This inspection visit took place on 10 October 2018 and was unannounced. It was completed by one inspector, an assistant inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Tarry Hill is set on a large communal site which includes supported living units. This home was registered before the introduction of Registering the Right Support; however, the service aims to adhere to the values set out as best practice. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. The home is a care home. 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.

Tarry Hill is five small homes set on one communal site. Each home was independent with their own communal spaces, kitchen and bedrooms for each person. There was a registered manager at this location. 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.’

When people had been identified as being at risk, assessments had not always been completed to provide the details and guidance required. People were not always protected from the risk of infection in relation to cleaning schedules and the use of personal protective equipment. We have made a recommendation in relation to the risk assessments and support people from other associated risks. Medicines were not always managed safely when people required as required medicine or medicine for a specific condition.

The staff were provided to meet the commissioned needs of individuals. However, when new agency staff had been employed to support people they were not given an induction or clear direction for their role in supporting people.

The provider had completed audits in relation to the ongoing improvement however these were not always effective. Notifications had not always been completed in relation to events. People had been encouraged to voice their feedback, however there was no formal process and areas identified in the past had not been addressed.

Staff had received skills to support people’s individual needs. Training was ongoing and new initiatives were being developed. People’s nutritional needs had been met and specific diets observed and supported.

Health care professionals had been regularly consulted to support people to achieve better outcomes for their health care and wellbeing. 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.

The provider worked with a range of internal and external healthcare professionals. They also worked in partnership with a range of organisations.

Staff had established positive relationships with people and knew people well. Staff showed kindness and compassion when delivering care. People’s dignity had been respected.

Care plans for people reflected a lot of detail and included people’s preferences. These included their communications methods and any cultural requirements. People enjoyed activities of their choice.

Complaints had been responded to. People were protected from harm and lessons had been learnt from events to drive improvements in this area. Staff and professionals were positive about the management changes within the home. Partnerships had been developed with a range of professionals to support people’s health had wellbeing.