drinks freely available to people who used the service. There was sufficient support provided to enable people to eat and drink sufficient amounts for their needs.

Medications were managed safely and staff ensured people received their medication in a timely way and in line with their prescriptions.

We observed how staff interacted with people who lived at Tarrant House. From our observations, people’s verbal and non verbal communication, we found people expressed satisfaction with the care and support that they received.

We spoke with two relatives. Comments included, “we are absolutely delighted” and “they really try their best”. We were told that staff and management were approachable and the home was always clean.

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for in a clean, hygienic environment and appropriate checks were undertaken before staff began work.

We found that there was an effective complaints system available and comments and complaints people made were responded to appropriately.