This inspection took place on 11 April 2018. When we last inspected the service in November 2015 they were meeting the regulations we looked at and we rated the service Good overall and in all five key questions.

The Params is a small care home which provides care and support for up to thirteen people with learning disabilities, sensory impairments and mental health needs. On the day of our inspection eleven people were living at this home.

At the time of the inspection, there was a registered manager. 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 told us they felt safe. Many of the people had been living at the Params for more than ten years and from what they told us, evidently considered themselves to be safe and secure in their home. People received care and support from staff who knew their needs and preferences well.

People were supported by staff who had also worked in the home in the long term and knew how to keep people safe. Risks to people's health and safety were assessed. There were good risk management plans in place.

People were supported by appropriate numbers of staff. Robust staff recruitment procedures helped to keep people safe.

People were supported with the safe administration of their medicines and there were regular audits undertaken by the provider to monitor the processes in place and to ensure people remained safe.

People were supported by staff who were well trained and supervised.

The provider ensured people's nutritional needs were met. People planned their meals, shopped for ingredients and cooked their own food with the support of staff.

People's healthcare needs were met and staff supported them to attend medical appointments.

Staff had undertaken training in the Mental Capacity Act 2005 and were aware of their responsibilities in relation to people who might be deprived of their liberty. They ensured people were given choices and the opportunity to make decisions.

People, their relatives and professionals told us staff were consistently kind and caring and established positive relationships with them and their families. Staff valued people, treated them with respect and promoted their rights, choice and independence.

Comprehensive care plans were in place detailing how people wished to be supported. We saw people were central to the process of how their care and support was delivered.

People participated in a wide range of activities within the home and in the community and received the support they needed to help them to do this.

There was a complaints procedure in place and relatives felt confident to raise any concerns either with the staff or the registered manager if they needed to. The complaints procedure was available in different formats so that it was accessible to everyone.

We found there was an open and transparent culture in the home where staff were encouraged to share in the development of the home for the people living in it.

We found the provider had a system in place that sought feedback about the quality of the service from different people involved with the service. There were good systems in place to use the feedback received to improve the service where necessary.

This inspection took place on 24 and 25 November 2015 and was unannounced. At our previous inspection in October 2013, we found the provider was meeting the regulations we inspected.

The Params is a residential care home that offers accommodation and personal care for up to 13 adults with learning disabilities, sensory impairments and mental health needs. The home is situated on a hill and only accessible via a set of steps. It is therefore not suitably designed for people who use wheelchairs. At the time of our inspection there were ten people using the service.

There was a registered manager who had worked at the home since 2012. 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 and their relatives told us they felt safe at The Params. Staff knew the correct procedures to follow if they considered someone was at risk of harm or abuse. They received appropriate safeguarding training and there were policies and procedures to support them in their role.

The service was clean, safely maintained and furnished to comfortable standards. Bedrooms were personalised according to people’s needs and interests.

People’s rights were protected because the provider acted in accordance with the Mental Capacity Act 2005. This is legislation that protects people who are not able to consent to care and support, and ensures people are not unlawfully restricted of their freedom or liberty. The manager and staff understood the requirements and took appropriate action where a person may be deprived of their liberty.

People’s needs were regularly assessed, monitored and reviewed to make sure the care was current and relevant. The care records were person centred and descriptive, ensuring staff had specific information about how they should support people. Care records included guidance for staff to safely support people by reducing risks to their health and welfare.

People were supported to keep healthy. Any changes to their health or wellbeing were acted upon and referrals were made to social and health care professionals to help keep people safe and well. Accidents and incidents were responded to appropriately. Medicines were managed safely and people had their medicines at the times they needed them.

Staff recruitment practices helped ensure that people were protected from unsafe care. There were enough qualified and skilled staff at the service and staff received essential training to support them in their role. This was followed by ongoing refresher training to update and develop their

knowledge and skills.

People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff.

Staff were patient, attentive and caring in their approach; they took time to listen and to respond in a way that the person they engaged with understood. They respected people’s privacy and upheld their dignity when providing care and support.

People were provided with a range of activities in and outside the service which met their individual needs and interests. Individuals were also supported to maintain relationships with their relatives and friends.

There was an open and inclusive atmosphere in the service and the manager showed effective leadership. People, their relatives and staff were provided with opportunities to make their wishes known and to have their voice heard. Staff received regular supervision and spoke positively about how the registered manager worked with them.

The provider completed a range of audits in order to monitor and improve service delivery. Where improvements were needed or lessons learnt, action

At the time of our inspection there were nine people using the service. Those people we spoke to told us that they liked to be called residents. During our visit we spoke with four residents, the registered manager, two staff and one relative.

Residents had an active timetable of daily events and when we spoke to the residents they told us that they enjoyed the things they did. One person said, “I go to college three times a week and I love that”. Another person said, “I do some domestic activities around the home and I enjoy what I do”. Another person proudly showed us their bedroom and how they had been able to bring in their own furniture and pictures.

During our visit we observed staff taking their time to listen to what people who used the service had to say. We also saw staff interacting with the people who used the service in a very kind courteous and respectful manner. One resident said, “the staff are kind to us". Another person told us, “I have lived here for a long time, it’s my home and I can talk to the staff about anything”.

The systems for the management of medication ensured that this was administered safely.

There was information about how people were able to make a complaint, and people were actively encouraged to comment about the service, and the provider acted upon the feedback they received.

At the time of our inspection there were ten people using the service. During our visit we spoke with two people who use the service, two staff and one community psychiatric nurse.

People who use the service told us they liked living at the home and they liked the staff. They said they got to do things they enjoyed, such as keeping fit and going to the shops. People said the staff were friendly and knew what they liked to do and what they liked to eat. We saw staff being respectful and talking to people in a friendly and caring way.

At the time of our inspection the staffing levels meant that peoples needs could be met by the service.

There was information about how people were able to make a complaint, and people were actively encouraged to comment about the service, and the provider acted upon the feedback they received.

The systems for the management of medication ensured that this was administered safely, however the temperature of the room where the medicines were stored sometimes reached above the recommended limit for the storage of medicines.