This was an unannounced inspection that took place on 1 September 2016.

The Hilders is a single-storey home providing accommodation and support for up to three adults who have learning and or physical disabilities. The property is owned by Mount Green Housing Association and the service is operated by the Care Management Group.

The service had a manager who has applied for registration with the Care Quality Commission. They were already registered as a manager for a different 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 and associated Regulations about how the service is run.

In March 2014, our inspection found that the service met the regulations we inspected against. At this inspection the home met the regulations.

The person currently living at the Hilders and their relative were satisfied with the service provided. During our visit there was a welcoming, friendly atmosphere with the person choosing what they wanted to do and when they wished. They also interacted positively with the manager and staff member on duty. The person was supported by staff to choose their activities. Any potential risks posed by the activities were assessed by staff and the person against the benefits of doing them. The activities were varied and took place at home and within the community. The service also provided a safe environment to live in.

The records kept were up to date, covered all aspects of the care and support the person received, including their choices, activities and safety. The person’s care plan was fully completed and the information contained was regularly reviewed. This enabled staff to perform their duties efficiently and professionally. The person was encouraged to discuss their health needs with staff and had access to GP’s and other community based health professionals, as required. Staff supported them to choose healthy and balanced diets that also met their likes, dislikes and preferences. This enabled them to be protected from nutrition and hydration associated risks. They said they were happy with the choice and quality of meals they ate.

The person using the service knew who the staff that supported them was and the staff knew them, their likes and dislikes. They were well supported and they liked the way their care was delivered. A relative said they thought the staff worked well as a team and they were kept up to date by staff about what was going on at the Hilders.

Staff had appropriate skills and provided care and support in a professional, friendly and supportive way that was focussed on the person. The staff were trained and accessible to the person using the service and their relatives. Staff said they enjoyed working at the home. They received good training and support from the manager.

A relative confirmed the manager was approachable, responsive, encouraged feedback from people and consistently monitored and assessed the quality of the service provided.

During our inspection we met three people who lived at the home and three members of staff. All the people who lived at the home had support from independent advocates, two of whom we spoke with after the inspection. We also spoke with three healthcare professionals who had an involvement with the home after the inspection.

Advocates and healthcare professionals told us that the quality of care people received was good. A healthcare professional told us, “Staff know people’s needs well and they provide good care” and an advocate said, “I’m impressed with the quality of care.” Advocates told us that people were supported to make decisions about their care and their day-to-day lives. One advocate said, "They don’t just tell him what’s going to happen; they encourage him to make choices.”

The design and layout of the home met the needs of the people who lived there. All areas of the home were wheelchair-accessible and adaptations had been made and equipment obtained where necessary. All parts of the home were clean, hygienic and free from odours.

We found that the provider carried out appropriate checks before staff began work.

Staff received the support they needed to do their jobs, including an induction when they started work, regular supervision and access to appropriate training.

We found that the provider had a written complaints procedure and that complaints received an appropriate response.

There were three male people being cared for at the time of inspection. We observed staff interacting with them in a respectful manner using various aids, such as flash cards, images, body language and objects of reference which helped to convey what was being said or asked.

We fount that people’s capacity to consent was considered and the where people did not have the capacity to consent the provider acted in accordance with legal requirements.

Peoples treatment and support was planned and delivered in line with their individual care plan. All care plans for people who used the service were person centred. Health professionals input was sought where necessary.

There was clear information available to staff on how and who to report to if they suspected someone was being abused. This meant that the provider had taken appropriate steps to protect people from the risk of abuse.

There were appropriate arrangements in place for the management of medicines. This meant that people had their medicines when they needed them and in a safe way.